Nasal nitric oxide in the inferior turbinate surface decreases with intranasal steroids in allergic rhinitis: A prospective study

Publication date: Available online 4 December 2018

Source: Auris Nasus Larynx

Author(s): Daisuke Takahara, Takashi Kono, Sachio Takeno, Takashi Ishino, Takao Hamamoto, Kazunori Kubota, Tsutomu Ueda

Abstract

Objective

It remains controversial whether nasal nitric oxide (NO) serves as a reliable parameter to evaluate treatment efficacy in patients with allergic rhinitis (AR). The measurement of local nasal NO levels has been shown to be a sensitive marker for the diagnosis of symptomatic AR patients. Here we assessed the applicability of nasal NO to evaluations of the efficacy of intranasal steroids (INS) in a prospective design.

Methods

We enrolled 25 patients with perennial AR and 10 age-matched healthy participants. The AR patients received fluticasone furoate (FF) once daily for 2 months. Fractional exhaled NO and nasal NO measurements were carried out using an electrochemical analyzer at pretreatment and at 2 weeks and 2 months after treatment. Nasal NO levels were directly measured at two different areas of the nasal cavity: the surface of the inferior turbinate (IT area) and the front of the middle meatus (MM area). Subjective nasal symptoms were also recorded at each visit.

Results

The mean total nasal symptom score in the AR patients decreased significantly after FF treatment (p < 0.0001). The mean nasal NO levels in the IT area in the AR patients were significantly higher at pretreatment than those of the healthy participants (109 vs. 62.5 ppb, respectively; p < 0.001). After FF administration, the nasal NO levels in the IT area of the AR group showed a significant reduction at both 2 weeks and 2 months (79.1 and 71.9 ppb, respectively; p < 0.05 and p < 0.01). There was no significant difference in nasal NO levels in the MM area between the controls and the AR group at any visit timepoint. When the ratio of the MM area to the IT area (MM/IT ratio) was plotted for each subject, the untreated AR patients showed a marked decrease in the ratio, whereas after the FF treatment, the AR patients' mean MM/IT ratios showed a significant increase. No significant difference compared to the control group existed at 2 months.

Conclusion

Nasal NO measurement around the inferior turbinate is an objective measure to evaluate allergic conditions and is useful to monitor therapeutic effects of INS.

https://ift.tt/2Ef1fIa

Bird-egg syndrome induced by α-livetin sensitization in a budgerigar keeper: Successful induction of tolerance by avoiding exposure to avians

Publication date: Available online 4 December 2018

Source: Allergology International

Author(s): Naoko Inomata, Katsuyuki Kawano, Michiko Aihara

https://ift.tt/2FXThoB

The Urticaria Control Test and Urticaria Activity Score correlate with quality of life in adult Japanese patients with chronic spontaneous urticaria

Publication date: Available online 4 December 2018

Source: Allergology International

Author(s): Shoko Nakatani, Yoshiko Oda, Ken Washio, Atsushi Fukunaga, Chikako Nishigori

https://ift.tt/2riFnmM

Clinical features of Helicobacter pylori antibody‐positive junior high school students in Nagano Prefecture, Japan

Abstract

Background

Previously, we conducted an epidemiological study screening for Helicobacter pylori antibody positivity among Japanese junior high school students. In this study, we updated the epidemiological data and assessed the clinical features of H pylori antibody‐positive junior high school students.

Materials and methods

We assessed H pylori antibody‐positive subjects who were identified between 2012 and 2015 at four junior high schools in Nagano Prefecture, Japan. H pylori infection was confirmed by urea breath test (UBT) or endoscopic examination. Endoscopy was performed after obtaining consent from the subject and their guardians. Eradication therapy consisted of triple therapy with proton pump inhibitor (PPI), amoxicillin (AMPC), and clarithromycin (CAM) or metronidazole (MNZ) for seven days. Eradication of H pylori was confirmed by UBT. We reviewed subjects' characteristics, endoscopic findings, histological findings, eradication regimes, outcomes, and adverse effects.

Results

The overall prevalence of H pylori antibody positivity was 3.2% (42/1298). We assessed thirteen H pylori antibody‐positive subjects. Eight subjects had a family history of H pylori infection. Six subjects had abdominal pain, and two subjects had iron deficiency anemia (IDA). Twelve subjects underwent endoscopy; one subject had duodenal ulcer, eleven subjects had antral nodular gastritis, and six subjects showed grade 2 closed type atrophic border according to the Kimura‐Takemoto classification. All subjects received eradication therapy; CAM was used in five subjects with CAM susceptibility as well as in three subjects with unknown information on CAM susceptibility, and MNZ was used in five subjects with CAM resistance. Eradication was successful in twelve subjects (one unconfirmed). There were three mild adverse effects (abdominal pain or diarrhea).

Conclusions

Helicobacter pylori test for junior high school students represents an opportunity to diagnose the peptic ulcer, iron deficiency anemia, and gastric atrophy.

https://ift.tt/2StA5k4

The effect of poly‐p‐dioxanone plates on the protection and vitality of cartilage: An animal study

Objectives/Hypothesis

In septorhinoplasty, septal, auricular, and costal cartilage are often used as autologous graft. Autologous grafts are preferred in nasal reconstruction. The aim of this study was to histopathologically examine the tissue compatibility and the effect on the stability and cartilage vitality of poly‐p‐dioxanone (PDS) plates.

Study Design

Ten adult New Zealand rabbits were used.

Methods

Ten New Zealand rabbits were used. Septal and auricular cartilage sections were removed; one of the two cartilage grafts was left plain, and the other was sutured to a PDS plate. Grafts were placed into the back of the rabbits. After 12 weeks, the graft material was examined microscopically.

Results

The specimens did not cause any significant foreign body reaction. Within 3 months, a significant degree of color, stability, and stiffness was lost. Microscopically, inflammation, necrosis, and cartilage cell degeneration scores were statistically significantly lower in the grafts using PDS (P < .05), and the vascularization, collagen, and cartilage proliferation scores were found to be statistically significantly higher (P < .05). No statistically significant difference was determined in respect of the bone proliferation scores (P > .05).

Conclusions

The use of PDS plates together with cartilage provided mechanical support to the graft. Therefore, changes that disrupt the integrity of the graft, such as inflammation, necrosis, and cartilage cell degeneration, were reduced, and changes that provide greater stability, such as vascularization, collagen, and cartilage proliferation, were increased.

Level of Evidence

NA Laryngoscope, 2018

https://ift.tt/2zJeD3n

Use of bovine pericardium for the treatment of anterior iatrogenic glottic web

https://ift.tt/2PjeGb9

Vertical head impulse and caloric are complementary but react opposite to Meniere's disease hydrops

Objectives/Hypothesis

Meniere's disease (MD) patients can show normal head impulses despite poor caloric test results. This study aimed to investigate the discrepancy in the vestibulo‐ocular reflex (VOR) in MD patients and whether endolymphatic hydrops (EH) influence the VOR.

Study Design

Prospective, cross‐sectional observational study.

Methods

Ninety MD patients were enrolled. Neuro‐otological testing, including a video head impulse test (vHIT) of all semicircular canals (SCs), and gadolinium‐enhanced inner ear magnetic resonance imaging were performed. The vestibular EH volume was quantitatively evaluated by processing magnetic resonance images.

Results

Abnormal vHIT results in MD patients were found most frequently in the posterior (44.4%) SCs, followed by the horizontal (13.3%) and anterior (10%) SCs. Canal paresis (CP) was assessed using the vHIT and the caloric test, and results were not significant when vHIT responses were assessed as CP only using the horizontal SC. The difference in the vestibular EH between the presence and absence of CP was not significant if assessed using the vHIT (P = .5591), but it was statistically different if assessed using the caloric test (P = .0467).

Conclusions

The contradictory reaction of VOR in MD patients may result from the high specificity but low sensitivity of CP in the horizontal vHIT. EH volume in the vestibule affects the caloric response but does not affect the vHIT response.

Level of Evidence

2b Laryngoscope, 2018

https://ift.tt/2zKCC2f