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 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Between September 1996 and January 1999 we used polysomnography (PSG) to examine 473 patients (involving a total of 662 records). The diagnosis was a sleep-related breathing disorder in 256 patients, including sleep apnea syndrome (SAS) in 194 patients, sleep hypoxicemia in 18 and insomnia in the other four. The SAS consisted of three subtypes: central apnea (CA) in 56 patients, obstructive apnea (OA) in 124 and mixed apnea (MA) in eight. The ratio of central apnea was relatively higher than the national average. Among the 473 patients, the most common complication was heart disease (133 patients) while other complications included hypertension, and respiratory and cerebrovascular diseases. Concerning the therapy for these patients, continuous positive airway pressure therapy was the most commonly applied and was effective in each type of SAS (CA, OA, MA). Other therapies included prosthetic mandibular advancement, bilevel positive airway pressure, medication and ENT operations. In Koga Hospital, there are many patients with heart disease and/or respiratory disease. We examined those patients who presented with snoring and/or apnea using PSG. Among these patients, SAS was the most common sleep disorder. The relative ratio of CA was high and the average age was higher than those with OA.
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PMID:The Koga Hospital Center for studies on sleep: status report. 1118 86

Due to its high and increasing prevalence, its impact on quality of life, the association with multiple comorbidities and the considerable socio-economic burden, allergic rhinitis is a major respiratory disorder and represents a global health concern. The ARIA working group has proposed a new classification for allergic rhinitis into intermittent or persistent, based on the duration of symptoms. The severity of allergic rhinitis is graded according to the impact of the disease on the quality of life. The diagnosis of allergic rhinitis involves a thorough history and clinical examination. In patients suspected of having persistent AR a complete and systematic nasal examination is an absolute requirement. Anterior rhinoscopy provides limited information. Nasal endoscopy is more useful, not to confirm AR but in particular to exclude other conditions, such as polyps, foreign bodies, tumours and septal deformations. To confirm the allergic origin of rhinitis symptoms, allergy tests must be performed. The first choice test is the skin prick test. Patients with allergic rhinitis should be evaluated for asthma and patients with asthma should be evaluated for rhinitis. A stepwise therapeutic approach is recommended based on the duration and severity of disease. The treatment of allergic rhinitis consists of allergen avoidance, pharmacotherapy and immunotherapy.
B-ENT 2005
PMID:Management of allergic rhinitis. 1636 67

Allergic rhinitis is a major chronic respiratory disease because of its prevalence, impacts on quality of life and work/school performance, economic burden, and links with asthma. Evidence based guidelines and recommendations for the diagnosis and management have been published in the first Allergic Rhinitis and its Impact on Asthma (ARIA) document. This document has now been updated: ARIA 2008. In this article, it is aimed to summarize the newly updated and published version of "Allergic Rhinitis and its Impact on Asthma (ARIA) 2008" in a Belgian perspective.
B-ENT 2008
PMID:Allergic Rhinitis and its impact on asthma update (ARIA 2008). The Belgian perspective. 1922 33

Aasthma is one of the most common chronic diseases with a prevalence of 5% in Germany. Nearly half of the patients complain about permanent voice disorders. Mucosal changes due to the obstructive respiratory disease as well as mucus abnormalities and regularly accompanying chronic rhinosinusitis may explain these symptoms. The additional influence of laryngopharyngeal reflux is discussed controversially. Additionally, dysphonia may as well occur due to side effects of the therapy with inhaled corticosteroids: the ingredients as well as physical effects may be responsible for the development of chronic laryngitis. The concomitant therapy by an ENT specialist is important in asthma-related voice disorders to identify the basic cause of dysphonia systematically and to intervene at an early stage.
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PMID:[Voice disorders in asthma]. 2071 71

In spite of the amount of literature demonstrating the relationship between upper and lower airways, both from the anatomical, and pathophysiological point of view, little is known about the epidemiology, diagnosis and treatment of the Rhino-Bronchial Syndrome (RBS). After the publication, in 2003, of a Consensus Report defining the Rhino-Bronchial Syndrome, an interdisciplinary group of experts made up from the Italian ENT Society (SIO) and the Interdisciplinary Scientific Association for the Study of Respiratory Diseases (AIMAR) met again in 2005 in order to study a protocol which would have, as the main tasks, the analysis of RBS signs and symptoms and standardization of the diagnostic approach. A secondary endpoint was to characterize the most effective therapeutic options and to correct the great dyshomogeneity in the therapeutic approaches. With this aim, 9 ENT and Pneumology Centres were selected, based on the ability to multidisciplinary cooperation, availability of useful instrumentation and homogeneous distribution over the entire National territory. Overall, 159 patients were enrolled according to clinical history (major and minor symptoms of upper and lower airways) and inclusion/exclusion criteria. All underwent a two level diagnostic approach. In 116 patients, the diagnosis was confirmed on the basis of I level (rhinopharyngeal endoscopy and basal spirometry, respectively, for upper and lower airways) examination. Allergic and infectious diseases were significantly more frequent (37.9% vs 20.9% and 73.3% vs 46.55, respectively) in patients with a confirmed diagnosis for Rhino-Bronchial Syndrome. Nasal obstruction (93%), rhinorrhoea (75%), cough (96%) and dyspnoea (69%) were the more frequent symptoms. The presence of meatal secretions or polyps were the clinical findings significantly differing at endoscopy in the two groups. After 3 months of treatment, according to "good clinical practice" (inhaled steroids, antibiotics, nasal lavages), 96% of the patients recovered. On the basis of these results, a diagnostic flow-chart is proposed according to which the persistence of some symptoms (cough, dyspnoea, rhinorrhoea and nasal obstruction) should lead the patient to a multidisciplinary and multi-level diagnostic approach by an otorhinolaryngology and a pneumology specialist working together for a definitive diagnosis. The recovery rate of about 94% of patients after 3 months of treatment, stresses the importance of a correct diagnosis.
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PMID:Rhino-Bronchial Syndrome. The SIO-AIMAR (Italian Society of Otorhinolaryngology, Head Neck Surgery-Interdisciplinary Scientific Association for the Study of the Respiratory Diseases) survey. 2180 60

An expert group of the European Academy of Allergy and Clinical Immunology (EAACI) and the European Rhinologic Society (ERS) has recently published the revised position paper for acute and chronic rhinosinusitis (EPOS 2012). In the following article, the most important aspects of the EPOS 2012 paper concerning chronic rhinosinusitis (CRS) are referenced. Every 10th European is suffering from a chronic inflammation of the nose and paranasal sinuses.2 EPOS key messages according CRS are: 1. CRS is an inflammatory disease, not an infection. 2. CRS comes in 2 different subtypes, namely CRS without polyps (CRSsNP) and CRS with polyps (CRSwNP). CRSwNP is diagnosed, when nasal polyps are visible at an appropriate nasal endoscopic examination. Otherwise CRSsNP is classified. In the EPOS 2012 paper the current pathogenetic knowledge of these 2 different CRS subtypes are discussed. Current research focuses on epithelial/immune cell interactions, the biofilm hypothesis and the superantigen hypothesis. Both CRS subtypes may be associated with different frequencies with other diseases, especially allergies, asthma and aspirin exacerbated respiratory disease (AERD). These comorbidities should be recorded and treated. The standard diagnostic procedures include medical history, nasal endoscopy, CT-scans of the paranasal sinus, and allergy test of common inhalant allergens. The classification of disease severity in mild, moderate and severe was complemented with a concept of symptom control in controlled, partly controlled and uncontrolled. Also, a 'difficult-to-treat-CRS' was defined. The choice of therapy depends upon symptom intensity. In patients with moderate and severe symptoms, usually several weeks of conservative treatment including topical steroids are administered. In non-responders, surgical treatment (functional endonasal sinus surgery) is indicated. The EPOS Group offers evidence-based treatment algorithms for general practitioners and ENT-specialists.
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PMID:[Chronic Rhinosinusitis - EPOS 2012 Part I]. 2343 Jun 97

Air pollution is one of the great problems of this century and it plays an important role in the increasing prevalence of chronic inflammatory problems in the upper airway in children. Since their lungs and immune system are not fully developed when exposure begins, newborns and children appear to be more sensitive to the effects of both outdoor and indoor air pollution. Furthermore, children spend most of their time indoors and are exposed more often to pollutants in indoor air. The link between health problems, chemical products and allergens (the latter mainly from cats and mites) has been extensively studied. Other important indoor contaminants are fungi, which are often present in damp buildings and can cause severe respiratory disease by producing spores, allergens, volatile irritant compounds and toxins. A proper identification of mould contamination of this kind is vital for correct diagnosis, treatment and the prevention of health problems, and improvements have been observed after the removal or cleaning of the contaminated materials and improvements to the ventilation of buildings. While a possible association between respiratory symptoms, such as rhinitis, and the presence of fungi in the indoor environment has been documented by several authors, other studies have observed no significant relationship. The development of standardised sampling, detection and diagnostic tests will be essential to understand the proper role of fungi in the indoor atmosphere and their impact on public health.
B-ENT 2012
PMID:The role of indoor pollution in the development and maintenance of chronic airway inflammation in children. 2343 12