Viral Rhinitis Research Articles

Sistem Pakar untuk Diagnosis Rinitis pada Anak menggunakan Metode Certainty Factor

Expert systems can assist an expert in making decisions that are realized in the form of a program. At this time the program is very helpful in improving various fields such as health, by managing the information that has been obtained. In this research, rhinitis is raised as a topic of discussion by working with experts who are experts in the field, after collecting data through interviews, the conclusion is obtained, namely how to determine whether someone has one of the three types of rhinitis (allergic rhinitis, bacterial rhinitis, and viral rhinitis) with the symptoms experienced and with a fast and accurate process. By using the certainty factor method and applying it to a web-based expert system, it makes it easier for patients and experts to solve the problem, there are 31 types of symptoms among the three types of rhinitis diseases that are used as the basis for the expert system after that with data from 20 patients at the hospital who suffer from various symptoms of rhinitis who have been diagnosed with the disease by experts as validation data and trials it is found that the system is 100% successful in accurately diagnosing each disease in all these patients.

Potential of topical therapy for acute rhinitis in paediatric practice

Rhinitis is an inflammation of the nasal mucosa with rhinorrhea, nasal congestion, sneezing and nasal itching. Rhinitis can be acute or chronic (allergic rhinitis, non-infectious rhinitis, infectious rhinitis) with nasal symptoms, ophthalmological symptoms, ear congestion, sore throat, postnasal drip, cough. Up to 98% of cases of acute infectious rhinitis develop against the background of an acute respiratory viral infection. The pathogenesis of acute viral rhinitis and acute viral sinusitis is based on nasal congestion, difficulty in mucociliary transport and blockage of the paranasal sinuses. When prescribing treatment for children with acute viral rhinitis and acute rhinosinusitis, it is necessary to take into account the age and weight of the child, use elimination therapy and improve drainage of the paranasal sinuses. The use in pediatric clinical practice of the combined decongestant, which includes α2-adrenomimetic and dexpanthenol, is effective and safe in the treatment of almost all conditions accompanied by nasal congestion, promotes rapid restoration of nasal breathing.

Treatment Regimen for Acute Viral Rhinitis in Patients with a History of Rhinitis Medicamentosa

Aims: The aim of this research is to study the efficacy of intranasal administration of 0.9% saline solution in patients with acute viral rhinitis and a history of Rhinitis medicamentosa.
 Materials and Methods: The study included 96 patients with a confirmed diagnosis of acute viral rhinitis and a history of Rhinitis medicamentosa. All patients were equally randomized to two groups. In both groups, patients were treated according to the European Position Paper on Rhinosinusitis and Nasal Polyps with nasal decongestants (oxymetazoline), but in Group 2, the treatment regimen was supplemented with topical use of 0.9% saline solution. Local TNF-α and IL-1β levels were determined in all patients on Days 1, 5, and 10. In addition, on the next day after oxymetazoline withdrawal, a Nasal airway resistance was measured in all patients using active posterior rhinomanometry.
 Results: The duration of rhinorrhea and nasal congestion and, respectively, the duration of oxymetazoline administration significantly differed between the groups (p<0.001) and was 7.9±1.1 days for Group 1 and 4.7±0.9 days for Group 2. In general, the dynamics of changes in local TNF-α and IL-1β levels in both groups was similar. Throughout the study, there was a progressive decrease in both inflammatory mediators, with faster changes occurring in Group 2. A strong positive correlation (rs=0.89; p<0.001) between TNF-α and IL-1β levels was established. According to the results of active posterior rhinomanometry on the day following oxymetazoline withdrawal, Nasal airway resistance was significantly higher in Group 1 (p<0.001), which indicates the presence of difficulty breathing in patients of this group. In addition, patient examination showed that manifestations of Rhinitis medicamentosa occurred in 3 (6.25%) patients of Group 1 and in 17 (35.42%) patients of Group 2. Differences between the groups were significant (p<0.01).
 Conclusion: The use of topical nasal decongestants, in particular oxymetazoline, in patients with acute viral rhinitis and a history of Rhinitis medicamentosa for more than 7 days has a potential risk of development of a recurrence of Rhinitis medicamentosa. Supplementing the treatment regimen for acute viral rhinitis with the topical use of 0.9% saline solution reduces the duration of treatment and the use of topical decongestants, and therefore prevents the recurrence of Rhinitis medicamentosa.

An unusual case of nasal foreign body presenting as recurrent otitis media

Otitis media (OM) is a common problem involving children. In the majority, the cause is related to dysfunction of the Eustachian tube due to bacterial or viral rhinitis and less commonly due to nasopharyngeal tumors. We present a case of recurrent OM which was evaluated and incidentally found a nasal foreign body for which the patient was asymptomatic. This nasal body was the cause of recurrent OM which is very unusual.

Dynamics of Changes in Quality of Life and Local Levels of TNF-α and IL-1β in Patients with Acute Viral Rhinitis

Introduction: Acute viral rhinitis is one of the most common pathologies among the population of the globe. Although, at first glance, this pathology seems simple and well-studied, but due to the high incidence, the load it creates on the health care system encourages in-depth study.
 Aims: To examine the dynamics of changes in quality of life and local levels of TNF-α and IL-1β in patients with acute viral rhinitis in different treatment regimens.
 Methodology: The prospective study included 84 patients with a confirmed diagnosis of acute viral rhinitis. In accordance with the purpose and objectives of the study, all patients on days 1, 5 and 10, in addition to routine studies, were determined by local levels of TNF-α and IL-1β, as well as to determine the quality of life.
 Results: In patients of the study group, only partial recovery of local levels of TNF-α and IL-1β and indicators of the physical component of quality of life was observed during 10 days of treatment. The emotional and functional components of quality of life in patients of this study were more correlated than with the physical component and local levels of proinflammatory cytokines, which are objective indicators of the activity of the inflammatory process. Complementing the traditional treatment regimen with 0.25% oxolin in the form of an ointment has reduced the duration of the disease, reduced the incidence of bacterial complications and improved the quality of life of patients with acute viral rhinitis in the short term.
 Conclusions: The dynamics of local levels of TNF-α and IL-1β reflects the nature of the inflammatory process in the nasal mucosa and clearly correlates with the physical component of quality of life.

Ways to prevent acute viral infection and its bacterial complications

Viruses of the ARVI group that are tropic to the epithelium of the upper respiratory tract are able to inhibit the function of the mucociliary system to a certain extent, which contributes to the attachment of bacterial infection. Thus, in respiratory inflammatory diseases, the infection is often combined. This means, that the question about approaches to treatment at the stage of prevention of the development of complications of ARVI arises. A significant increase in the relapse of chronic sinusitis has been observed over the past 10 years. According to A.I. Kryukov et al. the relapse of inflammatory diseases of the paranasal sinuses, the chronic process has no tendency to decrease, aided by the unfavorable ecological situation, the growth of allergic and viral respiratory diseases, poor nutrition to which the body is not evolutionarily adapted. Worsening of chronic sinusitis contributes to many factors, but the starting point is almost always viral infections. Relapse, as a rule, begins with viral rhinitis, which is rarely an independent disease. Most often, a runny nose is a symptom of ARVI or ARI (influenza, parainfluenza, adenovirus infection, etc.). The entrance gate of infection is the epithelial cells of the respiratory tract. The main pathological process in sensitive cells develops both as a result of the penetration of the virus from the outside, and due to the activation of latent or chronic viral infection under the influence of various factors, including other infection.The appointment of drugs with anti-inflammatory, immunomodulatory, adaptogenic activity is one of the promising options for the prevention of both primary viral infection and the development of bacterial complications.We have included a drug that combines adaptogenic and immunomodulatory activities in the treatment of chronic sinusitis. Trekrezan belongs to the group of adaptogens – low-toxic compounds, it is recommended as a measure for the treatment and prevention of viral infections and increasing resistance to various stress factors (hypoxia, hypothermia) and adverse environmental effects.

Technological aspects of the development of anti-viral activity nasal gel

Today, there is a clear tendency among the Ukrainian population to increase the incidence of viral rhinitis. Among the nasal medicines of symptomatic action for this pathology treatment in the modern Ukrainian pharmaceutical market there are, mainly, synthetic drugs of foreign production, many of which are made in the form of drops or sprays. However, more and more attention is paid to nasal gels use, which ensure the maintenance of active ingredients on the nose mucous membrane, do not violate the movement of the flashing epithelium, maintain the natural moisture of the nasal mucosa and have prolonged therapeutic action.Aim. To develop the technology of a new native nasal gel based on plant biologically active substances origin for the symptomatic treatment of viral rhinitis.Materials and methods. The work uses physical-chemical, structural-mechanical, technological, microbiological and statistical methods.Results. Based on the colloidal study, thermal stability, pH, rheological properties and osmotic activity of the studied gel samples, the rational concentrations of auxiliary substances in its composition were determined. Rational concentrations of active pharmaceutical ingredients (licorice root dry extract, Siberian pine and Eucalyptus essential oils) have been established based on microbiological studies. It is shown that the technology of nasal gel should consist of the base preparation and the active ingredients subsequent introduction. Taking into account the physical and chemical properties of active pharmaceutical ingredients, namely their solubility, licorice root dry extract are introduced into the gel in the form of aqueous solution, and essential oils – in the form of a solution in ethanol (96 %).Conclusions. Based on the complex of conducted experimental researches, rational technology of nasal gel under the conventional name “Phytorin-plus” was developed. The critical parameters in the process of its production (time of homogenization – 20 min, speed of the blade mixer rotation – 42 rpm, speed of the anchor mixer rotation – 20 rpm, the vacuum depth – 0.6-0.7 bar) were established.

Study of the nasal gel’s “Phytorin-plus” stability for the treatment of viral rhinitis

Topicality. In order to treat viral rhinitis effectively, it is actual to create new nasal gels with a complex antiviral and antimicrobial action. The nasal gel under the conventional name “Phytorin-plus” with the content of dry licorice root extract, essential oils of eucalyptus and pine for the treatment of this pathology was developed at the Technology of Drugs Department of the NUPh. Aim. To investigate the stability, establish the shelf life and storage conditions of the proposed gel.Materials and methods. The study subjects were five series of samples of nasal gel “Phytorin-plus”. In accordance with the requirements of the State Pharmacopoeia of Ukraine, the quality control of the medicine was carried out according to the indicators: description, homogeneity, identification and quantitative determination of active ingredients, pH value, microbiological purity, weight of the contents of the package. Rheological properties were studied on a viscometer BROOKFIELD DV-II + PRO (USA).Results and discussion. Based on the complex of physical, chemical and structural-mechanical researches, the shelf life and storage conditions of the nasal gel were determined for 2 years in aluminum tubes at a temperature of (8-15) °C and/or (15-25) °C. It has been shown that gel “Phytorin-plus” is a structured system with certain thixotropic properties. Calculated parameters of mechanical stability and coefficients of dynamic dilution of samples of the medicine confirm its stability in the process of storage.Conclusions. The stability of the nasal gel has been “Phytorin-plus” was experimentally studied, its shelf life and storage conditions have been determined.

Experimental substantiation of the base of the nasal gel for viral rhinitis treatment

Purpose of the study . Experimentally substantiate the composition of the nasal gel’s base for the viral rhinitis treatment. Materials and methods . In order to select structure-forming component in the gel base, the authors investigated the possibility of using sodium carboxymethylcellulose, methylcellulose, PEO-4000 and PEO-400, carbopol 934 P, hydroxyethylcellulose, xanthan, and sodium alginate as a gelling agent. Solutions of ammonia, sodium hydroxide and triethanolamine were used to neutralize aqueous dispersions of carbopol. To ensure moderate osmotic activity, to prevent drying and irritation of the skin, a hydrophilic non-aqueous solvent, propylene glycol, is incorporated into the gel base. Organoleptic, physical, chemical, structural-mechanical and biopharmaceutical parameters of model samples of nasal gel were determined by the methods of the State Pharmacopoeia of Ukraine. Statistical processing of the results was carried out with the help of the program Statistica 6.0. Results . The choice of the optimal gelling agent was carried out based on the studies of organoleptic, physical, chemical, structural-mechanical and biopharmaceutical indices of model samples of the gel. The authors selected carbopol 934 P as the gelling agent. The optimum concentration of the selected gelling agent and the neutralizing agent in the composition of the gel base was established basing on the study of the pH of the model base samples. The sample with the content of carbopol 934 P at a concentration of 1.5 % and triethanolamine at a concentration of 1.5 % was closest to the normal pH of the mucous membrane of the nasal cavity; it also possessed the most satisfactory rheological parameters. The choice of the optimum amount of propylene glycol in the gel base is based on the study of the osmotic activity of the samples. The optimum concentration is 10 %. Ethanol (96 %) in the gel base was used as a solvent for essential oils that are the part of the nasal gel at a concentration of 3 %. Conclusions. Based on the conducted organoleptic, physical, chemical, structural-mechanical and biopharmaceutical studies, the composition of the nasal gel’s base for the viral rhinitis treatment was experimentally substantiated.

Don’t Hurt Anybody, or You’ll Get the Mare: Connections between Common Cold and the Mythical Being slogutis in Lithuanian Folklore

In the Lithuanian folk medicine, classification of illnesses rests on several aspects, including separation of sicknesses affecting children and grownups, or discerning conditions caused by other untreated troubles (like fright). Based on the level of contagiousness, infectious and noncommunicable illnesses are discerned. Those considered infectious encompass a rather broad range: from epidemic (like plague and cholera) to skin complaints (warts and scabies). The article is centered on the Lithuanian folk belief (LTR 1415/119/) attributing common cold to the infectious illnesses. Since this is an unprecedented case, the research aims at finding out if common cold was considered an infectious decease in the Lithuanian folk medicine and if so, on what grounds. The author attempts establishing a potential connection between cold (Lith. sloga) and the mythical being incubus (Lith. slogutis); also her aim is finding out if common cold meant the same thing in the 19th – 20th centuries as it does in the 21st one.According to the data from the “Dictionary of the Lithuanian Language”, other vernacular names for the cold (viral rhinitis) are established. This prompts deeper investigation of other possible meanings of the word sloga, thus leading to further examination of its fourth meaning – namely, the mythical being slogutis.According to etiological and folk belief legends, slogutis (incubus, or nightmare), a being that tortures people in their sleep, most frequently evolves from the dead unbaptized children. This being can appear both in anthropomorphic (child, man, woman, Jew) or zoomorphic (cat, dog, hen, pig) shape. Although in terms of gender slogutis correlates with the general European notion of succubus / incubus, it does not quite correspond to it. Motivation for choosing the victim could include disregard for the rules of the community life or violation of taboos, or perpetrating some wrongs (with slogutis as a punishment). There are references to oppression by slogutis as a form of revenge. Of course, in some cases the reasons for this torture remain unclear. Surveying of folklore and international contexts elucidates the notion of slogutis as a being threatening human health and life. Further analysis reveals that experiencing such nightmares was diagnosed as a decease, therefore slogutis could have been perceived not only as a supernatural being, but also as a sickness.The last part of the article deals with the notion of cold against the background of folk medicine. Apparently, some ways of treatment imply the notion of cold as something alien: there are attempts at creating a cold-unfriendly environment and mocking at the cold in hope it would feel offended and leave the patient alone. Sometimes people resorted to active measures and employed the pars pro toto principle attempting to destruct the sickness or to pass it onto somebody else. The research revealed that the notion of cold (rhinitis) is in some cases supplemented with elements of slogutis. This enables deeper understanding of the connection between those two sicknesses. Both synonymous usage (confusion) of the names and means of treatment allow asserting that cold and incubus (sloga and slogutis) could have been perceived as two sides of the same trouble – the external and the internal one. Although the data to prove the systematic status of cold / slogutis as an infectious decease in the folk medicine is scarce, the hypothetic possibility remains, encouraging further investigation of these materials.

Benefits, pitfalls and risks of phytotherapy in clinical practice in otorhinolaryngology

ObjectivesTo elucidate the benefits, pitfalls and risks of phytotherapy in the clinical practice of otorhinolaryngology. Material and methodsThe PubMed and Cochrane databases were searched using the following keywords: phytotherapy, phytomedicine, herbs, otology, rhinology, laryngology, otitis, rhinitis, laryngitis and otorhinolaryngology. Seventy-two articles (18 prospective randomized studies, 4 Cochrane analyses, 4 meta-analysis and 15 reviews of the literature) devoted to clinical studies were analyzed. Articles devoted to in vitro or animal studies, biochemical analyses or case reports (including fewer than 10 patients) and articles dealing with honey, aromatherapy or minerals were excluded. ResultsPer os ginkgo biloba has no indications in tinnitus, presbycusis or anosmia following viral rhinitis. Traditional Asian medicine has no proven benefit in sudden deafness or laryngeal papillomatosis. Per os mistletoe extracts associated to conventional treatment for head and neck squamous cell carcinoma does not increase 5-year survival. Extracts of various herbs, notably echinacea, eucalyptus, petasites hybridus, pelargonium sidoides, rosemary, spirulina and thyme, show superiority over placebo for rhinosinusitis and allergic rhinitis, as does gingko biloba for selected vertigo. There have been encouraging preliminary results for intratumoral injection of mistletoe in head and neck carcinoma and acupoint herbal patching for allergic rhinitis. Herb intake should be screened for in case of certain unexplained symptoms such as epistaxis, headache or dizziness, or signs suggesting allergy. Phytotherapy should be interrupted ahead of surgery and/or chemotherapy. ConclusionScientific proof of the benefit of phytotherapy in otorhinolaryngology remains to be established but, given its widespread use and the reported data, knowledge of this form of treatment needs to be developed.

Investigation of chemosensitivity during and after an acute cold.

Viral rhinitis (the "common" cold) is a frequent worldwide disease. Olfactory dysfunction is one complication that arises during infection, which in most cases heals up spontaneously upon recovery, whereas in some cases it may persist as a partial or total loss of olfaction. The aim of this prospective study was to investigate the change of other chemosensory systems during a cold. Fifty-eight patients (age 18 to 69 years) with an acute cold were compared to a healthy control group (n = 59; age 19 to 63 years). All patients were examined on 2 occasions separated by approximately 4 weeks. Orthonasal, retronasal, gustatory, and trigeminal nasal function were investigated. Furthermore, ratings of real foods, in terms of intensity and pleasantness, were obtained. Compared to the control group, patients showed a decreased orthonasal (threshold and discrimination) and retronasal function. Furthermore, patients exhibited a decreased sensitivity to salt and a reduced ability to localize menthol, indicating a decreased taste and trigeminal function, respectively. Upon recovery from the infection, orthonasal olfactory and trigeminal sensitivity increased, whereas retronasal sensitivity showed no improvement and salt sensitivity decreased. This comprehensive study provides empirical evidence that chemosensory impairment is prevalent during a cold, and additionally shows for the first time that chemosensory features associated with food consumption persist postinfection.

The relationship between allergic rhinitis and viral infections.

Viral airway inflammation is one of the most common respiratory conditions. The clinical symptoms of viral rhinitis, especially watery rhinorrhea and nasal congestion, may be similar to the symptoms of allergic rhinitis. Both conditions affect considerable numbers of patients and can lead to many upper airway consequences, especially secondary bacterial infection. Viral infection can also lead to lower respiratory traction conditions such as bronchitis, bronchiolitis, pneumonia and, especially, asthma. This article will review the existing scientific literature examining the linkage and relationship between viral infection and allergic airway disease. The relationship between viral and allergic airway inflammation can be discussed in terms of the influence of pathogenesis from one condition to the other. Recently, many studies show how early infection can decrease the chance of allergic development. However, there is some evidence demonstrating that viral infection can deteriorate the clinical symptoms of airway allergy. Viral infection can affect the immune system and allergy as both 'enhancing effect' and 'protective effect'. The influential factors depend on the virulence of the viral strain, the innate immune system and the environmental conditions.

Odorat : de l’aéroportage au cortex

Olfactory physiology involves four main steps: nasal airflow perireceptor events, transduction, and central olfaction. Complex and diverse physiological processes are involved at each step and may be undermined by numerous pathological processes. Nasal airflow physiology involves fluid mechanics and specifc physicochemical properties of odorants; its main pathology is nasal polyposis. Perireceptor events involve transport molecules and enzymes which eliminate xenobiotics; its main pathology is chronic rhinitis. Transduction is the role of primary olfactory neurons, which detect and discriminate various chemical molecules across a wide range of concentrations. To fulfill this task, these cells use a large family of G protein-coupled receptors (odorant receptors). The main pathology is acute viral rhinitis affecting the olfactory organ. Finally, after olfactory signals are generated, the information is processed and coded in the olfactory bulb before being disseminated to several areas of the brain; its pathology is dominated by neurodegenerative disorders.

Recurrent epistaxis in children: When should we suspect coagulopathy?

Abstract The objective of this study was to evaluate children and adolescents with recurrent epistaxis and to spot variables that may predict underlying bleeding disorder. This was a prospective study. Thirty-six children with recurrent epistaxis were recruited from ENT outpatient clinic as well as emergency room of Cairo University children hospital. Patients with systemic causes for epistaxis were not included. All patients were subjected to basic workup to differentiate between ENT and hematological causes of epistaxis. Accordingly, extended ENT investigations or coagulation studies were performed. Results showed 47.6% incidence for bleeding disorders, 39.7% incidence for ENT causes, and 12.7% incidence for idiopathic causes. Reported coagulopathies included idiopathic thrombocytopenic purpura with an incidence of 26.7%, platelet functions disorders such as Glanzmann’s thrombasthenia (13.3%) and Bernard-Soulier syndrome (10%), aplastic anemia (3.3%), hemophilia A (3.3%), Von Willebrand disease (3.3%), and unclassified (40%). Reported local ENT causes included bacterial rhinitis (88%) (lodged foreign body was found in 1/3 of these patients, digital trauma by habitual nose picking was detected in another 1/3, and the remaining 1/3 represented cases of complicated previous viral rhinitis), nasal allergy (8%), and adenoid (4%). The study recommended some statistically significant predictors for bleeding disorders such as positive consanguinity, high epistaxis bleeding score, presence of other bleeding sites, low hemoglobin level and platelet count, and elevated activated partial thromboplastin time.

Погляд терапевта на лікування гострого вірусного риніту у вагітних

У статті проаналізовано вплив гострих респіраторних інфекцій протягом вагітності. Особлива увага приділяється впливу синдрому ендогенної інтоксикації та обґрунтуванню вибору для його дослідження. Проаналізовано й описано роль оксиду азоту в патогенезі запального та імунного процесів при вагітності, ускладненій гострою респіраторною вірусною інфекцією. Приділено увагу особливим вимогам при лікуванні цієї категорії пацієнток. Запропоновано спосіб лікування гострого вірусного риніту у вагітних шляхом застосування комбінації препаратів енгістол і синупрет. Встановлено, що проведення комплексного лікування вагітних із гострою респіраторною вірусною інфекцією, гострим ринітом із застосуванням препарату енгістол у комбінації з препаратом рослинного походження синупрет має патогенетичну спрямованість завдяки протизапальній, дезінтоксикаційній, противірусній, антигістамінній і імуномодулюючій властивостям препаратів.Нами встановлено, що серед інших методів лікування гострої респіраторної вірусної інфекції у вагітних запропонована терапія є високоефективною, не має побічних ефектів і добре переноситься вагітними жінками. Спосіб доступний, не завдає шкоди, сприяє оптимізації лікування вагітних, забезпечує його доцільність й можливість масового використання.

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.

Pediatric endonasal endoscopic dacryocystorhinostomy

Dacryocystorhinostomy (DCR) in children is indicated in cases of common congenital nasolacrimal duct obstruction (CNLDO) unresponsive to medical therapy, probing or intubation. The purpose of this manuscript is to evaluate the effectiveness of endonasal endoscopic pediatric DCR. The authors present a series of eight children (seven boys and one girl) who underwent a pediatric endonasal DCR between September 2007 and December 2008. The mean age was: 4.3 years (range: 8 months to 9 years old). Three children had a craniofacial abnormality. There were ten primary DCRs and one revision DCR. In nine cases, the indication was a pure primary low mechanical obstruction persistent after one or more probings. In the 10th case there was also a stenosis of the inferior canaliculus diagnosed during the DCR. The revision DCR was indicated because of the closure of the stoma created 3 years ago. A silicone intubation was put in place only in two cases: in case of a stenosis of the inferior canaliculus (3 months) and the other in case of revision DCR (1 month). The follow-up for primary DCRs was 10.5 months (range: 6–15) and for revision surgery 6 months (after the retrieve of the stent). In primary DCRs, there was a complete resolution of symptoms in nine out of 10 cases. The 10th case experienced a transient slight epiphora during a viral rhinitis. In case of revision DCR, the child was free of symptoms. In conclusion pediatric DCR is a very effective and safe procedure for the treatment of a low mechanical obstruction of the lacrimal pathway in children unresponsive to previous probings. Stenosis of the inferior canaliculus can give some slight intermittent epiphora despite a wide and patent stoma. Moreover craniofacial abnormalities are more common in children than in adults undergoing a DCR.

La rhinite allergique de l’enfant d’âge préscolaire existe-t-elle ?

Rhinitis and asthma are interdependent entities sharing airway inflammation. Rhinitis produces a number of symptoms of varying severity, including intermittent or persistent rhinorrhea, sneezing, nasal itching, post-nasal drainage and nasal congestion. These symptoms can be induced by aeroallergens and can be accompanied by allergic conjunctivitis. However, chronic, non-allergic rhinitis is not rare and can be very similar in its clinical presentation. An episode of acute viral rhinitis frequently precedes an exacerbation of virus induced asthma. Repetitive episodes of acute post-viral rhinitis in preschool children can give a false impression of persistent rhinitis during the seasonal peak of viral respiratory infections.

Mediators and cytokines in allergic and viral-triggered rhinitis

Intermittent allergic rhinitis and common cold constitute frequent conditions and show similar clinical symptoms. The purpose of this study was to investigate the pattern of cytokines in the nasal fluid of patients with acute symptoms caused by allergic and viral rhinitis. Nasal secretions were analyzed by immunosorbent assay techniques using a cytokine panel assay and routine ELISA. Allergic patients had significantly higher levels of eosinophil cationic protein (ECP), interleukin (IL)-5, and tryptase. Significantly elevated concentrations of proinflammatory cytokines (IL-1b, IL-6, IL-7, IL-17, interferon [IFN] gamma, and tumor necrosis factor [TNF]-alpha) as well as chemokines for cellular infiltration (IL-8, monocyte chemoattractant protein 1, and macrophage inflammatory protein 1beta), factors for cellular proliferation (granulocyte colony-stimulating factor [G-CSF] and granulocyte macrophage colony-stimulating factor [GM-CSF]), and elastase were found in viral rhinitis. IL-10 was only detectable in viral rhinitis. IL-4 was significantly higher in patients with viral rhinitis than allergic rhinitis, and IL-5 was significantly elevated in viral rhinitis compared with controls. In viral-triggered rhinitis, we detected a predominantly Th1-type cytokine pattern with potent proinflammatory mediators. Factors reflecting a neutrophil and eosinophil immune response, due to IL-5, IL-8, GM-CSF, ECP, and elastase were shown. Nasal secretions of patients with allergic rhinitis showed highest concentrations of tryptase, IL-5, and ECP, reflecting a mast cell and eosinophil immune response. Nasal secretion levels of IL-4 did not show highest levels in allergic rhinitis but did in viral rhinitis. IL-4 also may play a role in limiting inflammatory processes by inhibiting the production of inflammatory cytokines.