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Chronic Nonallergic Rhinitis

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121. Primary Care Corner with Geoffrey Modest MD: Vitamin D and atopic dermatitis in kids

. The current study looked further into the immunologic changes and clinical effects of vitamin D supplementation in AD patients (see Arch Allergy Immunol 2015;166:91–96​ ). Details: –39 children with chronic AD (mean age 4, 38% with family history of asthma, 87% family history of allergies, 33% of the kids had asthma and 33% had rhinitis; 8% had mild AD/46% moderate and 46% severe; 90% with total IgE increased and 23% had documented food allergy, 21% for inhalants only; 38% tested positive for dust mite (...) in Th2 cells and decrease in Th1 cells in their skin, though there are differences in these T-cell subsets in the acute AD phase, with Th2 cells and their associated cytokines of IL-4, IL-5, IL-13 predominating, but in the chronic phase the Th1 cells and their associated IFN-g, IL-5,IL-12 predominate. Vitamin D receptors are all over the body, including in the skin and in the immune system, and a small RCT in AD patients randomized to vitamin D 1,600 IU/d found clinical improvement after 60 days

2015 Evidence-Based Medicine blog

122. Rhinosinusitis

, this can block the sinuses and cause pain. There are several types of sinusitis, including Acute, which lasts up to 4 weeks Subacute, which lasts 4 to 12 weeks Chronic, which lasts more than 12 weeks and can continue for months or even years Recurrent, with several attacks within a year Acute sinusitis often starts as a cold, which then turns into a bacterial infection. Allergies, nasal problems, and certain diseases can also cause acute and chronic sinusitis. Symptoms of sinusitis can include fever (...) infekce. Místní komplikace zahrnují jednak vliv na záněty okolních struktur vč. jejich chronicity (rhinitis či pharyngitis chronica). Závažné mohou být komplikace při šíření zánětu do orbity, popř. lebky. Častěji se objevují např. záněty průdušek a průduškové astma – tzv. sinobronchiální syndrom. Léčba s. zahrnuje klid, dostatečné zvlhčování vzduchu, obklady, nosní kapky ke zmírnění zduření sliznice, antibiotika. V těžších případech je nutné provést punkci dutin s jejich výplachem. V případě

2015 FP Notebook

123. Eosinophilia Syndrome

Syndrome Aka: Eosinophilia Syndrome , Nares Syndrome , Nonallergic Rhinitis with Eosinophilia From Related Chapters II. Definitions Nonallergic Rhinitis with Eosinophilia Subtype of characterized by nasal III. Epidemiology Perennial More common in adults May represent up to a third of cases IV. Symptoms Congestion V. Labs ing ( or ) negative Nasal secretion microscopy Nasal and mast cell degranulation VI. Differential Diagnosis See Chronic See VII. Associated conditions: Triad sensitivity Non-IgE (...) -mediated s Images: Related links to external sites (from Bing) These images are a random sampling from a Bing search on the term "Eosinophilia Syndrome." Click on the image (or right click) to open the source website in a new browser window. Related Studies (from Trip Database) Ontology: Eosinophilic non-allergic rhinitis (C0684902) Concepts Disease or Syndrome ( T047 ) SnomedCT 93447004 English NARES , Eosinophil non-allergic rhinit , Eosinophilic non-allergic rhinitis , Eosinophilic nonallergic

2015 FP Notebook

124. Pilot evaluation of the nasal nitric oxide response to humming as an index of osteomeatal patency. (Abstract)

Pilot evaluation of the nasal nitric oxide response to humming as an index of osteomeatal patency. Paranasal sinuses are reservoirs for nitric oxide (NO), and humming facilitates nasal diffusion of NO. The nasal NO response to humming has previously been shown to be blunted with chronic sinusitis and nasal polyposis. We hypothesized that the nasal NO response to humming will be proportional to radiographic osteomeatal patency when comparing allergic rhinitis (AR) patients (without chronic (...) the study. Seventeen AR patients (5 IAR and 12 PAR) participated, as did 16 nonallergic controls. Among controls, quiet nasal NO levels--corrected for fractional exhaled NO--rose significantly with OMC area and fell significantly with Lund-Mackay scores (p < 0.05). However, we observed no proportionality between H/Q ratio and radiographic OMC patency.Analysis of nasal NO samples taken under quiet conditions from normal controls was consistent with the paranasal sinuses acting as a reservoir of nasal

2012 American journal of rhinology & allergy

125. Urticaria

be pinpoint in size, or several inches in diameter. is a related condition (also from allergic and nonallergic causes), though fluid leakage is from much deeper blood vessels in the subcutaneous or submucosal layers. Individual hives that are painful, last more than 24 hours, or leave a bruise as they heal are more likely to be a more serious condition called . Hives caused by stroking the skin (often linear in appearance) are due to a benign condition called . Cause [ ] Hives can also be classified (...) by the purported causative agent. Many different substances in the environment may cause hives, including medications, food and physical agents. In perhaps more than 50% of people with chronic hives of unknown cause, it is due to an reaction. Medications [ ] Drugs that have caused allergic reactions evidenced as hives include , sulphate of , , , , , , trichazole, , , , , , and . The antidiabetic , in particular, has been documented to induce allergic reactions manifesting as hives. Drug-induced hives has been

2012 Wikipedia

126. Factors affecting outcome of inferior turbinate mucotomy in treatment of postnasal drip syndrome. (Abstract)

) with hyperplasia of the inferior turbinates underwent bipolar diathermy mucotomy. Nonallergic noninfectious rhinitis was diagnosed in 18, neutrophilic in 58, allergic in 18 and NARES in 14 patients. The participants were questioned about postnasal drip (PND) intensity before and 2 months after surgery.Results of mucotomy significantly depended on the etiology of chronic rhinitis and were worst in patients with NARES (p < 0.05). Percent values of reduction of PND intensity after mucotomy and percent of daytime (...) Factors affecting outcome of inferior turbinate mucotomy in treatment of postnasal drip syndrome. Postnasal drip syndrome may result from isolated hyperplasia of nasal inferior turbinates due to chronic rhinitis. Mucotomy (conchotomy) performed in such patients is generally effective but in some individuals the problem persists after surgery.The aim of this study was to determine factors influencing outcome of the therapy.One hundred six patients aged 17-60 years (mean = 34, SD = 12

2010 American journal of rhinology & allergy

127. Study to Investigate Effects of CAL-263 in Subjects With Allergic Rhinitis Exposed to Allergen in an Environmental Chamber

a positive Radio Allergen Sorbent Test (class 2 or greater) for grass pollen during the previous 12 months or at screening Is otherwise healthy Is able to provide written informed consent Exclusion Criteria: Is a female of childbearing History of chronic nasal or upper respiratory tract symptoms or disorders other than allergic rhinitis History of nonallergic rhinitis, chronic sinusitis or severe asthma Has a nasal condition likely to affect the outcome of the study Is currently taking regular medication (...) about this study, you or your doctor may contact the study research staff using the contacts provided below. For general information, Layout table for eligibility information Ages Eligible for Study: 18 Years to 55 Years (Adult) Sexes Eligible for Study: All Accepts Healthy Volunteers: No Criteria Inclusion Criteria: Age >18 and <55 years Has a history of seasonal allergic rhinitis for at least 2 years Has sensitivity to grass pollen demonstrated by a positive response to skin prick testing Has

2010 Clinical Trials

128. Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy. (Abstract)

and safety of ultrasound treatment of the hypertrophied inferior turbinates, which is a technique recently applied in rhinologic surgery. We aimed, also, to compare this method with the radiofrequency cold coblation turbinate reduction and the traditional submucosal monopolar inferior turbinate cauterization. We studied prospectively 60 patients with chronic hypertrophic rhinitis of nonallergic etiology, who underwent different surgical methods of turbinate reduction, divided into two groups: (1) in 30 (...) Comparison of ultrasound turbinate reduction, radiofrequency tissue ablation and submucosal cauterization in inferior turbinate hypertrophy. Chronic nasal obstruction owed to chronic hypertrophic rhinitis is a common cause of nasal airway obstruction. In cases unresponsive to conservative treatment, various surgical techniques are commonly performed, but the issue of the optimal surgical procedure is still controversial. The objective of the present study was to evaluate the effectiveness

2010 European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery Controlled trial quality: uncertain

129. Allergic and mixed rhinitis: Epidemiology and natural history. (Abstract)

Allergic and mixed rhinitis: Epidemiology and natural history. Allergic rhinitis (AR) is a prevalent chronic respiratory problem in the United States associated with significant comorbidities and health care costs. Recent surveys suggest that mixed rhinitis (MR), which refers to patients with nonallergic AR (NAR) and AR, is a specific rhinitis subtype that may represent between 50 and 70% of all AR patients although the true prevalence of these conditions has not been confirmed. It is important (...) to make a clear distinction between these chronic rhinitis (CR) phenotypes as symptom triggers; response to treatment and prevalence of comorbidities such as sinusitis may be significantly different. Incorporating patient centric questionnaires that can reliably characterize AR, MR, and NAR phenotypes will improve our ability to further investigate the natural history/epidemiology, mechanisms, and development of novel therapies for NAR-related CR subtypes.

2010 Allergy and Asthma Proceedings

130. Local production of IgE in the respiratory mucosa and the concept of entopy: does allergy exist in nonallergic rhinitis? (Abstract)

Local production of IgE in the respiratory mucosa and the concept of entopy: does allergy exist in nonallergic rhinitis? To review research regarding locally produced IgE and its impact on patients with chronic rhinitis.PubMed search with the following keywords: entopy, local IgE, nonallergic rhinitis, idiopathic rhinitis, vasomotor rhinitis, and allergic rhinitis.Articles were selected based on their relevance to entopy and locally produced IgE and its clinical effect and relationship (...) to idiopathic rhinitis (IR).Local IgE has been found in a variety of tissues, including nasal and bronchial mucosa. IgE is produced in these local tissues and not simply the product of migration to the tissue from regional lymphoid tissue or blood. Local IgE has been identified in most of both atopic and nonatopic asthmatic patients and allergic rhinitis patients. Up to 40% of patients with IR and a positive nasal provocation test result have evidence of locally produced IgE, which has been coined entopy

2010 Asthma & Immunology

131. Rhinitis and sinusitis. (Abstract)

significant direct medical expenditures. Both conditions also create even greater indirect costs to society by causing lost work and school days and reduced workplace productivity and school learning. Management of allergic rhinitis involves avoidance, many pharmacologic options, and, in appropriately selected patients, allergen immunotherapy. Various types of nonallergic rhinitis are treated with avoidance measures and a more limited repertoire of medications. For purposes of this review, sinusitis (...) Rhinitis and sinusitis. Rhinitis and sinusitis are among the most common medical conditions and are frequently associated. In Western societies an estimated 10% to 25% of the population have allergic rhinitis, with 30 to 60 million persons being affected annually in the United States. It is estimated that sinusitis affects 31 million patients annually in the United States. Both rhinitis and sinusitis can significantly decrease quality of life, aggravate comorbid conditions, and require

2010 Journal of Allergy and Clinical Immunology

132. Reliability of EP3OS symptom criteria and nasal endoscopy in the assessment of chronic rhinosinusitis - a GA(2) LEN study. Full Text available with Trip Pro

(2) LEN European survey.On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, allergic rhinitis, and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in prevalence of CRS between two study points, the standardized absolute repeatability, and the chance-corrected repeatability (kappa) were determined. In two centers, 342 participants underwent nasal endoscopy. The association of symptom-based CRS with endoscopy (...) and self-reported doctor-diagnosed CRS was assessed.There was a decrease in prevalence of CRS between the two study phases, and this was consistent across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I(2) = 0). There was fair to moderate agreement between the two occasions (kappa = 39.6). Symptom-based CRS was significantly associated with positive endoscopy in nonallergic subjects, and with self-reported doctor-diagnosed CRS in all subjects, irrespective of the presence of allergic rhinitis.Our findings

2010 Allergy

133. Relationships among rhinitis, fibromyalgia, and chronic fatigue. (Abstract)

Relationships among rhinitis, fibromyalgia, and chronic fatigue. New information about the pathophysiology of idiopathic nonallergic rhinopathy indicates a high prevalence in chronic fatigue syndrome (CFS). This article shows the relevance of CFS and allied disorders to allergy practice. CFS has significant overlap with systemic hyperalgesia (fibromyalgia), autonomic dysfunction (irritable bowel syndrome and migraine headaches), sensory hypersensitivity (dyspnea; congestion; rhinorrhea (...) ; and appreciation of visceral nociception in the esophagus, gastrointestinal tract, bladder, and other organs), and central nervous system maladaptations (central sensitization) recorded by functional magnetic resonance imaging (fMRI). Neurological dysfunction may account for the overlap of CFS with idiopathic nonallergic rhinopathy. Scientific advances are in fMRI, nociceptive sensor expression, and, potentially, infection with xenotropic murine leukemia-related virus provide additional insights to novel

2010 Allergy and Asthma Proceedings

134. allergic rhinosinusitis

allergic rhinosinusitis allergic rhinosinusitis - General Practice Notebook This site is intended for healthcare professionals General Practice Notebook | Medical search allergic rhinosinusitis Allergic rhinitis may be: seasonal (also called "hay fever") caused by grass, tree pollen allergens, symptoms can seen during the same time each year perennial caused by house dust mites, symptoms occur right throughout the year occupational caused by allergens at workplace e.g.- flour allergy in a baker (...) (1) Allergic rhinitis can also be divided according to the severity and persistence of symptoms: mild intermittent moderate severe intermittent mild persistent moderate severe persistent (1) It is characterized by rhinorrhoea nasal blockage sneezing attacks for longer than 1 hour per day lasting longer than 2 weeks itching - eyes, nose watery eyes fatigue malaise headache (2) wheezing shortness of breath (3) Allergic rhinitis may coexist with asthma, eczema, or chronic sinusitis. It occurs when

2010 GP Notebook

135. Estimating the Costs to the NHS of Smoking in Pregnancy for Pregnant Women and Infants

to pollen 977 J30.2 Other seasonal allergic rhinitis 65 J30.3 Other allergic rhinitis 348 J30.4 Allergic rhinitis, unspecified 287 J31.0 Chronic rhinitis 1,230 J31.1 Chronic nasopharyngitis 37 J31.2 Chronic pharyngitis 435 J32.0 Chronic maxillary sinusitis 1,113 J32.1 Chronic frontal sinusitis 183 J32.2 Chronic ethmoidal sinusitis 200 J32.3 Chronic sphenoidal sinusitis 54 J32.4 Chronic pansinusitis 229 J32.8 Other chronic sinusitis 311 J32.9 Chronic sinusitis, unspecified 3,490 J33.0 Polyp of nasal (...) 35,627 J04.0 Acute laryngitis 716 J04.1 Acute tracheitis 337 J04.2 Acute laryngotracheitis 127 J05.0 Acute obstructive laryngitis [croup] 13,061 J05.1 Acute epiglottitis 529 J06.0 Acute laryngopharyngitis 51 J06.8 Other acute upper respiratory infections of multiple sites 323 J06.9 Acute upper respiratory infection, unspecified 48,580 107,675 Aged under 1 only 5,336 LOWER RESPIRATORY J22.X Unspecified acute lower respiratory infection 122,093 J30.0 Vasomotor rhinitis 85 J30.1 Allergic rhinitis due

2008 Public Health Research Consortium

136. Diagnosis and evaluation of asthma in adults

may be an adjunct to diagnosis and is discussed in this section. Symptoms Common symptoms of asthma include wheezing, chest tightness, dyspnea and cough. The characteristics of these symptoms, which are variable, often paroxysmal and provoked by allergic or nonallergic stimuli such as cold air and irritants, are useful in diagnosis. Nocturnal occurrence is common. Measuring the patient's response to a therapeutic trial may be helpful in diagnosis. Nonpulmonary symptoms that suggest (...) a predisposition to allergy - rhinitis, conjunctivitis and eczema - are also common in, but not specific to, asthma patients. In patients with symptoms that are persistent or that do not respond to simple treatment, objective confirmation of variable airflow obstruction is required. Variable airflow obstruction Objective measurements are needed to confirm the diagnosis of asthma in all patients and to assess its severity. Objective documentation of variable airflow obstruction can be obtained through

1999 CPG Infobase

137. Provocative factors in asthma

for viral provocation of allergy and asthma. This is consistent with a study of experimental HRV infection in asthmatic adults, which resulted in augmented eosinophilic inflammation (assessed in sputum) and enhanced bronchial responsiveness. In another controlled study of experimental HRV infection in people with allergic rhinitis (but no asthma) and a nonallergic control group, there was a significant increase in bronchial responsiveness to histamine in the allergic group. Rhinovirus infection (...) risk factor for symptomatic asthma. Nevertheless, the importance of the environment is dependent on the predominant exposures in that environment, which are influenced by cultural and geographic factors. Seasonal changes in indoor allergen levels have been associated with changes in bronchial responsiveness. In 32 people with asthma, who were allergic to dust mites, the provocative concentration of histamine giving a 20% fall in FEV 1 (PC 20 ) increased from 2.05 mg/mL in autumn to 4.51 mg/mL

1999 CPG Infobase

138. In a 45 yr old man with post nasal drip, what is the most effective treatment to reduce symptoms? What alternatives are there?

the TRIP, Cochrane and Medline databases as well as the NLH Specialist Library for ENT but found no overview of interventions for post nasal drip. However, we did locate information on individual treatments. The Agency for Healthcare Research and Quality (AHRQ) evidence-based technology assessment on the management of allergic and non-allergic rhinitis reported: “Studies provide strong support for the beneficial effect of cromoglycate in the management of both seasonal and perennial allergic rhinitis (...) for controlling the spectrum of allergic rhinitis symptoms and should be considered as first line therapy in patients with moderate to severe symptoms.” [2] Grzincich writing in an abstract to an article on the effectiveness of intranasal corticosteroids notes: “Intranasal corticosteroids (IC) are most commonly prescribed to treat allergic rhinitis (perennial and seasonal). There are now many IC available to treat rhinitis, all effective on nasal obstruction, rhinorrhea, sneezing, itching and post-nasal drip

2006 TRIP Answers

139. A patient suspects he is allergic to aspirin and ibuprofen, his 'symptoms' appear mild (cold-like). What are the main features of aspirin allergy and how common is a shared allergy to both aspirin an

in atopic individuals (persons with a hereditary predisposition toward developing certain hypersensitivity reactions such as hay fever, asthma, or urticaria). Additionally, NSAIDs exacerbate urticaria in one third to two thirds of patients with chronic idiopathic urticaria.” We found little to offer by way of evidence about patients who are sensitive to both aspirin and ibuprofen, although eBNF says of NSAIDS (4): “they are contra-indicated in patients with a history of hypersensitivity to aspirin (...) -specified methods, the reported sensitivity rates to aspirin were lowest (0.3% to 0.9%) for patients without allergic tendencies, higher in asthmatics, and highest if patients had nasal polyps or severe atopy. Although not determined in any of these studies, the rate of sensitivity in a general (nonclinical) population would doubtlessly be substantially lower than the rate of three per 1000 reported for nonallergic patients. The admixture of different clinical groups, varying definitions

2006 TRIP Answers

140. Differential Gene Expression in Lung and Peripheral Blood After Inhaled Allergen Challenge

and normal phenotypes. This approach is designed to identify novel genes associated with both asthma pathogenesis (differentially expressed in the exposure-response study) and asthma susceptibility (genetically associated with asthma in a linkage/association study). Patients with asthma and allergic rhinitis have long been known to have positive skin test responses to house dust. In the 1960's it was shown that the dust mite was the most important source of allergen in house dust. Techniques for growing (...) dust mites in the laboratory enabled the preparation of dust mite allergen extracts. Identification of the major allergens of dust mite along with specific skin test methodology has resulted in standardized dust mite allergen extracts for diagnostic and therapeutic use. Numerous epidemiologic studies have demonstrated the importance of sensitization to dust mite as risk factors for asthma and allergic rhinitis symptoms. Administration of dust mite by inhalation is considered investigational

2008 Clinical Trials

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