scholarly journals Nasal peak inspiratory flow (NPIF) as a diagnostic tool for differentiating decongestable from structural nasal obstruction

2014 ◽  
Vol 52 (2) ◽  
pp. 116-121
Author(s):  
D. Chin ◽  
G. Marcells ◽  
J. Malek ◽  
E. Pratt ◽  
R. Sacks ◽  
...  

Background: Identifying the cause of nasal obstruction is critical before surgical intervention. Structural nasal obstruction, due to nasal valve stenosis, is unlikely to benefit from simple septoplasty and turbinate reduction. This study assesses changes in nasal peak inspiratory flow (NPIF) as a tool for discriminating decongestable versus structural obstruction. Methodology: Cross-sectional study of patients undergoing nasal airflow assessment was performed. Rhinomanometry, nasal obstruction visual analogue scores (VAS) and NPIF were performed pre- and post-decongestion. Population groups were defined with decongestable or structural obstruction by relative post-decongestion changes in airways resistance and symptoms. Results: Fifty two patients were assessed, 24 with decongestable, 28 with structural obstruction. Pre- and post-decongestion NPIF were similar between groups. Absolute and percentage NPIF change were larger with decongestable versus structural obstruction. Sensitivity and specificity for predicting decongestable obstruction were 75.0% and 60.7% for NPIF increase >20 L/min; 75.0% and 64.3% for NPIF increase >20%. The respective positive predictive values were 62.1% and 64.3%. Conclusion: NPIF increase after decongestion is larger with decongestable than structural nasal obstruction. NPIF alone cannot discriminate the two conditions and does not replace more formal assessment.

2014 ◽  
Vol 52 (2) ◽  
pp. 116-121 ◽  
Author(s):  
D. Chin ◽  
G. Marcells ◽  
J. Malek ◽  
E. Pratt ◽  
R. Sacks ◽  
...  

2012 ◽  
Vol 126 (12) ◽  
pp. 1238-1240 ◽  
Author(s):  
N K F Koo Ng ◽  
D Young ◽  
G W McGarry

AbstractBackground:Predicting which chronic rhinosinusitis patients have nasal obstruction due to reversible mucosal inflammation could prevent unnecessary surgery.Aim:To investigate whether the change in nasal peak inspiratory flow following maximal decongestion (i.e. mucosal reversibility) at first visit predicts the response to topical steroids in chronic rhinosinusitis patients, as measured by the 22-item Sinonasal Outcome Test.Methods:Prospective study of 128 consecutive new adult patients presenting with nasal obstruction due to chronic rhinosinusitis (January 2008 to July 2010). The 22-item Sinonasal Outcome Test questionnaire was administered and the nasal peak inspiratory flow assessed. Following maximal nasal decongestion, the nasal peak inspiratory flow was again tested and the difference calculated. Topical steroids were administered for at least six weeks. The 22-item Sinonasal Outcome Test was then repeated and the difference calculated.Results:Data were analysed using means and correlation studies (Spearman's rank correlation). There was no correlation between the pre- versus post-decongestion nasal peak inspiratory flow difference and the pre- versus post-steroid 22-item Sinonasal Outcome Test difference, in chronic rhinosinusitis patients with or without nasal polyps.Conclusion:The difference between pre- and post-decongestion nasal peak inspiratory flow does not predict chronic rhinosinusitis patients' response to topical steroids.


2014 ◽  
Vol 129 (S1) ◽  
pp. S51-S56 ◽  
Author(s):  
A W Kam ◽  
E Pratt ◽  
R J Harvey

AbstractBackground:Nasal dilator strips are thought to widen and stiffen the anterior nasal cavity, and thus improve symptoms of nasal obstruction. It is postulated that anthropomorphic differences in external nasal proportions between races may influence the effectiveness of such dilator strips.Methods:Caucasian and Asian subjects were compared. Nasal peak inspiratory flow, nasal airway resistance, minimum cross-sectional area and visual analogue scale measurements of nasal obstruction were recorded at baseline and following the application of two different dilator strips.Results:Nine Caucasian and six Asian subjects were recruited (n = 15). There was a significant difference between races in terms of nasal peak inspiratory flow improvements following nasal strip application (mean of 29.4 litres per minute in Caucasiansvs14.6 litres per minute in Asians;p = 0.04). Only Caucasians experienced a significant decrease in nasal airway resistance (median of 0.12 Pa/cm3/s;p < 0.01).Conclusion:Nasal peak inspiratory flow, minimum cross-sectional area and visual analogue scale values improved from baseline with strip application in both populations. Only Caucasians experienced significant nasal airway resistance improvement with strip application. Both cohorts experienced nasal peak inspiratory flow improvement, with Caucasians experiencing a significantly larger improvement.


2020 ◽  
Vol 9 (12) ◽  
pp. 3949
Author(s):  
Cristina Represas-Represas ◽  
Luz Aballe-Santos ◽  
Alberto Fernández-García ◽  
Ana Priegue-Carrera ◽  
José-Luis López-Campos ◽  
...  

Objective: Although the importance of assessing inspiratory flow in the selection of treatments for chronic obstructive pulmonary disease (COPD) is understood, evaluation of this factor is not yet widespread or standardized. The objective of the present work was to evaluate the peak inspiratory flow (PIF) of patients with COPD and to explore the variables associated with a suboptimal PIF. Methods: An observational, cross-sectional study was carried out at specialized nursing consultations over a period of 6 months. We collected clinical data as well as data on symptoms, treatment adherence, and patient satisfaction with their inhalers via questionnaires. PIF was determined using the In-Check Dial G16® device (Clement Clarke International, Ltd., Harlow, UK). In each case, the PIF was considered suboptimal when it was off-target for any of the prescribed inhalers. The association with suboptimal PIF was evaluated using multivariate logistic regression and the results were expressed as the odds ratio (OR) with 95% confidence interval (CI). Results: A total of 122 COPD patients were included in this study, of whom 34 (27.9%) had suboptimal PIF. A total of 229 inhalers were tested, of which 186 (81.2%) were dry powder devices. The multivariate analysis found an association between suboptimal PIF and age (OR = 1.072; 95% CI (1.019, 1.128); p = 0.007) and forced vital capacity (OR = 0.961; 95% CI (0.933, 0.989); p = 0.006). Conclusions: About a third of patients in complex specialized COPD care have suboptimal PIFs, which is related to age and forced vital capacity.


2021 ◽  
pp. e20200473
Author(s):  
Caroline Palácio da Silva1 ◽  
Jean Silva Aretakis Cordeiro1 ◽  
Murilo Carlos Amorim de Britto1 ◽  
Patrícia Gomes de Matos Bezerra1 ◽  
Lívia Barboza de Andrade1

2017 ◽  
pp. 46-52
Author(s):  
Thanh Thai Le ◽  
Phuong Nam Tran ◽  
Thi Ngan An Nguyen

Aims: To study outcomes of septoplasty and partial inferior turbinectomy (PIT) method, expecting leastsurgical equipment, good result, price rationalization. Methods: Prospective, cross-sectional study. Including 40 patients treated by septoplasty and PIT method. Assessment had been made after 3 months post-op. Results: The common symptoms were nasal obstruction (100%), headache (40%). The deformities of nasal septalwere deviation (42.5%), crest (30%). There were 67.5% of patients with severe bilateral hypertrophic inferior turbinate, mostly over grade II, enlargement both soft and bone parts (60%). After 3 months, the nasal obstruction and headache presented good or great results in 90% of patients, 93.7% of patients had straight nasal septaland 90% hadsmall inferior turbinate.VAS: patients’s contentment was 100%. Conclusions: The study showed that septoplasty and partial inferior turbinectomy presented good results with 87.5% after surgery and 90% after 3 months. Key words: septal deformity, hypertrophy inferior turbinate, septoplasty, partial inferior turbinectomy


Author(s):  
Tripta S. Bhagat ◽  
Luv Kumar ◽  
Prakhar Garg ◽  
Apoorv Goel ◽  
Amit Aggarwal ◽  
...  

Cellulitis is a bacterial infection of the dermis and subcutaneous tissues occupying a large proportion of hospital beds. This study was conducted for analysis of patients with cellulitis according to their demographics and clinical presentation and to examine their comorbidities, complications, and its management. This observational cross-sectional study was conducted in the Department of Surgery at Santosh Medical College and Hospitals involving a total of 60 cases having cellulitis and other soft tissue infections of lower limb. Analysis of their demographic profile, management, and complications was done. Cellulitis is seen commonly in males, 46 (76.6%). The mean age of patients affected by cellulitis in the study was 36.4 ± 1.23 years. The most common site affected is leg involving more people in field jobs. The most common risk factor was trauma in 46.6%, and other factors were diabetes mellitus and smoking, while abscess formation was the most common complication observed in 36.6% of cases. A total of 56.6% cases were managed conservatively, while 43.3% cases required surgical intervention. Mean hospital stay in this study was 5.02 ± 0.23 days. It was concluded that cellulitis is subcutaneous, spreading bacterial infection is more common in males, and its incidence is highest in working age group population. Lower limb is commonly involved. Trauma, smoking, and diabetes are significant risk factors for development of cellulitis. Abscess is the most common complication. About 50% patients with cellulitis can be managed conservatively and the rest require surgical intervention.


2018 ◽  
Author(s):  
Joelma Carvalho Santos ◽  
Andrea Dória Batista ◽  
Carla Maria Mola Vasconcelos ◽  
Roberto Souza Lemos ◽  
Valter Romão de Souza ◽  
...  

AbstractBackgroundARFI elastrography has been used as a noninvasive method to assess the severity of liver fibrosis in viral hepatitis, although with few studies in schistosomiasis mansoni. We aimed to evaluate the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point.Methodology/Principal findingsThis cross-sectional study included 358 adult schistosomotic patients subjected to US and pSWE on the right lobe. Two hundred two patients (62.0%) were women, with a median age of 54 (ranging 18-92) years. The pSWE measurements were compared to the US patterns of PPF, as gold standard, according to the Niamey classification. The performance of pSWE was calculated as the area under the ROC curve (AUC). Patients were further classified into two groups: 86 patients with mild PPF and 272 patients with significant PPF. The median pSWE of the significant fibrosis group was higher (1.40 m/s) than that of mild fibrosis group (1.14 m/s, p<0.001). AUC was 0.719 with ≤1.11 m/s as the best cutoff value for excluding significant PPF. Sensitivity and negative predictive values were 80.5% and 40.5%, respectively. Whereas, for confirming significant PPF, the best cutoff value was >1.39 m/s, with specificity of 86.1% and positive predictive value of 92.0%.Conclusions/SignificancepSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.Author summaryIn the developing world, over 207 million people are infected with parasitic Schistosoma worms. Among the species of Schistosoma that infect humans Schistosoma mansoni is one of the most common causes of illness. Here, we investigated the performance of point shear wave elastography (pSWE) for predicting significant periportal fibrosis (PPF) in schistosomotic patients and to determine its best cutoff point. We examined 358 people from northeast of Brazil for Schistosoma infections. The present study showed that pSWE was able to differentiate significant from mild PPF, with better performance to predict significant PPF.


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