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Zhao P, Kariya S, Higaki T, Makihara S, Rikimaru T, Okano M, Ando M. Chronic rhinosinusitis possibly associated with decreased lung function in chronic cough patients. Braz J Otorhinolaryngol 2024; 90:101424. [PMID: 38581960 PMCID: PMC11004496 DOI: 10.1016/j.bjorl.2024.101424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2023] [Revised: 02/13/2024] [Accepted: 02/22/2024] [Indexed: 04/08/2024] Open
Abstract
OBJECTIVES The purpose of this study is to investigate the lung function in Chronic Rhinosinusitis (CRS) patients with Chronic Cough (CC). METHODS A total of 1413 CC patients were retrospectively screened and 109 CRS patients with CC were enrolled. Lung function, Lund-Mackay Computed Tomography (CT) score, smoking status, peripheral blood eosinophil count, and immunoglobulin E concentration in serum samples, and Sino-Nasal Outcome Test were examined. Normal control subjects are also recruited. RESULTS The Forced Expiratory Volume in 1 second (FEV1.0), Percent Predicted FEV1.0, and FEV1.0/Forced Vital Capacity (FVC) ratio in the patients were significantly low as compared with the control subjects. The FEV1.0/FVC ratio was negatively correlated with the Lund-Mackay CT scores of the patients with a high CT score. CONCLUSIONS The CRS patients with CC should be investigated with lung function. In addition, the multidisciplinary evaluation including a pulmonologist is needed to manage the CRS patients with CC. LEVEL OF EVIDENCE Level 4.
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Affiliation(s)
- Pengfei Zhao
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan.
| | - Shin Kariya
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan; Kawasaki Medical School, Department of Otolaryngology-Head and Neck Surgery, Kurashiki, Japan
| | - Takaya Higaki
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan
| | - Seiichiro Makihara
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan
| | - Toru Rikimaru
- Fukuoka Sanno Hospital, Division of Respiratory Medicine, Fukuoka, Japan
| | - Mitsuhiro Okano
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan; International University of Health and Welfare School of Medicine, Department of Otorhinolaryngology, Narita, Japan
| | - Mizuo Ando
- Okayama University Academic Field of Medicine, Dentistry and Pharmaceutical Sciences, Department of Otolaryngology-Head and Neck Surgery, Okayama, Japan
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Parker SM, Smith JA, Birring SS, Chamberlain-Mitchell S, Gruffydd-Jones K, Haines J, Hennessey S, McGarvey LP, Marsden P, Martin MJ, Morice A, O'Hara J, Thomas M. British Thoracic Society Clinical Statement on chronic cough in adults. Thorax 2023; 78:s3-s19. [PMID: 38088193 DOI: 10.1136/thorax-2023-220592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2023]
Affiliation(s)
- Sean M Parker
- Department of Respiratory Medicine, North Tyneside General Hospital, Northumbria Healthcare NHS Foundation Trust, North Shields, UK
| | - Jaclyn Ann Smith
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
| | - Surinder S Birring
- Department of Respiratory Medicine, Kings College Hospital, London, UK
- Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | | | | | - Jemma Haines
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | | | | | - Paul Marsden
- Division of Infection, Immunity and Respiratory Medicine, University of Manchester, Manchester, UK
- North West Lung Centre, Manchester University NHS Foundation Trust, Wythenshawe Hospital, Manchester, UK
| | | | - Alyn Morice
- Castle Hill Hospital, Cottingham, UK
- University of Hull, Hull, UK
| | - James O'Hara
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Population Health Sciences Institute, Newcastle University, Newcastle, UK
| | - Mike Thomas
- Academic Unit of Primary Care and Population Science, University of Southampton, Southampton, UK
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Donaldson AM. Upper Airway Cough Syndrome. Otolaryngol Clin North Am 2023; 56:147-155. [DOI: 10.1016/j.otc.2022.09.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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Øie MR, Helvik AS, Sue-Chu M, Steinsvåg SK, Thorstensen WM. Sinonasal Symptoms in COPD: Burden and Associations with Clinical Markers of Disease. Int J Chron Obstruct Pulmon Dis 2022; 17:2137-2147. [PMID: 36101792 PMCID: PMC9464443 DOI: 10.2147/copd.s372991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2022] [Accepted: 08/22/2022] [Indexed: 11/23/2022] Open
Abstract
Purpose Sinonasal symptoms are prevalent in COPD, and knowledge of the relationship between these symptoms and clinical markers of COPD is limited. This study explores the associations between the burden of sinonasal symptoms and clinical markers and thresholds recommended for guiding treatment decisions in the GOLD guidelines. Patients and Methods Sinonasal symptoms were quantified with the rhinological subscale of the Sino-Nasal-Outcome-Test (SNOT-22) in 93 COPD patients characterized by the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) 2012 diagnostic criteria for rhinosinusitis without nasal polyps (RSsNP). Associations between a high burden, defined as a SNOT22_rhinological score of ≥11, and the following markers were assessed by adjusted multivariable linear regressions; severity of dyspnea [modified Medical Research Council (mMRC)] and cough [Visual Analogue Scale (VAS)], physical activity [6-minute walking distance (6MWD)], mortality risk (BODE index), and HRQoL [disease-specific COPD Assessment Test (CAT) and St. Georges Respiratory Questionnaire (SGRQ), and physical component summary, Short Form-36 version 2.0 (PCS SF-36v2)]. Odds ratios for the association of a high burden and threshold levels for regular treatment were estimated by adjusted binomial logistic regression models. Results A high burden was associated with greater severity of dyspnea and cough, lower 6MWD, higher BODE index and poorer HRQoL. The odds ratio of having CAT and SGRQ scores that are above the thresholds recommended for treatment was 5–7-fold greater in the high burden group. Conclusion A high burden of sinonasal symptoms is positively associated with the clinical markers of symptom severity and mortality risk and is inversely associated with physical activity and HRQoL in COPD. These findings add further support that the UAD concept also applies to COPD. Enquiry about sinonasal symptoms in COPD patients should be incorporated into the clinical routine.
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Affiliation(s)
- Marte Rystad Øie
- Department of Otolaryngology, Head and Neck Surgery, St. Olavs hospital, 7006 Trondheim University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - Anne-Sofie Helvik
- Department of Otolaryngology, Head and Neck Surgery, St. Olavs hospital, 7006 Trondheim University Hospital, Trondheim, Norway.,Department of Public Health and Nursing, Norwegian University of Science and Technology, Trondheim, Norway
| | - Malcolm Sue-Chu
- Department of Circulation and Medical Imaging, Norwegian University of Science and Technology, Trondheim, Norway.,Department of Thoracic Medicine, St. Olavs hospital, Trondheim University Hospital, Trondheim, Norway
| | - Sverre Karmhus Steinsvåg
- Department of Otolaryngology, Head and Neck Surgery, Sørlandet Hospital, Kristiansand, 4604, Norway.,Haukeland University Hospital, Bergen, Norway
| | - Wenche Moe Thorstensen
- Department of Otolaryngology, Head and Neck Surgery, St. Olavs hospital, 7006 Trondheim University Hospital, Trondheim, Norway.,Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
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De Vincentis A, Baldi F, Calderazzo M, Caliceti U, Guarnieri G, Lombardi F, Lombardo FP, Maggi S, Onder G, Vaghi A, Zanasi A, Antonelli Incalzi R. Chronic cough in adults: recommendations from an Italian intersociety consensus. Aging Clin Exp Res 2022; 34:1529-1550. [PMID: 35666453 DOI: 10.1007/s40520-022-02154-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 05/11/2022] [Indexed: 12/18/2022]
Abstract
BACKGROUND Chronic cough (CC) is a burdensome health problem in adult and older people, with a major impact on quality of life. Its management is often troublesome, and many guidelines have been released. Notwithstanding, a proportion of cases still do not reach a definite diagnosis and resolutive treatment. A coordinated approach between different specialists would be highly recommended, but its implementation in clinical practice suffers from the lack of shared protocols and poor awareness of the problem. The present consensus document has been implemented to address these issues. AIMS To develop evidence-based recommendations for the management of adults with CC. METHODS A 12-member expert task force of general practitioners, geriatricians, pneumologists, allergologists, otorhynolaringologists and gastroenterologists was established to develop evidence-based recommendations for the diagnostic and therapeutic approach to subjects with CC. A modified Delphi approach was used to achieve consensus, and the US Preventive Services Task Force system was used to rate the strength of recommendations and the quality of evidence. RESULTS A total of 56 recommendations were proposed, covering 28 topics and concerning definitions and epidemiology, pathogenesis and etiology, diagnostic and therapeutic approach along with the consideration of specific care settings. CONCLUSION These recommendations should ease the management of subjects with CC by coordinating the expertise of different specialists. By providing a convenient list of topics of interest, they might assist in identifying unmet needs and research priorities.
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Affiliation(s)
- Antonio De Vincentis
- Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy.
| | - Fabio Baldi
- Gastroenterology and Digestive Pathophysiology, Villalba Hospital, Bologna, Italy
| | | | - Umberto Caliceti
- Emeritus Professor of Otorhinolaringology, Università di Bologna, Bologna, Italy
| | - Gabriella Guarnieri
- Department of Cardiac-Thoracic-Vascular Sciences and Public Health, University of Padua, Padua, Italy
| | - Francesco Lombardi
- Fondazione Policlinico IRCCS A. Gemelli, and Università Cattolica del Sacro Cuore, Roma, Italia
| | - Francesco Paolo Lombardo
- General Practitioner, Società Italiana di Medicina Generale (SIMG), Pneumology Area, Florence, Italy
| | - Stefania Maggi
- Institute of Neuroscience, Aging Branch, CNR, Padua, Italy
| | - Graziano Onder
- Department of Cardiovascular, Endocrine-Metabolic Diseases and Ageing, Istituto Superiore di Sanità, Rome, Italy
| | - Adriano Vaghi
- ASST-Rhodense, UOC Pneumologia, Garbagnate Milanese, Milan, Italy
| | | | - Raffaele Antonelli Incalzi
- Unit of Internal Medicine and Geriatrics, Università Campus Bio-Medico di Roma, Fondazione Policlinico Universitario Campus Bio-Medico di Roma, via Alvaro del Portillo, 200, 00128, Rome, Italy
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The Role of Respiratory Flora in the Pathogenesis of Chronic Respiratory Diseases. BIOMED RESEARCH INTERNATIONAL 2021; 2021:6431862. [PMID: 34435047 PMCID: PMC8382525 DOI: 10.1155/2021/6431862] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/20/2021] [Accepted: 07/31/2021] [Indexed: 12/13/2022]
Abstract
Large quantities of bacteria, including Firmicutes, Actinobacteria, and Bacteroidetes, colonize the surface of the respiratory mucosa of healthy people. They interact and coexist with the local mucosal immune system of the human airway, maintaining the immune stability and balance of the respiratory system. While suffering from chronic respiratory diseases, the microbial population in the airway changes and the proportion of Proteobacteria is increased in patients with asthma. The abundance of the microbial population in patients with chronic obstructive pulmonary disease (COPD) is decreased, and conversely, the proportion of Firmicutes and Proteobacteria increased. The diversity of airway microorganisms in cystic fibrosis (CF) patients is decreased, while pathogenic bacteria and conditional pathogenic bacteria are proliferated in large numbers. The proportion of Firmicutes and Proteobacteria is increased in patients with upper airway cough syndrome (UACS), which replaces the dominance of Streptococcus and Neisseria in the pharynx of a normal population. Therefore, a clear understanding of the immune process of the airway flora and the immune dysfunction of the flora on the pathogenesis of chronic respiratory diseases can provide new ideas for the prevention and treatment of human respiratory diseases.
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