Treatment Of Rhinitis In Children Research Articles

Comparing effectiveness of various decongestants in the treatment of acute infectious rhinitis

Rhinitis is characterized by nonspecific symptoms, but they reduce the quality of life as much as possible. Within the framework of this work, the clinical efficacy of drugs based on tuaminoheptane and xylometazoline was evaluated. To achieve this goal, the authors initiated a prospective single-center non-randomized comparative pilot study, the task of which was to compare the effectiveness of intranasal drugs containing tuaminoheptane sulfate and acetylcysteine (Rinofluimucil) and xylometazoline + seawater in pediatric patients with acute uncomplicated rhinitis.Characteristics of children and research methods. The study included patients who met the inclusion / exclusion criteria, they were divided into 2 groups after a standard ENT examination (patients of Group 1 were prescribed with tuaminoheptane sulfate and acetylcysteine (Rinofluimucil), patients of Group 2 were prescribed with a combination of xylometazoline and sea water. The study included 61 patients (32 boys and 19 girls aged 4 to 16 years): 30 patients in Group 1 (tuaminoheptane sulfate and acetylcysteine, Rinofluimucil) and 31 patients in Group 2 (xylometazoline + sea water); comparable by sex and age.Results. Comparison of the patients’ condition at the beginning and at the end of the treatment course demonstrated that both drugs had a therapeutic effect: for each of the assessed indicators in both study groups, there was a pronounced positive trend (statistically significant for all studied symptoms, p<0.01). None of the observed patients during treatment demonstrated unwanted side effects and complications in the middle ear.Conclusion. Intranasal use of a combination of tuaminoheptane sulfate and acylcysteine (Rinofluimucil) has shown efficacy comparable to that of an intranasal spray containing xylometazoline in the treatment of acute uncomplicated rhinitis in children. The advantage of a drug based on tuaminoheptane is the expected gentle effect on the mucous membrane of the nasal cavity and the additional therapeutic effect of the original acetylcysteine, which is characteristic of Rinofluimucil.

The current state of the problem with the diagnosis and treatment of allergic rhinitis in pediatric practice

Among all allergic diseases in pediatric practice, allergic rhinitis is one of the most common pathologies of the upper respiratory tract. This review deals with the problem of modern principles for the diagnosis and treatment of allergic rhinitis in children based on the analysis of literature sources using electronic databases PubMed, Web of Science, MedLine, the Cochrane Library. Allergic rhinitis is an important medical and social problem of our time the importance of which has increased significantly in recent years. The growing number of people sensitized to pollen, the variety of symptoms and the negative impact on the quality of life of patients make pollen allergy one of the major problems in pediatrics. Despite the development of international national protocols and clinical guidelines, in many countries the control of allergic rhinitis in children remains insufficient. Therefore, it is necessary to take into account the individual characteristics of patients, pay attention to both nasal and extranasal symptoms, consider all pathognomonic diagnostic aspects, because the underdiagnosis of this allergic disease leads to inadequate therapy, complications, more severe atopy and reduced quality of children’s life in general. Recently, there is growing evidence of the need for personalized selection of the most effective therapy for allergic rhinitis in children. In-depth study of the pathogenetic role of circadian molecular clock in children with seasonal allergic rhinitis using informative molecular genetic methods may allow characterizing in detail the mechanism of regulation of allergic inflammation of the upper airway mucosa and evaluating the role of circadian genes in the development of allergic diseases, in particular allergic rhinitis. In the future, these studies may become an alternative to improve control over the course of allergy and the organization of a comprehensive monitoring system, development of new strategies for the treatment and prevention of allergic rhinitis in children.

Aspects of differential diagnosis and treatment of rhinitis in children under 2 years of age

Introduction.Clinical manifestations of rhinitis have a negative impact not only on the physical, social, and psychological health of children, but also on their parents, especially in families with a first child. Nasal congestion, nasal breathing difficulty cause problems with sleep and feeding.Aim of the study.To estimate the occurrence of rhinitis in children under two years old in the outpatient practice of otorhinolar-yngologists, to consider features of the course and differential diagnostics of various rhinitis types, to evaluate the effectiveness of nasal irrigation-elimination therapy in the treatment of acute rhinitis symptoms.Materials and Methods.Between September 2020 and July 2021, 220 patients between 0 to 18 years were managed: preschool-aged patients comprised 120 patients (54.5%), of whom 27 patients under two years old had symptoms of rhinitis, including those with symptoms lasting more than two weeks.Results.Among the patients referred to us, infectious rhinitis was diagnosed in the majority of cases - in 18 patients (66,7%), which can be explained not only by the timing of the study but also by the highest prevalence of this pathology among the diseases of the nasal cavity. Allergic and non-allergic rhinitis occurred in only 4 (14.8%) and 5 (18.5%) persons, respectively. Symptomatic irrigation therapy with saline solutions is just as necessary for young children as it is for older children and adults. Some difficulties in nasal cavity care during rhinitis are the anatomical narrowness of the nasal passages and lack of blowing skills in young children. In these situations, preference should be given to gentle, non-traumatic, gentle aspiration with prior irrigation of the nasal cavity with an isotonic saline solution. When a nasal aspirator was used, there was a decrease in the duration of nasal discharge during the illness and a reduction in the duration of the disease.Conclusion.Rhinitis in young children is a common but underestimated problem. Clinical manifestations are more often associated with typical symptoms: nasal congestion, discharge, nasal breathing difficulty, and sneezing. The use of irrigation-elimination intranasal therapy with the use of a nasal cavity aspirator can reduce the timing of clinical symptoms of rhinitis and reduce the overall duration of the disease.

Досвід застосування левоцетиризину в терапії алергічного риніту в дітей

У роботі наведено досвід застосування антигістамінного препарату третього покоління левоцетиризину (L-Цет, ТОВ «Кусум Фарм») у терапії алергічного риніту в дітей. Доведено високу ефективність препарату, добру переносимість та зручність у застосуванні, що дозволяє рекомендувати його для комплексної терапії алергічного риніту в дітей.

An Instant, Safe, Antihistamine, Anti-Inflammatory and Decongestant Polymeric Nasal Barrier to Prevent and To Treat Allergic Rhinitis in Children

Introduction: Allergic rhinitis (AR) in children is a common chronic pathology with a strong impact on patient quality of life. The main physiopathology affects the nasal cavity as a multi-factorial disease involving nasal mucosa damage, nasal inflammation with high concentrations of histamine, pro-inflammatory cytokines such as histamine, TNF-α, IL-4, IL-5, IL-6, IL-10, IL-13, and IgE antibodies on the nasal mucosa. Systemic entry of these proteins through damaged nasal mucosa maintains continued inflammatory and allergen cascades. Therefore, an ideal treatment should be multitarget in order to stop allergen exposure, inflammation, and nasal mucosa barrier degradation, but such treatments are nearly impossible to conceive. We envisaged an osmotic and protective nasal barrier film, not only capable of protecting the nasal mucosa from allergen exposure but also of trapping and neutralizing selected cytokines and cleaning the nasal surface continuously without using any harmful substance for children. Materials and Methods: We associated highly osmotic glycerol solution with specific plant polymers to conceive an osmotic but stable film. As plant polymers (tannins) can bind with selective proteins, a range of glycerol binding non-cytotoxic polymers were screened using the sandwich ELISA method to select those having binding affinity for allergen induced nasal proinflammatory cytokines. After verifying cytotoxicity and irritant potential, a 15-day observational clinical study was performed with approval from the ethics committee on 30 children aged between 4-13, suffering from allergic rhinitis. The test product (TP) was supplied in 15-ml nasal sprays and applied 2-3 times per day for a period of 15 days. Saline solution served as control (CP). The scores of nasal and ocular symptoms, effect on quality of life, eosinophil count in nasal smears, and need for antihistamine treatment was evaluated at the start, at 30 minutes and on days 2, 3 and 15 of treatment. Results: A few specific polymers were able to bind with selected cytokines and histamine at adequate filmogen concentrations. The osmotic film was stable, non-irritant and was able to clean the nasal mucosa continuously for 4-6h after each application. Clinical observations of Total Nasal Symptom Score (TNSS) grouping the scores of nasal congestion, runny nose, sneezing, and itching, revealed a strong decrease right after the 1st treatment in both groups but the reduction was much stronger and faster with the TP. The mean TNSS score reduction was 44.74% in CP vs 83.53% in the TP group after 7 days of treatment (p<0.001). Total Ocular Symptom Score (TOSS) was decreased by 21.13% and 51.41% in CP v/s 35.12 and 99.59% in TP group on days 2 and 7, respectively. Nasal smear eosinophil count was equally strongly reduced in the TP v/s CP group. No treatment-related side effects were recorded in any of the groups. Conclusion: Protecting the nasal mucosa against allergens, neutralizing inflammatory cytokines, and keeping the nasal surface clean with an osmotic polymeric film, constitute a major breakthrough for the treatment of allergic rhinitis in children. This simple but scientific and logical approach should avoid exposing children to chemicals and to their long-term side effects.

ДОСВІД ЗАСТОСУВАННЯ ХОЛЕКАЛЬЦИФЕРОЛУ В ЛІКУВАННІ АЛЕРГІЧНОГО РИНІТУ В ДІТЕЙ.

Метою даного дослідження було оцінити ефективність застосування препарату вітаміну D3 в комплексній терапії алергічного риніту (АР) у дітей. Під нашим спостереженням перебувало 34 дитини із сезонним та цілорічним алергічним ринітом, у сироватці крові яких визначали рівень 25(ОН)D за різних режимів дозування холекальциферолу. Вихідний рівень 25(ОН)D у сироватці крові дітей з АР становив 26,91 нг/мл (Me=26,91; Q1=18,23; Q3=28,91), після застосування препарату вітаміну D3 в дозі 2000 щодня протягом 2 місяців – 37,56 нг/мл (Me=37,56; Q1=27,78; Q3=42,35), після літньої пори (без приймання холекальциферолу) – 38,12 нг/ л (Me=38,12; Q1=34,26; Q3=44,79) та після призначення підвищених доз холекальциферолу (4000 МО щодня під час ремісії захворювання та 5000 МО щодня під час загострення хвороби курсом 2 місяці) – 48,35 нг/мл (Me=48,35; Q1=43,67; Q3=62,78). Дітям з алергічним ринітом після застосування підвищених доз препарату вітаміну D3 було рекомендовано приймання холекальциферолу цілорічно, крім літніх місяців, у підтримуючій дозі – 1000 МО щодня, а при загостренні захворювання рекомендовано підвищувати добову дозу до 2000 МО щодня. Хворі під нашим спостереженням перебували протягом 1–1,5 року. При проведенні оцінки клінічного перебігу алергічного риніту в дітей відмічалось полегшення перебігу захворювання, що вказує на доцільність застосування холекальциферолу в дітей з АР цілорічно, крім літніх місяців.

Алергічний риніт і бронхіальна астма у дітей: оцінка ефективності левоцетиризину

The aim of the study was to investigate the efficacy and safety of the drug Cetrilev for treatment children withallergic rhinitisand asthma. Methods. 60 children aged 6–14 years with persistent allergic rhinitisand asthma were included in this study. All the children were divided into two groups: group 1(32 children) and group 2 (29 children). Group1 of children were given Cetrilev («Euro Lifecare LTD») in addition to the standard treatment, with a dosage of 1 tablet (5 mg) per day for 4 weeks. Children from the comparison group 2 received only the standard treatment. As a standard treatment of Asthma, Montelukast 5 mg was given once daily in the evening. To evaluate the effectiveness of all the children held a score of symptoms of allergic rhinitis and asthma, spirometry, nasal cytology, asthma control testing. Results. The study have shown that the inclusion of the drug Cetrilev in therapy children with allergic rhinitis and asthma had a positive effect on symptoms such as rhinitis and asthma. Children of the group1had significant regression of symptoms of allergic rhinitis , reduction of inflammatory changes in the mucosa of the upper respiratory tract, improvement of lung function. Conclusion: Therapeutic effect of the drug Cetrilev is associated with anti-allergic and anti-inflammatory effects. The absence of side effects, good tolerability of this drug can be recommended for its treatment of allergic rhinitis in children of school age with asthma. Key words: allergic rhinitis,asthma, treatment, levocetirizine.

The effectiveness of an isotonic solution of sea salt with panthenol in the treatment of allergic rhinitis in children

The article presents the results of research on the effectiveness of using an isotonic solution of sea salt with panthenol in the treatment of allergic rhinitis in children.

Chinese herbal medicine modified Yu ping feng San Formula for treatment of Allergic Rhinitis in Children: a systematic review

Purpose: CGX is a modification of a traditional Korean herbal medicine, which is under clinical trial phase III for hepatofibrosis therapeutic effect. The objective is to present the status for CGX development regarding its clinical backgrounds, pharmacological studies in animal models, and current process of randomized clinical trial. Methods: CGX has been used for patients suffering various liver diseases, including chronic viral hepatitis and alcoholic liver disorders. The safety of CGX was evaluated in animalbased repeated toxicological studies using rats and beagle dogs. The pharmacological actions against hepatic fibrosis were evidenced in various chronic liver injury animal models using chemicals (CCl4, DMN, or TAA), chronic alcohol consumption, choline-deficient (MCD) diet, and bile duct ligation (BDL) respectively. It is now under a ramdomized controlled multicenter trial.phase III for hepatofibrosis. Results: The total number of participants is 174 in 2 Hospitals, who are suffering from chronic HBV, HCV or Alcoholic liver disease. The inclusion criteria is patientswith LSM5.5 kPa to 16kPa, aged between 18∼75 year. The exclusion criteria is the conditions of too severe status as follows; ascites, esophageal varix, TB > 3mg/dl, AST, ALT > ULN > 5 folds, INR > 2.0 or platelet 30. The drug treatment period is 6 months for 3 groups (placebo, 1gram or 2 gram of CGX daily). The primary measurement is the changed value of LSM (liver stiffness mesurement) during 6 months, and the secondary measurements are the changed value of hyaluronic acid (HA), serumTGF1, PDGF, AST to platelet ratio index (APRI) and QOL (SF-36) respectively. Conclusion: It is expected that multi-sites clinical trial evidences the fibro-therapeutic effects of CGX in patients with chronic viral or alcoholic liver diseases. Contact: Chang Gue Son, ckson@dju.ac.kr

TREATMENT OF ALLERGIC RHINITIS IN CHILDREN: SELECTION OF ANTIHISTAMINE DRUG AND NECESSITY OF FURTHER INVESTIGATIONS

This literature review contains analysis of research results on treatment of allergic rhinitis in children according to the evidence-based medicine. Oral and intranasal antihistamine drugs along with intranasal steroids are the first-line drugs for treatment of allergic rhinitis, although the latter are more efficient in suppression of nasal stuffiness. First- and second-generation antihistamine agents used nowadays in medical practice are discussed in the article. The advantages of non-sedative 2d-genereation antihistamine drugs, especially so called active metabolites (fexofenadine, cetirizine, levocetirizine, desloratadine) are emphasized. The data on loratadine and desloratadine as ones of the most effective drugs in childhood allergic rhinitis are shown in detail. The possible directions for the further investigations in order to provide effective control over allergic inflammation in children resistant to medicinal agents are discussed.

ACUTE RHINITIS IN CHILDREN

Acute rhinitis as a manifestation of acute respiratory infection is one of the most common complaints in pediatric practice. High prevalence of this condition, significant impact of the symptoms on the life quality of a child and frequent complications cause the necessity of the further search for the appropriate treatment of acute viral rhinitis in children.

Microdisperse cellulose powder for prevention of allergic rhinitis in children

The data of open comparative clinical study is given according to efficiency and safety of microdisperse cellulose powder used for prevention and treatment of allergic rhinitis in children.

Effectiveness and tolerability of Euphorbium comp. SN for the symptomatic treatment of rhinitis in children aged 2–6 years

Background Complementary/alternative medicine (CAM) is commonly used for symptomatic treatment of rhinitis. The effectiveness and tolerability of the homeopathic preparation Euphorbium comp. SN in young children was studied in daily clinical practice. Methods Prospective observational study conducted in 25 practices (paediatric, general and internist) in Germany. Included were children aged 2–6 years, diagnosed with acute rhinitis. The treatment with Euphorbium comp. SN was administered as nasal spray dosed at 3×1 spray puffs/day. Changes in doses and daily regimens were at the discretion of the treating physicians. The observation period was 6 days. Only patients with no concomitant therapies administered as nasal sprays during the course of the observation period were included in the analysis. Effectiveness was evaluated on symptomatic improvement (Likert scale) between the time of enrolment and the last observation. Effectiveness variables were symptoms of rhinitis, overall degree of illness, improvement (yes/no) and tolerability of therapy. Effectiveness and tolerability were evaluated by the treating physicians together with parents. Results The study included 283 subjects, 47% of which were female. Mean age was 4.1±1.1 years; height 102.7±10.6 cm (range 76.0–103.0 cm); mean weight 16.9±3.8 kg (range 10.0–16.0 kg). The mean duration of observation was 6.6 ±2.1 days. At inclusion, the mean duration of illness was 5.4±10.7 days. Doses of Euphorbium remained unchanged during the observation period in 97% of subjects. The percentage of subjects with moderate-to-severe symptoms was reduced during the course of therapy from 137 (48%) at the first visit to 18 (6%) at the final observation. No subjects had severe symptoms at the end of the observation period, down from 5 at inclusion. At the end of the observation period, the overwhelming majority of subjects (95%) were considered improved and 82% were free of symptoms. The mean lag time between the start of therapy and the first symptomatic improvement was 2.1±1.3 days. The treatment was well tolerated, with 97% of treating physicians reporting ‘very good’ or ‘good’ tolerability. This assessment was shared by 96% of parents. Conclusions The homeopathic preparation Euphorbium comp. SN is an effective and well tolerated therapy for the symptomatic treatment of acute rhinitis in young children in everyday clinical practice.

Quality of Life and Safety of Olopatadine HCl Nasal Spray for the Treatment of Seasonal Allergic Rhinitis in Children

Quality of Life and Safety of Olopatadine HCl Nasal Spray for the Treatment of Seasonal Allergic Rhinitis in Children

Allergic rhinitis in children : diagnosis and treatment

Allergic rhinitis is a common disease of childhood characterized by nasal, throat, and ocular itching, rhinorrhea, sneezing, nasal congestion. Those affected with allergic rhinitis often suffer from associated inflammatory conditions of the mucosa, such as allergic conjunctivitis, rhinosinusitis, asthma, otitis media with effusion, and other atopic conditions, such as eczema and food allergies. Allergic rhinitis must be diagnosed and treated properly to prevent complications and impaired quality of life. Despite a high prevalence, allergic rhinitis isoften undiagnosed and inadequately treated, especially in the pediatric population. The first step in treatment is environmental control when appropriate. It may be difficult to eliminate all offending allergens effectively to reduce symptoms, so medications are often required. Many different classes of medications are now available, and they have been shown to be effective and safe in a large number of well-designed, clinical trials. Antihistamines are effective in treating immediate symptoms of sneezing, pruritus, watery eyes, and rhinorrhea. Second generation antihistamines are the preferred antihistamines because of their superior side effect profile. Thus, decongestants are commonly used with oral antihistamines. Intranasal corticosteroids are the most effective therapy for allergic rhinitis. Leukotriene modifier may be as effective as antihistamines in treating allergic rhinitis symptoms. Cromolyn sodium is an option for mild disease when used prophylactically, and ipratropium bromide is effective when rhinorrhea is the predominant symptom. When avoidance measures and medications are not effective, specific immunotherapy is an effective alternative. Only immunotherapy results in sustained changes in the immune system. Because of improved understanding of the pathogenesis, new and better therapies may be forthcoming. The effective treatment of allergic rhinitis in children will reduce symptoms and will improve overall health and quality of life, making a happier, healthier child. (Korean J Pediatr 2006;49:593-601)

Optimum Treatment of Allergic Rhinitis in Children

Allergic rhinitis is a very common disease, occurring in 10% of children and up to 20% of adolescents. The effects of the disease are frequently underestimated and not regarded as a serious health problem. However, if not properly treated, the disease is associated with harmful sequelae and poor quality of life. The treatment of allergic rhinitis in children depends on 3 therapeutic approaches: avoidance of provoking factors, pharmacological therapy and immunotherapy. Environmental control measures should be directed against allergens as well as against nonspecific irritating factors such as tobacco smoke. Conventional therapy depends on the appropriate selection and combination of antihistamines, mast cell stabilisers, decongestants and topical corticosteroids. Immunotherapy must not be used indiscriminately and should be prescribed only when clearly indicated. Compliance with the treatment regimen is an essential element of therapeutic success.

Cetirizine treatment of rhinitis in children with pollen allergy: evidence of its antiallergic activity

Cetirizine treatment of rhinitis in children with pollen allergy: evidence of its antiallergic activity

Cetirizine treatment of rhinitis in children with pollen allergy: evidence of its antiallergic activity

Cetirizine is an antihistamine, largely used in the treatment of allergic rhinoconjunctivitis, which also exerts anti-allergic activity. To evaluate cetirizine as treatment for children with rhinitis due to pollen allergy, and to evaluate its anti-allergic activity in such a clinical condition. The study was designed as parallel groups, double-blind, placebo-controlled, randomized. Twenty allergic children were enroled and subdivided in two groups, receiving a 4 week treatment during the pollen season. The following parameters were monitored: clinical symptoms evaluated by the allergist before and after treatment and by the patients through a daily diary card, inflammatory cells count, expression of ICAM-1 on nasal epithelial cells, inflammatory mediator levels in nasal lavage and peripheral blood before and after treatment, and pollen counts. This study shows that cetirizine treatment is able to reduce: clinical symptoms (P < 0.01), inflammatory cell infiltrate (P < 0.03), ICAM-1 expression on epithelial cells (P < 0.05), and soluble ICAM-1 (P < 0.05) and ECP (P < 0.05) in nasal lavage. Cetirizine is able to clinically improve nasal symptoms due to pollen allergy and to reduce allergic inflammation, which is related to allergen exposure.