Moderate-severe Persistent Allergic Rhinitis Research Articles

Effectiveness of Kinetic Oscillation Stimulation Treatment in Persistent Moderate-severe Allergic Rhinitis Compared to Medical Therapy

Introduction: KOS represent an innovative non-surgical solution developed at the Karolinska University Hospital in Stockholm (Sweden) which consists of a intranasal stimulation via an air inflated catheter indicated to treat non allergic rhinitis and migraine. The KOS method for rhinitis has proved to be so effective as it simultaneously stimulates the nasal mucosa and the local autonomic nervous system, which represents the predisposing ultrastructural factor and is able to maintain the neurogenic inflammation responsible for the nasal symptoms of chronic rhinitis, very disabling for the quality of life of rhinitic patients. We wanted to verify whether the positive results obtained in the treatment of non-allergic rhinitis that we observed in our previous study could also be obtained in patients with allergic rhinitis, who similarly share many of the nasal symptoms. Materials and Methods: A total of 110 patients (63 males), aged >18 years, consecutively enrolled, all undergoing complete ENT evaluation with physical clinical examination, endoscopy, nasal symptoms VAS and SNOT-22 questionnaire, affected by allergic rhinitis (AR) persistent moderate-to-severe grade. All patients were alternately assigned to 2 homogeneous groups (Group A: Control Subjects, Group B: KOS Treated Patients), each group included 55 individuals. Simple randomization was achieved with a sequence of random numbers from a computer-generated sequence. During the study, both groups received standard medications (Ebastine tablet 10 mg and Mometasone furoate nasal spray 50 mcg/actuation per nostril per day) for 90 days. At the beginning of medical treatment, group B patients underwent first KOS treatment (repeated after 20 days). Both groups were asked to report any side effects during the study. Results: The treated patients already benefited immediately after the extraction of the balloon reporting a sensation of a more patent nose and reduction of nasal secretions which progressively improves in the following days. For the subjective complaints (nasal obstruction, sneezing, rhinorrhea, and itching), the improvement was significant within each group, with the most significant improvements in treatment group B. When the KOS treatment group was compared with medical treatment alone (Group A), greater efficacy was observed in Group B with regards to the reduction of nasal symptoms and nasal endoscopic findings. Regarding the objective results (rhinomanometric assessments), similar trends, such as subjective ones, were observed within each group. The improvements within each treatment group were significant without side effects. Comparison between Groups A and B, before and after treatment, with the SNOT-22 questionnaire relating to the 5 most important questions (5 most important items) showed an improvement in both study groups but with better results, however regards efficacy, in Group B. Discussion: Our results reveal a greater efficacy achieved using a combined approach, with the association between medical treatment and KOS, compared to medical treatment alone, in the control of the sympotms of AR associated with hypertrophy of the inferior turbinates. The symptoms evaluated by VAS showed greater efficacy in their control in those patients in treatment group B, in particular those patients who had undergone treatment with KOS presented objective parameters (AAR, endoscopic score) and SNOT-22 better than the group receives only medical care. Conclusion: KOS treatment, in combination with medical therapy, improves nasal flow more effectively than medical treatment alone in persistent moderate to severe AR. In particular, the local nasal symptoms were significantly reduced. Patients undergoing the KOS treatment report improvement in their nasal rhinitis symptoms within a few days, which improve further, also in our experience, after a second boost application.

Symptom control and health-related quality of life in allergic rhinitis with and without comorbid asthma: A multicentre European study.

Allergic rhinitis (AR) is a major non-communicable disease that affects the health-related quality of life (HRQoL) of patients. However, data on HRQoL and symptom control in AR patients with comorbid asthma (AR+asthma) are lacking. In this multicentre, cross-sectional study, patients with AR were screened and administered questionnaires of demographic characteristics and health conditions (symptoms/diagnosis of AR and asthma, disease severity level, and allergic conditions). HRQoL was assessed using a modified version of the RHINASTHMA questionnaire (30, 'not at all bothered' - 150 'very much bothered') and symptom control was evaluated by a modified version of the Control of Allergic Rhinitis/Asthma Test (CARAT) (0, 'no control' - 30, 'very high control'). Out of 643 patients with AR, 500 (78%) had asthma as a comorbidity, and 54% had moderate-severe intermittent AR, followed by moderate-severe persistent AR (34%). Compared to the patients with AR alone, patients with AR+asthma had significantly higher RHINASTHMA (e.g., median RHINASTHMA-total score 48.5 vs. 84, respectively) and a significantly lower CARAT score (median CARAT-total score 23 vs. 16.5, respectively). Upon stratifying asthma based on severity, AR patients with severe persistent asthma had worse HRQoL and control than those with mild persistent asthma. The association was significantly higher among non-obese participants compared to obese ones, with RHINASTHMA-upper symptoms score but not with CARAT. Our observation of poorer HRQoL and symptoms control in AR patients with comorbid asthma supports the importance of a comprehensive approach for the management of AR in case of a comorbid allergic condition.

Comparison of Fluticasone Furoate and Cetirizine Versus Fluticasone Furoate and Montelukast in Allergic Rhinitis

Background: The complexity of treatment in allergic rhinitis remains to be a global challenge. The medical treatment option for moderate-severe persistent allergic rhinitis is the combination of intranasal corticosteroid (INCS) and oral antihistamine or leukotriene receptor antagonist (LTRA). The combination INCS with LTRA is selected based on the presence of asthma. Purpose: To determine the effect of fluticasone furoate plus cetirizine administration comparing fluticasone furoate plus montelukast on nasal eosinophils count and clinical improvement in patients with moderate-severe persistent allergic rhinitis. Method: This study was purely experimental research with the study design randomized clinical trial, double-blind, pre and post test control. Patient were divided into two group. Group-1 received intranasal fluticasone furoate 110 μg once daily and oral cetirizine 10mg and Group-2 received intranasal fluticasone furoate 110 μg once daily and Montelukast 10mg. The treatment efficacy is assessed from nasal eosinophil count and total five symptoms score (T5SS) based on Visual Analogue Scale (VAS) before and 4 weeks after treatment. Result: Both groups show a decrease in the nasal eosinophil count and T5SS score based on VAS before and after treatment (p< 0.05). The group-2 shows a statistically significant improvement in nasal obstruction and rhinorrhea compare to the group-1 (p <0.05). The decrease in nasal eosinophil count and T5SS is higher in the group-2 than the group-1, however, it is not statistically significant. Conclusion: The combination of fluticasone furoate and montelukast is more effective in reducing nasal obstruction and rhinorrhea than the combination of fluticasone furoate and cetirizine.

The use of nasal allergen vs allergen exposure chambers to evaluate allergen immunotherapy

ABSTRACT Introduction Allergen-specific immunotherapy (AIT) is the only disease-modifying treatment option for allergic rhinitis (AR) patients with persistent moderate-severe AR for whom traditional pharmacotherapies are ineffective. The nasal allergen challenge (NAC) and allergen exposure chamber (AEC) are two translational models of AR that can be used to investigate the properties, safety, and efficacy of AIT. Areas Covered Peer-reviewed, human-centered articles utilizing AEC or NAC models to investigate AIT between 2010 and 2020 were curated from PubMed, EMBASE, and OVID Medline databases. AECs have been used to evaluate traditional subcutaneous and sublingual administrations of AIT, including cross-protective effects and different dosing regimens. More recently, the effectiveness of novel AIT formulations has been evaluated. NACs are another model used to study AIT, including using novel intralymphatic routes of administration. It is an especially powerful and versatile tool to determine if basic science and animal model findings are clinically translatable. Expert opinion The AEC and NAC models both produce clinically relevant and reproducible results. AECs are more effective for studying many participants but are limited because they require a specialized facility. As more AIT therapies and new formulations are developed over time, the versatility of the NAC will be especially useful.

Improvement in Psychological Condition of Patients With Persistent Moderate–Severe Allergic Rhinitis by Drug Therapy Combined With Psychological Intervention

To investigate the effect of drug treatment combined with psychological intervention on mental disorders in patients with persistent moderate-severe allergic rhinitis. Sixty patients with persistent moderate-severe allergic rhinitis who met the criteria were randomly divided into 2 groups: control group and experimental group. The control group was only given medication, whereas the experimental group was given psychological intervention on the basis of the same medication. Cognitive behavioral therapy was used for psychological intervention. After 12 weeks of treatment, Self-Rating Anxiety Scale (SAS), Self-Rating Depression Scale (SDS), and rhinoconjunctivitis quality of life questionnaire (RQLQ) were used to evaluate the changes in anxiety, depression, and quality of life before and after treatment. The SAS and SDS scores of the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similarly, the SAS and SDS scores of the experimental group after treatment were lower than those before treatment with statistically significant difference. In addition, after treatment, the SAS and SDS scores of the experimental group were statistically lower than those of the control group. The results of RQLQ showed that the scores of each dimension in the control group after treatment were lower than those before treatment, and the difference was statistically significant. Similar results were found in the experimental group. After treatment with these 2 different schemes, the RQLQ scores of sleep, nonnasal/eye symptoms, and emotion in the experimental group were statistically lower than those in the control group. Drug therapy or drug therapy combined with psychological intervention can alleviate anxiety and depression of patients with persistent moderate-severe allergic rhinitis and improve their quality of life. Moreover, based on the effect of improving mental disorder and quality of life of patients, drug therapy combined with psychological intervention is better than drug treatment alone.

Herbal cake-partitioned moxibustion combined with Rhinocort spray is superior to Rhinocort spray alone in improving symptoms of moderate-severe allergic rhinitis patients

To observe the clinical effect of herbal cake-partitioned moxibustion combined with Rhinocort spray in the treatment of symptoms, sleep quality and daily life quality of patients with moderate-severe allergic rhinitis(AR)．. A total of 67 patients with persistent moderate-severe AR were recruited in the present study and randomized into a treatment group (n＝35) and a control group (n＝32). The patients in the treatment group were treated by herbal cake-partitioned moxibustion (applied to Dazhui [GV14], and bilateral Feishu [BL13], Shenshu [BL23] and Zhiyang [GV9], 3 moxa-cones/time, once every other day) plus Rhinocort spray (once in the morning and evening separately, 256 µg/d), and patients in the control group treated by Rhinocort spray alone (the same to that mentioned above). All the treatments were given for 4 weeks. The therapeutic effect was evaluated with reference to the "Principles and Recommended Schemes for Diagnosis and Treatment of AR" formulated by Otolaryngology Branch of Chinese Medical Association before and after the treatment. The severity of symptoms of AR was assessed by using visual analogue scale (VAS), the life quality of nasal conjunctivitis assessed using "Rhino-conjunctivitis Quality of Life Questionnaire (RQLQ)"， and the sleep quality assessed using "Pittsburgh Sleep Quality Index (PSQI)" before and after the treatment, followed by 3 months' follow-up survey. After the treatment, the VAS and RQLQ scores in both groups and PSQI of the treatment group were significantly decreased in comparison with their own base-line levels of pre-treatment in each group (P<0.05). The RQLQ and PSQI in the treatment group were substantially lower than those in the control group (P<0.05). No marked difference was found between the two groups in VAS(P>0.05). Follow-up survey showed that the VAS and RQLQ scores in both groups and PSQI of the treatment group were still significantly lower than those of pre-treatment in each group(P<0.05), and the VAS, RQLQ and PSQI scores of the treatment group were significantly lower than those of the control group(P<0.05). After 4 weeks' treatment, of the 32 and 35 AR patients in the control and treatment groups, 7 and 16 experienced marked improvement, 16 and 14 were effective, and 9 and 5 failed, with the effective rate being 71.9% and 85.7%, respectively. The effective rate of the treatment group was significantly superior to that of the control group (P<0.05). Herbal cake-partitioned moxibustion combined with Rhinocort spray has a good therapeutic effect in improving symptoms, sleep and quality of life in patients with persistent moderate-severe AR, which is obviously superior to that of Rhinocort spray alone in improving sleep and quality of life.

Development and Effects of Health Education Program using Flipped Learning for Allergic Rhinitis Patients

Purpose: This study was conducted to develop and test effects of flipped learning on a health education program for allergic rhinitis patients. Methods: The study was a nonequivalent control group pretest-posttest design, with 38 participants (experimental group: 19, control group: 19). The education program for allergic rhinitis patients with flipped learning developed for this study was conducted in pre-class, in-class, and post-class stages for a total of 12 weeks. For the in-class stage, a TREAT model suitable for patient education program was developed. Data were analyzed with an independent t-test and repeated measures ANOVA. Results: The experimental group showed significant improvement in knowledge (F=15.029, p&lt;.001), self-efficacy (F=6.814, p&lt;.001) and self-care behavior (F=41.761, p&lt;.001). In addition, subjective symptoms (F=61.453, p&lt;.001) and quality of life (F=52.413, p&lt;.001) improved. Conclusion: The results of this study show that flipped learning in an education program is an effective method for those in their twenties persistent moderate-severe allergic rhinitis. Therefore, the education program for allergic rhinitis developed by this study is actively recommended for nurses or health managers at universities to educate subjects in their twenties with allergic rhinitis.

Impact of moderate-severe persistent allergic rhinitis on thoraco-abdominal kinematics and respiratory muscle function

Objective: To assess thoraco-abdominal kinematics, respiratory muscle strength and electromyographic activity of the diaphragm (EAdi) in moderate-severe allergic rhinitis (AR) patients. Methods: A cross-sectional study involving 40 individuals (20 in the AR group) and 20 in the control group [CG]) was conducted. Ventilatory pattern and chest wall volume distribution (optoelectronic plethysmography), respiratory muscle strength (manovacuometry and sniff nasal inspiratory pressure [SNIP]), and EAdi were assessed in both groups. Results: The AR patients had impaired thoraco-abdominal kinematics (reduced total chest wall volume) (p = 0.004), lower values of total respiratory cycle time (p = 0.014) and expiratory time (p = 0.006). They also presented an increase of percentage contribution of the abdominal rib cage (p = 0.475) and respiratory rate (p = 0.019). A positive correlation among pulmonary rib cage tidal volume and MIP (r = 0.544; p < 0.001), SNIP (r = 0.615; p < 0.001), and MEP (r = 0.604; p < 0.001) was observed. After adjusting for age, BMI and gender through multivariate analysis, the individuals with AR presented lower values ​​of MIP (β = −24.341; p < 0.001), MEP (β = −0.277; p < 0.001), SNIP (β = −34.687; p < 0.001) and RMS (β = −0.041; p = 0.017). Conclusions: The individuals with moderate-severe persistent AR had worse respiratory muscle strength, diaphragm activation and chest wall volume distribution with a higher abdominal contribution to tidal volume than the control group. These findings reinforce the notion that the upper and lower airways work in an integrated and synergistic manner.

Peak expiratory flow rate assessment to screen for asthma in children with allergic rhinitis

Background: Allergic rhinitis is a common disease affecting around 10-25% of the population worldwide. There is a temporal relationship between the onset of allergic rhinitis and asthma and the ‘unified airway hypothesis’ explains this. Many researchers have demonstrated bronchial hyper-responsiveness prior to onset of asthma symptoms further validating this hypothesis. Further many studies favour treating allergic rhinitis may prevent the onset of asthma. So, detecting allergic rhinitis earlier and treating it adequately is of vital importance. The aims and objectives of this study is to identify bronchial hyper responsiveness in children with allergic rhinitis, prior to the onset of asthmatic symptoms, by measuring PEFR and its clinical correlates.Methods: A prospective observational study was conducted in Department of Paediatrics in Sree Balaji Medical College and Hospital. Inclusion and Exclusion Criteria were defined, and the study was conducted on a total of 85 children. After taking informed consent from parents, the children coming under the study population were analyzed for their baseline characteristics and PEFR is measured using a low reading Mini Wright peak flow meter and compared with mean value of south Indian children using the formula, PEFR= {(HEIGHT IN CM-100) X5} +100.Results: The mean PEFR as expressed in percentage of expected PEFR is 77.28% in males and 83.34% in females. The mean percentage of expressed PEFR does not vary significantly between different age groups. Of the 85 children,48(56.5%) have mild intermittent allergic rhinitis,28(32.9%) have mild persistent allergic rhinitis,5(5.9%) have moderate-severe intermittent allergic rhinitis and 4(4.7%) have moderate-severe persistent allergic rhinitis. There were 37(43.5%) blockers (with predominant nose block) and 48(56.5%) runners (with predominant rhinorrhea).Conclusions: PEFR is abnormal in 41.2% of children with allergic rhinitis. PEFR reduces linearly as the severity of allergic rhinitis increases. PEFR decreases as the number of cardinal symptoms increases. PEFR increases significantly after treatment of allergic rhinitis alone.

Long-term effectiveness of moxibustion on herbs for moderate-severe persistent allergic rhinitis population: A study protocol for a randomized controlled trial

BackgroundAllergic rhinitis (AR) is defined as an immunoglobulin led atopic disorder that affects the nasal mucosa. Moxibustion on herbs, a common complementary and alternative medicine approach, is frequently used for treating AR in clinical practice. Western medicine is good at quick symptomatic relief, while offer little or no sustainable and steady long-term effect. Little established evidence is available to support the long-term effectiveness of moxibustion on herbs for AR. ObjectiveThis study is a randomized controlled trial to assess the long-term effectiveness of moxibustion on herbs in moderate-severe persistent AR population. MethodsThe study sample size is 56 patients. Eligible patients with moderate-severe persistent AR will be randomized into a moxibustion on herbs combined with conventional treatment group (MOHCT group) and a conventional treatment group (CT group) in a 1:1 ratio. Patients in the MOHCT group will receive a 30-min moxibustion on herbs treatment on Zhìyáng (至阳 GV 9), Dàzhuī (大椎 GV 14) and bilateral Shènshū (肾俞 BL 23), Fèishū (肺俞 BL 13) for a total of 12 times on the basis of conventional treatment, while those in the CT group will receive conventional treatment alone. The primary outcome measure is VAS score for total nasal symptoms, which will be obtained via a self-recorded AR diary. The secondary outcome measures include the average occurrence of symptoms per week, use of medication and Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ). DiscussionThe objectives of this study include (1) to evaluate the long-term effectiveness and safety of moxibustion on herbs for treating AR; (2) to evaluate whether moxibustion on herbs can reduce the frequency of AR symptoms in patients with moderate-severe persistent allergic rhinitis. The finding of this study will provide evidence on the long-term effectiveness of moxibustion on herbs for moderate-severe persistent AR.

The effect of zinc supplementation on the improvement of clinical symptoms and the quality of life of persistent moderate severe allergic rhinitis patients

The effect of zinc supplementation on the improvement of clinical symptoms and the quality of life of persistent moderate severe allergic rhinitis patients

Efficacy analysis of psychological intervention on the basis of medication for the treatment of moderate-severe persistent allergic rhinitis

Objective:To observe the effect of psychological intervention on the basis of drug therapy for moderate-severe persistent allergic rhinitis.Method:Sixty patients with moderate-severe persistent allergic rhinitis were randomly divided into two groups: control group and study group. The control group was only given pure drug therapy. The study group was given drug treatment and psychological intervention. Both groups were treated for 12 weeks. Before and after the treatment, the patients were graded by SAS, SDS and RQLQ to assess their anxiety and depression, as well as changes in the quality of life. Finally, a statistical analysis was performed.Result:After the treatment, the SAS and SDS scores of the control group and the study group were lower than those scores before treatment, and the difference was statistically significant (P<0.05). The SAS and SDS scores were lower in the study group than in the control group after treatment, and the difference was statistically significant (P<0.05).After the treatment, the scores of RQLQ in the control group and the study group were lower than those scores before treatment. and the difference was statistically significant (P<0.05). After treatment with two regimens, the scores of the sleep, the non-nose/eye symptoms, and the emotion were lower in the study group than those scores in the control group, and the difference was statistically significant (P<0.05).Conclusion:To improve the mental disorder and the quality of life of the moderate-severe persistent allergic rhinitis patients, on the basis of drug treatment along with psychological intervention is more effective than using medical treatment.

A study of the curative effect of endoscopic-assisted posterior nasal neurotomy on patients with moderate severe persistent allergic rhinitis

Objective:To investigate the feasibility and effect of endoscopic-assisted posterior nasal neurotomy on patients with moderate-severe persistent allergic rhinitis (AR).Method:Endoscopic-assisted posterior nasal neurotomy were operated on 32 moderate-severe persistent AR patients who were insensitive to drugs and desensitization treatment,and curative effect were evaluated by scoring according to the diagnosis and curative effect evaluation standard of AR.Result:Follow-up evaluations were perfected after one year. Among them 17 cases were markedly effective,15 cases were effective,and the rate of total effective was 100%,without complications such as nose bleeds,dry eye,etc.Conclusion:The advantages of endoscopic-assisted posterior nasal neurotomy on moderate-severe persistent allergic rhinitis patients include the localization of posterior nasal nerve is clear,easy to operate,the short-term effect is remarkable,and less complications,therefore it's worth using on the AR patients who are failing in drugs and specific immune treatment.

Effect of nasal glucocorticoid combined with loratadine or montelukast on allergic rhinitis

Objective:To evaluate the effect of nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists on the treatment of moderate severe allergic rhinitis, and explore the optimal scheme of personalized treatment for AR patients.Method:Fiftyseven patients with persistent moderatesevere allergic rhinitis were randomly divided into three groups and treated by mometasone furoate aqueous nasal spray (group MOM), mometasone furoate aqueous nasal spray combined with loratadine (group MOM+L), mometasone furoate aqueous nasal spray combined with montelukast (group MOM+M) for 4 weeks. Four major clinical symptoms of allergic rhinitis: nasal congestion, nose itching, sneezing and runny nose were evaluated by "symptom rating score" before treatment and after treatment for 4 weeks.Result:After treatment, the total nasal symptom scores of each group showed a decreasing tendency, and the differences between various time points were statistically significant (P< 0.05). For the symptom of nasal congestion, the symptom score of MOM+M group was significantly lower than that of MOM group and MOM+L group at the 2nd and 4th week after treatment. For the symptoms of sneezing and nasal itching, MOM+L group had the lowest score at each time point after treatment and the difference was statistically significant compared with MOM group (P< 0.05), but there was no significant difference between MOM group and MOM+M group (P> 0.05). For the symptom of runny nose, the score of MOM+L group was significantly lower than MOM group (P< 0.05) at the 1st and 2nd week, MOM+M group was significantly lower than MOM group (P< 0.05) at the 2nd and 4th week, while there was no significant difference between MOM+L group and MOM+M group (P> 0.05).Conclusion:Nasal glucocorticoid alone or combined with secondgeneration antihistamines or leukotriene receptor antagonists can effectively control nasal symptoms of moderatesevere allergic rhinitis, yet the effect of combination therapy is better. For nasal congestion, nasal glucocorticoid combined with leukotriene receptor antagonists have a better effect. For nasal itching and sneezing, the choice of nasal glucocorticoid combined with second-generation antihistamines may be more sensible. For runny nose, nasal glucocorticoid combined with second-generation antihistamines or leukotriene receptor antagonists have similar efficacy.

Effectiveness of Moxibustion Combined with Conventional Treatment for Moderate-Severe Persistent Allergic Rhinitis: Protocol for a Randomized, Controlled Trial

Effectiveness of Moxibustion Combined with Conventional Treatment for Moderate-Severe Persistent Allergic Rhinitis: Protocol for a Randomized, Controlled Trial

Comorbidities and Phenotypes of Rhinitis in Korean Children and Adolescents: A Cross-sectional, Multicenter Study.

PurposeRhinitis is a nasal inflammatory disease in children and adolescents. However, little is known about the phenotypes and characteristics of allergic rhinitis (AR) in Korean children and adolescents. The objective of this study was to analyze the symptoms and comorbidities of rhinitis, to compare AR to non-allergic rhinitis (NAR), and to reveal the phenotypes and features of AR in a Korean pediatric population.MethodsPatients under 18 years of age with rhinitis symptoms were recruited from January 2013 to January 2015 by pediatric allergists. We analyzed symptoms, phenotypes, comorbidities, and allergen sensitization in this cross-sectional, multicenter study.ResultsMedical records were collected from 11 hospitals. The AR group has 641 (68.3%) patients, with 63.2% of boys and 7.5 (±3.4) years of mean age. The NAR group has 136 (14.5%) patients, with 55.1% of boys and 5.5 (±2.9) years of mean age. Moderate-severe persistent AR affected 41.2% of AR patients. Nasal obstruction was more common in NAR patients (P<0.050), whereas AR patients sneezed more (P<0.050) and more commonly had conjunctivitis, asthma, and otitis media (P<0.050). Sinusitis was the most common comorbidity in both groups. Allergen sensitization was caused by house dust mites (HDMs) (90.2%), pollen (38.7%), and animal dander (24.8%) in AR patients. Pollen and animal dander sensitization significantly increased age-dependently (P<0.050), but 91.9% of AR patients were already sensitized to HDMs before 5 years old.ConclusionsOur study revealed that AR was more prevalent than NAR and that 41.2% of AR presented with moderate-severe disease in Korean pediatric populations. Sinusitis was the most common comorbidity, and sleep disturbance was associated with the severity of rhinitis. The majority of AR patients were sensitized to HDMs in preschool ages. Further studies, including nationwide and longitudinal data, will help understand the relationship between these diseases.

Skin Prick Test Analysis in Allergic Rhinitis Patients: A Preliminary Study in Abuja, Nigeria.

Allergic rhinitis (AR) is prevalent in Nigeria, though little information exists on the allergen. We assessed the clinical features of AR patients in our environment based on the allergic rhinitis impact on asthma (ARIA) classification. Only patients with positive skin prick test (SPT) were recruited. Seventy-four patients participated in the study. AR and asthma comorbidity were observed in 13.5%. The proportion of “sneezers-runners” was higher than “blockers” with significantly more “sneezers-runners” having persistent AR (P = 0.007). No relationship was established between these predominant symptoms and the aeroallergens used in this study. Intermittent mild and moderate/severe AR were evident in 13.5% and 31.1%, while persistent mild and moderate/severe were seen in 20.3% and 35.1%, respectively. House dust mites allergen yielded the highest number of positive responses (22.6%) followed by tree pollen (16.8%). No relationship was observed between the allergens tested and AR severity. Majority of patients were oligosensitive (33.8%) and polysensitive (35.1%) and were not significantly associated with AR severity (P = 0.07). Most AR patients presenting for treatment in Abuja, Nigeria, had moderate-severe persistent AR and showed similar SPT sensitization pattern with countries having similar climatic conditions. Sensitization patterns were not related to ARIA classification or predominant AR symptoms.

Noninvasive measurement of nasal NO and fractional exhaled NO in healthy people and patients with allergic rhinitis

To measure the nasal nitric oxide (NNO) and fractional exhaled nitric oxide (FENO) in healthy people and patients with allergic rhinitis (AR), and to discuss the clinical significance of the results. Ninety-six healthy volunteers and 51 patients with moderate-severe persistent AR, but without asthma, were enrolled. NNO and FENO concentrations were measured noninvasively by using of NIOX MINO (Aerocrine AB, Solna, Sweden).SPSS 13.0 software was used to analyze the data. The concentration of NNO in healthy people was 245.0 [189.8;331.3] ppb (median [25th percentile; 75th percentile], the followings were same as). The concentration of FENO was 14.0 [10.0; 18.0] ppb. The concentration of NNO in patients with AR was 304.0[179.5; 397.5]ppb. The concentration of FENO was 21.0 [16.0; 40.5] ppb. The concentration of NNO in the AR patients was higher than that in the healthy persons, but the difference did not reach statistical significance (Z = 1.349, P = 0.177).On the other hand, FENO concentrations were significantly increased in patients compared with concentrations in healthy persons (Z = 5.555, P = 0.000). FENO concentrations of patients with moderate-severe persistent AR are increased significantly even though the patients do not have typical symptoms of asthma. This finding suggests that AR patients should be treated actively in order to prevent asthma from developing in them.

Turbinoplasty with Quantic Molecular Resonance in the Treatment of Persistent Moderate-Severe Allergic Rhinitis: Comparative Analysis of Efficacy

Allergic rhinitis (AR) presents as the main and most invasive symptom in the blocking of the nose. This condition is almost always related to hypertrophy of the inferior turbinates. When the medical treatments are found to be insufficient to solve the obstructive symptom of the patient, the quality of life is considerably impaired and it is often necessary to submit the patient to a surgical approach. In the present study we aimed to establish the efficacy and safety of a new technique recently introduced for the shrinkage of hypertrophic turbinates using a specific device, based on a new radiofrequency energy that does not produce thermal mucosal damage, viz., quantic molecular resonance (QMR) in a group of patients with persistent moderate-severe allergic rhinitis, in addition to standard medical treatment (nasal steroid and oral antihistamine). All patients were randomly assigned to two homogeneous groups (group A, control subjects; group B, treated patients); each group included 145 individuals. During the study, both groups received standard medications (ebastine, 10-mg tablet, and budesonide nasal spray at 100 micrograms/nostril per day) for 90 days. Before the medical treatment, patients in group B underwent inferior endoscopic turbinoplasty using QMR. All of the patients enrolled in this study were submitted to a complete otorhinolaryngologic evaluation with objective clinical examination (basal rhinomanometry, nasal provocation test rhinomanometry, and mucociliary transport time), endoscopy, and questionnaires (22-item Sino-Nasal Outcome Test and visual analog scale for nasal symptoms). Greater efficacy has been achieved using a combined approach with the association of medical and QMR treatment, compared with medical treatment alone, in the control of AR associated with hypertrophy of the inferior turbinates, in particular in the reduction of turbinate volume at rhinoendoscopy. QMR inferior turbinoplasty, in conjunction with medical therapy, improves the nasal flow, without any thermal mucosal damage, more effectively when compared with medical treatment alone in persistent moderate-to-severe AR. In particular, local reactivity, as measured with nasal provocation test, was noticeably reduced.

The Quality of Life - An Indicator of Fair Treatment of Allergic Rhinitis

The current concept of quality of life reported to health status is described by patients in relation to personal expectations. These expectations vary over time and are influenced by the duration and severity of disease, the limitations of any kind, and family support. Quality of life is measured using individual questionnaires. These questionnaires are multidimensional and cover multiple aspects such as physical condition, emotional, social and cognitive status. Other aspects of the questionnaire refer to the individual's status in society and the perception of sickness. The purpose of this study was to estimate the quality of life of patients with allergic rhinitis and to establish the best treatment. To assess quality of life we used five symptoms score and visual analog scale. We have studied 92 cases with allergic rhinitis. Patients included in the study were between 6 and 18 years. Patients completed questionnaires that reflect quality of their life. Depending on the severity of symptoms patients were divided into two groups: patients with mild persistent allergic rhinitis (22%) and patients with moderate-severe persistent allergic rhinitis (78%).