scholarly journals Is there evidence to link acid reflux with chronic sinusitis or any nasal symptoms? A review of the evidence

2011 ◽  
Vol 49 (1) ◽  
pp. 11-16
Author(s):  
E.P. Flook ◽  
B.N. Kumar
Keyword(s):  
Chronic Sinusitis ◽  
Acid Reflux ◽  
Paediatric Population ◽  
Causal Factor ◽  
Potential Bias ◽  
Adult Case ◽  
Nasal Symptoms ◽  
Paediatric Cohort ◽  
Chronic Rhino Sinusitis ◽  
Randomised Controlled

BACKGROUND: Acid reflux into the oesophagus, larynx, pharynx or nasopharynx has been suggested as a causal factor in chronic rhino-sinusitis (CRS), which can then be refractory to nasal treatments. The aim of this review was to conclude on the strength of the link between GORD, LPR, nasopharyngeal reflux, nasal symptoms and CRS. METHOD: Medline and Embase search. RESULTS: Nineteen papers describing varying studies on CRS, GORD, LPR and PPI therapy were found. Four adult case-controlled studies showed more acid reflux events/symptoms in refractory CRS patients. Paediatric cohort studies showed more reflux events in rhinosinusitis patients than the general paediatric population, but they are not conclusive. Many papers do not use robust CRS diagnostic criteria for inclusion into studies and take no confounding factors into consideration. CONCLUSION: The evidence of a link is poor with no good randomised controlled trials available. The few adult studies that show any link between acid reflux and nasal symptoms are small case-controlled studies with moderate levels of potential bias. There is not enough evidence to consider anti-reflux therapy for adult refractory CRS and there is no evidence that acid reflux is a significant causal factor in CRS.

The effect of probiotics on prevention of upper respiratory tract infections in the paediatric community – a systematic review

2020 ◽  
Vol 11 (3) ◽  
pp. 201-211
Author(s):  
İ.E. Emre ◽  
Y. Eroğlu ◽  
A. Kara ◽  
E.C. Dinleyici ◽  
M. Özen
Keyword(s):  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Data Extraction ◽  
Antibiotic Use ◽  
Paediatric Population ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Randomised Controlled ◽  
Tract Infections

Prevention of acute upper respiratory tract infections (URTIs) is becoming an increasingly important concept in public health application due to the increase in antibiotic resistance. Probiotics have been shown to have some effect on prevention in various reviews. In this study we aimed to re-asses the effect of probiotics as there has been a substantial increase in literature regarding the effects and safety of probiotics in the paediatric population. Two major databases were systematically searched to identify clinical trials eligible for inclusion. Study selection, data extraction and quality assessment were carried out by two reviewers. This review comprises 33 randomised controlled trials (RCTs) applied to a paediatric population with high-quality methodology. The primary outcome for this review was the incidence of respiratory tract infections. Secondary outcomes were severity of symptoms, missed days of school, incidence of antibiotic use and safety of prebiotic use. This review showed that probiotics have an impact on decreasing the incidence of URTIs and the severity of symptoms. The use of probiotics is extremely safe and as studies increase in evaluation of the effect of probiotics more and more show a significant beneficiary effect. Although still a long way from becoming a unanimous treatment modality, the small positive changes that probiotics have on URTIs is important to consider and the use of probiotics should be encouraged more.

Mepolizumab reduces nasal symptoms in asthmatic patients with chronic rhino-sinusitis and nasal polyposis: a 12 months real-life study

2020 ◽  
Author(s):  
Mauro Maniscalco ◽  
Aikaterini Detoraki ◽  
Maria D’Amato ◽  
Raffaella Giacco ◽  
Cecilia Calabrese ◽  
...  
Keyword(s):  
Nasal Polyposis ◽  
Real Life ◽  
Life Study ◽  
Asthmatic Patients ◽  
Nasal Symptoms ◽  
Chronic Rhino Sinusitis ◽  
Real Life Study

Possible Relationship of Gastroesophagopharyngeal Acid Reflux with Pathogenesis of Chronic Sinusitis

1999 ◽  
Vol 13 (3) ◽  
pp. 197-202 ◽  
Author(s):  
Seckin O. Ulualp ◽  
Robert J. Toohill ◽  
Raymond Hoffmann ◽  
Reza Shaker
Keyword(s):  
Chronic Sinusitis ◽  
Acid Reflux ◽  
Relationship Of

Adult cystic hygroma: successful use of OK-432 (Picibanil®)

2008 ◽  
Vol 122 (11) ◽  
pp. 1260-1264 ◽  
Author(s):  
S L Woolley ◽  
D R K Smith ◽  
S Quine
Keyword(s):  
Post Partum ◽  
Paediatric Population ◽  
Cystic Hygroma ◽  
Management Plan ◽  
Cystic Lymphangioma ◽  
Review Of The Literature ◽  
Adult Case ◽  
First Line ◽  
Cystic Lymphangiomas ◽  
First Line Treatment

AbstractObjective:We report an adult case of cystic lymphangioma treated with OK-432 (Picibanil®).Method:A case report and review of the literature concerning the use of OK-432 to treat cystic lymphangioma is presented.Results:A 31-year-old woman developed a cystic lymphangioma four weeks post-partum. This was treated initially by aspiration, for diagnostic purposes. Investigation suggested that surgery would be challenging. A review of the literature demonstrated success with OK-432 in the treatment of this condition, although primarily in the paediatric population. This patient was successfully treated thus, and at the time of writing remained symptom free. A suggested management plan is outlined.Conclusion:Treatment with OK-432 is useful in the management of cystic lymphangiomas in adults and should be considered as first line treatment.

scholarly journals The challenges in paediatric pulmonary arterial hypertension

2014 ◽  
Vol 23 (134) ◽  
pp. 498-504 ◽  
Author(s):  
Maurice Beghetti ◽  
Rolf M.F. Berger
Keyword(s):  
Pulmonary Arterial Hypertension ◽  
Arterial Hypertension ◽  
Paediatric Population ◽  
Walking Distance ◽  
Therapeutic Approaches ◽  
End Points ◽  
Mortality And Morbidity ◽  
Optimal Dosing ◽  
Pulmonary Arterial ◽  
Randomised Controlled

Pulmonary arterial hypertension (PAH) is a rare, progressive disease affecting both adults and children. While overall survival has improved in recent years, the need for improved therapeutic approaches remains. Treatments for paediatric PAH have not yet been sufficiently examined, particularly regarding potential toxicities and optimal dosing, and there is a lack of appropriate clinical trial end-points and validated treatment goals that might enable a goal-oriented therapeutic approach. Adult randomised controlled trials in PAH are demonstrating a shift towards more long-term designs, focusing on mortality and morbidity end-points rather than changes in 6-min walking distance. However, such trial designs may not be feasible within the paediatric setting due to challenges such as sufficient recruitment and retention of paediatric patients. Consideration should, therefore, be given towards identifying optimal end-points for the paediatric population, allowing sufficient duration to evaluate efficacy and safety of potential treatments.Herein we consider some of the complexities involved in the management of paediatric PAH, specifically presenting diagnostic challenges as well as reflecting on the lack of evidence currently available to support various therapeutic approaches within the paediatric population.

scholarly journals Predictors of mortality and clinical characteristics among carbapenem-resistant or carbapenemase-producing Enterobacteriaceae bloodstream infections in Spanish children

2020 ◽  
Vol 76 (1) ◽  
pp. 220-225 ◽  
Author(s):  
M F Ara-Montojo ◽  
L Escosa-García ◽  
M Alguacil-Guillén ◽  
N Seara ◽  
C Zozaya ◽  
...  
Keyword(s):  
Organ Transplant ◽  
Empirical Therapy ◽  
Bloodstream Infections ◽  
Paediatric Population ◽  
Carbapenem Resistant ◽  
Paediatric Cohort ◽  
Single Centre Study ◽  
Sources Of Infection ◽  
Underlying Diseases ◽  
Hospital Acquired

Abstract Background Carbapenem-resistant Enterobacteriaceae (CRE) are an emerging problem in the paediatric population worldwide with high mortality rates in bloodstream infection (BSI). Objectives To evaluate predictors of 30 day mortality in CRE BSI in a paediatric cohort. Methods A retrospective observational single-centre study (December 2005–August 2018) was conducted. Cases of CRE BSI in children 0 to 16 years were included. Microbiological identification (MALDI Biotyper) and antimicrobial susceptibility testing (Vitek2® and MicroScan panel NBC44) according to EUCAST breakpoints were performed. PCR OXVIKP® was used to confirm carbapenemase genes (OXA-48, VIM, KPC, NDM). Demographic characteristics, underlying diseases, source of bacteraemia, antimicrobial therapy and outcomes were collected from medical records. Survival analysis to establish predictors of 30 day mortality was performed. Results Thirty-eight cases were included; 76.3% were hospital-acquired infections and 23.7% related to healthcare. All patients had at least one underlying comorbidity and 52.6% were recipients of an organ transplant. VIM carbapenemase was the predominant mechanism (92.1%). Previous CRE colonization or infection rate was 52.6%. Intestinal tract (26.3%) and vascular catheter (21.1%) were the most common sources of infection. Crude mortality within 30 days was 18.4% (7/38); directly related 30 day mortality was 10.5%. Conditions associated with an increment in 30 day mortality were intensive care admission and inadequate empirical therapy (P < 0.05). Combination-antibiotic targeted treatment and a low meropenem MIC were not related to improved survival. Conclusions CRE BSI mortality rate is high. The most important factor related to 30 day survival in our CRE BSI cohort in children was empirical treatment that included at least one active antibiotic.

scholarly journals Randomised, double-blind, placebo-controlled pilot trial of omeprazole in idiopathic pulmonary fibrosis

Thorax ◽  
2019 ◽  
Vol 74 (4) ◽  
pp. 346-353 ◽  
Author(s):  
Prosenjit Dutta ◽  
Wendy Funston ◽  
Helen Mossop ◽  
Vicky Ryan ◽  
Rhys Jones ◽  
...  
Keyword(s):  
Idiopathic Pulmonary Fibrosis ◽  
Pulmonary Fibrosis ◽  
Controlled Trial ◽  
Geometric Mean ◽  
Pilot Trial ◽  
Acid Reflux ◽  
Forced Expiratory Volume ◽  
Double Blind ◽  
Cough Frequency ◽  
Randomised Controlled

BackgroundCough is a common, disabling symptom of idiopathic pulmonary fibrosis (IPF), which may be exacerbated by acid reflux. Inhibiting gastric acid secretion could potentially reduce cough. This study aimed to determine the feasibility of a larger, multicentre trial of omeprazole for cough in IPF, to assess safety and to quantify cough.MethodsSingle-centre, double-blind, randomised, placebo-controlled pilot trial of the proton pump inhibitor (PPI) omeprazole (20 mg twice daily for 3 months) in patients with IPF. Primary objectives were to assess feasibility and acceptability of trial procedures. The primary clinical outcome was cough frequency.ResultsForty-five participants were randomised (23 to omeprazole, 22 to placebo), with 40 (20 in each group) having cough monitoring before and after treatment. 280 patients were screened to yield these numbers, with barriers to discontinuing antacids the single biggest reason for non-recruitment. Recruitment averaged 1.5 participants per month. Geometric mean cough frequency at the end of treatment, adjusted for baseline, was 39.1% lower (95% CI 66.0% lower to 9.3% higher) in the omeprazole group compared with placebo. Omeprazole was well tolerated and adverse event profiles were similar in both groups, although there was a small excess of lower respiratory tract infection and a small fall in forced expiratory volume and forced vital capacity associated with omeprazole.ConclusionsA large randomised controlled trial of PPIs for cough in IPF appears feasible and justified but should address barriers to randomisation and incorporate safety assessments in relation to respiratory infection and changes in lung function.

scholarly journals Clinical effects of probiotics: scientific evidence from a paediatric perspective

2013 ◽  
Vol 109 (S2) ◽  
pp. S70-S75 ◽  
Author(s):  
Olle Hernell ◽  
Christina E. West
Keyword(s):  
Very Low Birth Weight ◽  
Scientific Evidence ◽  
Paediatric Population ◽  
Preliminary Evidence ◽  
Optimal Timing ◽  
Viral Gastroenteritis ◽  
Clinical Effects ◽  
Healthy Children ◽  
Low Birth Weight Infants ◽  
Randomised Controlled

Probiotics are live micro-organisms that when given in adequate amounts can cause health benefits. The safety and efficacy of probiotics in the prevention and treatment of various clinical conditions have been evaluated in randomised controlled clinical trials, systematic reviews and meta-analyses. Generally, their safety has been documented. As a supplement to standard rehydration therapy, probiotics have been demonstrated to shorten the duration of diarrhoea resulting from acute viral gastroenteritis and in preventing antibiotic-associated diarrhoea in healthy children. Preliminary evidence suggests that probiotics might prevent necrotising enterocolitis in very-low-birth-weight infants, but further studies are needed before definite conclusions can be drawn. Probiotics have also been assessed in the treatment and prevention of allergic disease but the results, although promising, need further confirmation. Targeting a paediatric population, probiotics have been evaluated in the treatment of irritable bowel syndrome, ulcerative colitis, Helicobacter pylori gastritis and infantile colic, but at this stage, there is no evidence to support their routine use for these indications. There is a great need for studies aiming at disentangling the mechanisms by which probiotics mediate their clinical effects and for comparative studies between various probiotic bacteria. We still need to know which probiotic(s) to use and for which indications. A clearer message on dosages, optimal timing and duration of administration is needed. For this purpose, more carefully designed and sufficiently powered, randomised controlled trials with predefined outcomes are needed.

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