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Bulut OC, Oladokun D, Lippert BM, Hohenberger R. Can Sex Improve Nasal Function?-An Exploration of the Link Between Sex and Nasal Function. EAR, NOSE & THROAT JOURNAL 2023; 102:40-45. [PMID: 33393816 DOI: 10.1177/0145561320981441] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
Abstract
OBJECTIVES This study was conducted to examine the impact of sexual activity on nasal breathing and compare such effect to that of a nasal decongestant. METHODS We evaluated nasal breathing at 5 different times: (1) before sexual activity (baseline), (2) immediately after sexual activity, (3) 30 minutes, (4) 1 hour (5), and 3 hours after sexual climax. Same measurements were taken on the second day following application of nasal decongestant spray. For evaluation of nasal breathing, we used a visual analogue scale (VAS). Additionally, we used a portable rhinometric device to measure resistance and nasal flow. RESULTS Nasal breathing improved significantly after sexual intercourse with climax to the same degree as after application of nasal decongestant for up to 60 minutes, as measured subjectively with the VAS (sex -3.6, P < .001; spray -3.2, P < .001). This was confirmed in the objective rhinometric data as mean nasal flow (mL/s) increased while resistance decreased immediately (flow sex +214, P < .001; flow spray +235, P < .001), 30 (flow sex +249, P < .001; flow spray +287, P < .001), and 60 minutes (flow sex +180, P < .001; flow spray +287, P < .001) post-intervention. Nasal breathing was back to the baseline level after 3 hours following sexual intercourse, while it continued to be improved for longer after application of nasal decongestant. Only participants having nasal obstruction (Nasal Obstruction Symptom Evaluation score >30) showed nasal function improvement after sex. CONCLUSIONS Sexual intercourse with climax can improve nasal breathing to the same degree as application of nasal decongestant for up to 60 minutes in patients having nasal obstruction.
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Affiliation(s)
- Olcay Cem Bulut
- Department of Otorhinolaryngology, SLK Kliniken Am Gesundbrunnen, Heilbronn, Germany.,Department of Otorhinolaryngology, University Hospital Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
| | - Dare Oladokun
- Department of Otolaryngology, York District Hospital, York, UK
| | - Burkard M Lippert
- Department of Otorhinolaryngology, SLK Kliniken Am Gesundbrunnen, Heilbronn, Germany
| | - Ralph Hohenberger
- Department of Otorhinolaryngology, University Hospital Heidelberg, Im Neuenheimer Feld, Heidelberg, Germany
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Radetić M, Mattar J, Košec A, Bacan F, Baudoin T. CHARACTERISTICS OF CHRONIC RHINOSINUSITIS PHENOTYPES IN PATIENTS UNDERGOING FUNCTIONAL ENDOSCOPIC SINUS SURGERY: AN OBSERVATIONAL COHORT RETROSPECTIVE STUDY. Acta Clin Croat 2022; 61:342-348. [PMID: 36818937 PMCID: PMC9934050 DOI: 10.20471/acc.2022.61.02.21] [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: 06/05/2019] [Accepted: 02/08/2021] [Indexed: 02/10/2023] Open
Abstract
This study analyzed the characteristics of chronic rhinosinusitis patients with and without nasal polyps failing conservative treatment and undergoing functional endoscopic sinus surgery as part of their treatment for chronic inflammatory sinonasal disease. The aim of this retrospective single-institution cohort study conducted at a university hospital tertiary referral center was to evaluate the characteristics of patients with both disease phenotypes in whom conservative treatment was unsuccessful. Patients who were surgically treated with functional endoscopic sinus surgery performed by two rhinology surgeons during a one-year period (2016) were enrolled in the study. Patient data collection included demographics, risk factor exposure, diagnosis, and type of endoscopic surgical procedure performed. In total, 185 patients were included in the study. Patients with malignant disease and those with incomplete data were excluded from the study. In the group of patients with nasal polyps, mean age, male gender, presence of allergy (34.9%), asthma (21.4%), aspirin sensitivity (6.3%), cystic fibrosis (1.6%), and previous nasal surgery rates (36.5%) were significantly higher as compared with the group of patients with chronic rhinosinusitis without nasal polyps. Septal deviation was more prevalent in the chronic rhinosinusitis group (55%) as compared to the group with nasal polyps (25%). The ethmoid (17%) and maxillary sinus (13%) were most frequently involved, but most of the patients who needed surgery had involvement of multiple or all sinuses (40%). The reasons for conservative treatment failure in chronic rhinosinusitis are multifactorial, but identifying the most prevalent characteristics in patients treated surgically may be helpful in identifying patients who would benefit most from surgery.
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Affiliation(s)
| | - Jeffry Mattar
- School of Medicine, University of Zagreb, Zagreb, Croatia
| | - Andro Košec
- School of Medicine, University of Zagreb, Zagreb, Croatia;,Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Filip Bacan
- School of Medicine, University of Zagreb, Zagreb, Croatia;,Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
| | - Tomislav Baudoin
- School of Medicine, University of Zagreb, Zagreb, Croatia;,Department of Otorhinolaryngology and Head and Neck Surgery, Sestre milosrdnice University Hospital Center, Zagreb, Croatia
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3
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Analysis of Reasonable Respiratory Efficiency in Tennis Competition and Training Environment Based on Cloud Computing. JOURNAL OF HEALTHCARE ENGINEERING 2022; 2022:4289667. [PMID: 35480156 PMCID: PMC9038377 DOI: 10.1155/2022/4289667] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/05/2022] [Revised: 01/19/2022] [Accepted: 03/11/2022] [Indexed: 11/23/2022]
Abstract
Competitive tennis is developing in the direction of quantification. How to use and give full play to all positive factors, in order to attack actively and give full play to the limits of body and psychology, breathing, as the basic metabolic function of human body, also plays a vital role in tennis. This paper studies that it plays an important role in the rationality and explosiveness of sports and the psychological and physiological regulation in competition. The characteristics of tennis events determine the importance of scientific and rational breathing. Reasonable breathing during exercise is conducive to maintaining the basic stability of the internal environment, improving the training effect, and giving full play to the functional ability of the human body, so as to create excellent sports results. First, reduce respiratory resistance. Second, there are two methods to improve alveolar ventilation efficiency and pulmonary ventilation: increasing respiratory rate and increasing respiratory depth. When the inhalation volume is constant, the alveolar gas freshness rate depends on the functional residual volume in the alveolar cavity at the end of expiratory or before inhalation. The less functional the residual air, the more fresh air inhaled, and the higher the oxygen partial pressure in alveolar gas. An effective way to reduce the functional residual volume in the alveolar cavity is to exhale as deeply as possible, so as to ensure that more oxygen enters the body. Reasonable breathing methods can not only accelerate the excitation of the body, increase movement strength, reduce fatigue, and promote recovery but also play a vital role in the rational allocation of physical fitness and the improvement of sports performance. The purpose of this study is to provide a theoretical basis for scientific tennis training by analyzing the characteristics of tennis events, the form of breathing in tennis and the efficiency of reasonable breathing in tennis.
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4
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Crowe TP, Hsu WH. Evaluation of Recent Intranasal Drug Delivery Systems to the Central Nervous System. Pharmaceutics 2022; 14:629. [PMID: 35336004 PMCID: PMC8950509 DOI: 10.3390/pharmaceutics14030629] [Citation(s) in RCA: 45] [Impact Index Per Article: 22.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 03/06/2022] [Accepted: 03/09/2022] [Indexed: 01/27/2023] Open
Abstract
Neurological diseases continue to increase in prevalence worldwide. Combined with the lack of modifiable risk factors or strongly efficacious therapies, these disorders pose a significant and growing burden on healthcare systems and societies. The development of neuroprotective or curative therapies is limited by a variety of factors, but none more than the highly selective blood-brain barrier. Intranasal administration can bypass this barrier completely and allow direct access to brain tissues, enabling a large number of potential new therapies ranging from bioactive peptides to stem cells. Current research indicates that merely administering simple solutions is inefficient and may limit therapeutic success. While many therapies can be delivered to some degree without carrier molecules or significant modification, a growing body of research has indicated several methods of improving the safety and efficacy of this administration route, such as nasal permeability enhancers, gelling agents, or nanocarrier formulations. This review shall discuss promising delivery systems and their role in expanding the clinical efficacy of this novel administration route. Optimization of intranasal administration will be crucial as novel therapies continue to be studied in clinical trials and approved to meet the growing demand for the treatment of patients with neurological diseases.
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Affiliation(s)
- Tyler P. Crowe
- Carver College of Medicine, University of Iowa, Iowa City, IA 52242, USA;
| | - Walter H. Hsu
- Department of Biomedical Sciences, Iowa State University, Ames, IA 50011, USA
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5
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Mayo-Yáñez M, Herranz-Larrañeta J, Calvo-Henríquez C. Commentary on can sex improve nasal function?-An exploration of the link between sex and nasal function. EAR, NOSE & THROAT JOURNAL 2022:1455613221077601. [PMID: 35152782 DOI: 10.1177/01455613221077601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Miguel Mayo-Yáñez
- Otorhinolaryngology-Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
| | - Jesús Herranz-Larrañeta
- Otorhinolaryngology-Head and Neck Surgery Department, 16811Complexo Hospitalario Universitario A Coruña (CHUAC), A Coruña, Galicia, Spain
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
| | - Christian Calvo-Henríquez
- Clinical Research in Medicine, International Center for Doctorate and Advanced Studies (CIEDUS), 16780Universidade de Santiago de Compostela (USC), Santiago de Compostela, Galicia, Spain
- Young-Otolaryngologists of the International Federations of Oto-Rhino-Laryngological Societies (YO-IFOS) Study Group, Paris, France
- Otorhinolaryngology-Head and Neck Surgery Department, Complexo Hospitalario Universitario Santiago de Compostela (CHUS), Santiago de Compostela, Galicia, Spain
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6
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Hox V, Beyaert S, Bullens D, Couto M, Langer D, Hellings P, Huart C, Rombaux P, Seys SF, Surda P, Walker A, Steelant B. Tackling nasal symptoms in athletes: Moving towards personalized medicine. Allergy 2021; 76:2716-2729. [PMID: 33605430 DOI: 10.1111/all.14786] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 02/05/2021] [Accepted: 02/15/2021] [Indexed: 01/16/2023]
Abstract
Adequate nasal breathing is indispensable for athletes, and nasal symptoms have been shown to interfere with their subjective feeling of comfortable breathing and quality of life. Nasal symptoms are caused by either structural abnormalities or mucosal pathology. Structural pathologies are managed differently from mucosal disease, and therefore, adequate diagnosis is of utmost importance in athletes in order to choose the correct treatment option for the individual. Literature suggests that nasal symptoms are more prevalent in athletes compared to the general population and certain sports environments might even trigger the development of symptoms. Given the high demands of respiratory function in athletes, insight into triggering factors is of high importance for disease prevention. Also, it has been suggested that athletes are more neglectful to their symptoms and hence remain undertreated, meaning that special attention should be paid to education of athletes and their caregivers. This review aims at giving an overview of nasal physiology in exercise as well as the possible types of nasal pathology. Additionally, diagnostic and treatment options are discussed and we focus on unmet needs for the management and prevention of these symptoms in athletes within the concept of precision medicine.
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Affiliation(s)
- Valerie Hox
- Department of Otorhinolaryngology Cliniques Universitaires Saint‐Luc Brussels Belgium
- Institute of Experimental and Clinical Research Pole of Pulmonology, Otorhinolaryngology and Dermatology UCLouvain Brussels Belgium
| | - Simon Beyaert
- Department of Otorhinolaryngology Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Dominique Bullens
- Clinical Division of Pediatrics University Hospitals Leuven Belgium
- Allergy and Clinical Immunology Research Group Department of Microbiology, Immunology and Transplantation KU Leuven Belgium
| | - Mariana Couto
- Allergy Unit Hospital CUF Descobertas, Lisbon, Portugal Lisbon Portugal
| | - Daniel Langer
- Respiratory Rehabilitation and Respiratory Division University Hospitals Leuven, KU Leuven Leuven Belgium
| | - Peter‐Willem Hellings
- Allergy and Clinical Immunology Research Group Department of Microbiology, Immunology and Transplantation KU Leuven Belgium
- Clinical Division of Ear, Nose and Throat Disease, Head and Neck Surgery University Hospitals Leuven Belgium
| | - Caroline Huart
- Department of Otorhinolaryngology Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Philippe Rombaux
- Department of Otorhinolaryngology Cliniques Universitaires Saint‐Luc Brussels Belgium
| | - Sven F. Seys
- Allergy and Clinical Immunology Research Group Department of Microbiology, Immunology and Transplantation KU Leuven Belgium
| | - Pavol Surda
- Department of Otorhinolaryngology Guy’s and St‐Thomas’ University Hospital London UK
| | - Abigail Walker
- Department of Ear, Nose and Throat Disease St‐George Hospital London UK
| | - Brecht Steelant
- Allergy and Clinical Immunology Research Group Department of Microbiology, Immunology and Transplantation KU Leuven Belgium
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7
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Gwizdala KL, Ferguson DP, Kovan J, Novak V, Pontifex MB. Placebo controlled phase II clinical trial: Safety and efficacy of combining intranasal insulin & acute exercise. Metab Brain Dis 2021; 36:1289-1303. [PMID: 33856613 DOI: 10.1007/s11011-021-00727-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/31/2021] [Indexed: 10/21/2022]
Abstract
A growing number of investigations are exploring the utility of intranasal insulin as a means of mitigating cognitive decline. However, as a basic tenant of dementia prevention programs is increasing physical activity, it is essential to obtain a preliminary assessment of the safety profile of combining intranasal insulin with physical activity; to ensure that undue risks are not incurred. Utilizing a randomized double-blind placebo-controlled design, a sample of 116 non-diabetic, fasted college-aged adults were randomly assigned to receive a dose of 0-to-120 IU of NovoLog (Insulin Aspart) before being randomized to 20 min of exercise or sitting control condition. The safety of intranasal insulin was assessed by examining the incidence of potential symptoms of hypoglycemia and changes in peripheral blood glucose. The efficacy of a combination therapeutic approach was assessed using behavioral measures of inhibition and sustained attention alongside neuroelectric indices of attentional engagement. The frequency of symptoms reported following administration of intranasal insulin were not observed to interact with exercise so as to make their occurrence any more or less prominent, nor was the frequency observed to relate to the dose of intranasal insulin. However, doses of intranasal insulin of 100 IU or more were observed to result in a 7-fold increase in the likelihood of a level 1 hypoglycemic event for those individuals in the exercise condition. This study provides preliminary evidence to suggest that exercise is not associated with an increase in risk when combined with lower doses of intranasal insulin.Clinical trial registration The trial is registered at ClinicalTrials.gov, number NCT04292535.
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Affiliation(s)
- Kathryn L Gwizdala
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA
| | - David P Ferguson
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA
| | - Jeffery Kovan
- Department of Intercollegiate Athletics, Michigan State University, East Lansing, MI, USA
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Matthew B Pontifex
- Department of Kinesiology, Michigan State University, 126E IM Sports Circle, East Lansing, MI, 48824-1049, USA.
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Abstract
Taste is a homeostatic function that conveys valuable information, such as energy density, readiness to eat, or toxicity of foodstuffs. Taste is not limited to the oral cavity but affects multiple physiological systems. In this review, we outline the ergogenic potential of substances that impart bitter, sweet, hot and cold tastes administered prior to and during exercise performance and whether the ergogenic benefits of taste are attributable to the placebo effect. Carbohydrate mouth rinsing seemingly improves endurance performance, along with a potentially ergogenic effect of oral exposure to both bitter tastants and caffeine although subsequent ingestion of bitter mouth rinses is likely required to enhance performance. Hot and cold tastes may prove beneficial in circumstances where athletes' thermal state may be challenged. Efficacy is not limited to taste, but extends to the stimulation of targeted receptors in the oral cavity and throughout the digestive tract, relaying signals pertaining to energy availability and temperature to appropriate neural centres. Dose, frequency and timing of tastant application likely require personalisation to be most effective, and can be enhanced or confounded by factors that relate to the placebo effect, highlighting taste as a critical factor in designing and administering applied sports science interventions.
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9
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Abstract
Assessment of the nose is critical in evaluating obstructive sleep apnea (OSA) because the nose plays an important role in the physiology of sleep by regulating nasal airway resistance and stimulating ventilation. Nasal obstruction is common in sleep apnea, contributes to OSA, and interferes with tolerance of OSA treatment with continuous positive airway pressure (CPAP) or oral appliances. Medical treatment of nasal obstruction and rhinitis with nasal corticosteroid sprays is associated with improved OSA severity and sleep symptoms. Surgery for nasal obstruction, including septoplasty, turbinate reduction, rhinoplasty, and sinus surgery, improves OSA-related quality-of-life measures and CPAP tolerance.
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10
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Tiotiu A, Plavec D, Novakova S, Mihaicuta S, Novakova P, Labor M, Bikov A. Current opinions for the management of asthma associated with ear, nose and throat comorbidities. Eur Respir Rev 2018; 27:27/150/180056. [PMID: 30463872 DOI: 10.1183/16000617.0056-2018] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/03/2018] [Indexed: 11/05/2022] Open
Abstract
Ear, nose and throat (ENT) comorbidities are common in patients with asthma and are frequently associated with poorer asthma outcomes. All these comorbidities are "treatable traits" in asthma. Identification and management of these disorders may spare medication usage and contribute to improved asthma control and quality of life, and a decrease in exacerbation rates.This review summarises recent data about the prevalence, clinical impact and treatment effects of ENT comorbidities in asthma including allergic rhinitis, chronic rhinosinusitis with and without nasal polyposis, aspirin-exacerbated respiratory disease, obstructive sleep apnoea and vocal cord dysfunction.Many of these comorbidities are possible to be managed by the pulmonologist, but the collaboration with the ENT specialist is essential for patients with chronic rhinosinusitis or vocal cord dysfunction. Further rigorous research is needed to study the efficacy of comorbidity treatment to improve asthma outcomes, in particular with the development of biotherapies in severe asthma that can also be beneficial in some ENT diseases.
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Affiliation(s)
- Angelica Tiotiu
- Pulmonology Dept, University Hospital, Nancy, France .,EA 3450 DevAH, Development, Adaptation, Cardio-Respiratory Regulations and Motor Control, University of Lorraine, Nancy, France
| | | | - Silviya Novakova
- Allergy Unit, University Hospital "St. George", Plovdiv, Bulgaria
| | | | - Plamena Novakova
- Dept of Allergology and Asthma, Aleksandrovska Hospital, Sofia, Bulgaria
| | - Marina Labor
- Pulmonology Dept, University Hospital Centre Osijek, Osijek, Croatia
| | - Andras Bikov
- NIHR Clinical Research Facility, Manchester University NHS Foundation Trust, Manchester, UK
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Ottaviano G, Ermolao A, Nardello E, Muci F, Favero V, Zaccaria M, Favero L. Breathing parameters associated to two different external nasal dilator strips in endurance athletes. Auris Nasus Larynx 2017; 44:713-718. [DOI: 10.1016/j.anl.2017.01.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Revised: 01/03/2017] [Accepted: 01/11/2017] [Indexed: 11/24/2022]
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Bindu B, Singh GP, Chowdhury T, Schaller B. Rhinitis and sleep disorders: The trigeminocardiac reflex link? Med Hypotheses 2017; 103:96-99. [PMID: 28571821 DOI: 10.1016/j.mehy.2017.04.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2017] [Accepted: 04/23/2017] [Indexed: 10/19/2022]
Abstract
Rhinitis, allergic or non-allergic, is an inflammatory condition of the nose. It is associated with a wide range of sleep disorders that are generally attributed to nasal congestion and presence of inflammatory mediators like cytokines and interleukins. However, the pathophysiological mechanisms behind these sleep disorders remain unclear. On the other hand, the trigeminocardiac reflex (TCR) has recently been linked to various sleep disorders like obstructive sleep apnea, sleep bruxism and rapid eye movement (REM) sleep apnea. TCR can be incited by stimulation of the trigeminal nerve or the area innervated by its branches including the nasal mucosa. Trigeminal nasal afferents can be activated on exposure to noxious stimuli (mechanical or chemical) like ammonia vapors, carbon-dioxide, nicotine, hypertonic saline, air-puffs and smoke. In rhinitis, there is associated neuronal hyper-responsiveness of sensory nasal afferents due to inflammation (which can be suppressed by steroids). This may further lead to increased occurrence of TCR in rhinitis. Moreover, there is involvement of autonomic nervous system both in rhinitis and TCR. In TCR, parasympathetic over activity and sympathetic inhibition leads to sudden onset bradycardia, hypotension, apnea and gastric motility. Also, the autonomic imbalance reportedly plays a significant role in the pathophysiology of rhinitis. Thus, considering these facts we hypothesize that the TCR could be the link between rhinitis and sleep disorders and we believe that further research in this direction may yield significant development in our understanding of sleep disorders in rhinitis.
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Affiliation(s)
- Barkha Bindu
- Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| | - Gyaninder Pal Singh
- Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India.
| | - Tumul Chowdhury
- Department of Anesthesiology and Perioperative Medicine, University of Manitoba, Winnipeg, MB, Canada
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Allergic Rhinitis and Sexual Dysfunction. CURRENT TREATMENT OPTIONS IN ALLERGY 2017. [DOI: 10.1007/s40521-017-0112-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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14
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Chowdhury T, Bindu B, Singh GP, Schaller B. Sleep Disorders: Is the Trigemino-Cardiac Reflex a Missing Link? Front Neurol 2017; 8:63. [PMID: 28289401 PMCID: PMC5326750 DOI: 10.3389/fneur.2017.00063] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 02/13/2017] [Indexed: 12/26/2022] Open
Abstract
Trigeminal innervated areas in face, nasolacrimal, and nasal mucosa can produce a wide array of cardiorespiratory manifestations that include apnea, bradypnea, bradycardia, hypotension, and arrhythmias. This reflex is a well-known entity called "trigemino-cardiac reflex" (TCR). The role of TCR is investigated in various pathophysiological conditions especially in neurosurgical, but also skull base surgery procedures. Additionally, its significance in various sleep-related disorders has also been highlighted recently. Though, the role of diving reflex, a subtype of TCR, has been extensively investigated in sudden infant death syndrome. The data related to other sleep disorders including obstructive sleep apnea, bruxism is very limited and thus, this mini review aims to investigate the possible role and correlation of TCR in causing such sleep abnormalities.
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Affiliation(s)
- Tumul Chowdhury
- Department of Anesthesiology and Perioperative Medicine, University of Manitoba , Winnipeg, MB , Canada
| | - Barkha Bindu
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Gyaninder Pal Singh
- Department of Neuro-anaesthesiology and Critical Care, All India Institute of Medical Sciences , New Delhi , India
| | - Bernhard Schaller
- Department of Research, University of Southampton , Southampton , UK
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15
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Giavina-Bianchi P, Aun MV, Takejima P, Kalil J, Agondi RC. United airway disease: current perspectives. J Asthma Allergy 2016; 9:93-100. [PMID: 27257389 PMCID: PMC4872272 DOI: 10.2147/jaa.s81541] [Citation(s) in RCA: 126] [Impact Index Per Article: 15.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023] Open
Abstract
Upper and lower airways are considered a unified morphological and functional unit, and the connection existing between them has been observed for many years, both in health and in disease. There is strong epidemiologic, pathophysiologic, and clinical evidence supporting an integrated view of rhinitis and asthma: united airway disease in the present review. The term “united airway disease” is opportune, because rhinitis and asthma are chronic inflammatory diseases of the upper and lower airways, which can be induced by allergic or nonallergic reproducible mechanisms, and present several phenotypes. Management of rhinitis and asthma must be jointly carried out, leading to better control of both diseases, and the lessons of the Allergic Rhinitis and Its Impact on Asthma initiative cannot be forgotten.
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Affiliation(s)
- Pedro Giavina-Bianchi
- Clinical Immunology and Allergy Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Marcelo Vivolo Aun
- Clinical Immunology and Allergy Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Priscila Takejima
- Clinical Immunology and Allergy Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Jorge Kalil
- Clinical Immunology and Allergy Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
| | - Rosana Câmara Agondi
- Clinical Immunology and Allergy Division, Faculty of Medicine, University of São Paulo, São Paulo, Brazil
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16
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Haavisto LE, Lukkarinen M, Lukkarinen H, Jartti T, Papadopoulos NG, Sipilä JI. Physical exercise increases nasal patency in asthmatic and atopic preschool children. Am J Rhinol Allergy 2014; 27:451-6. [PMID: 24274218 DOI: 10.2500/ajra.2013.27.3956] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Physical exercise causes a decrease in nasal mucosal congestion and hence an increase in nasal patency. This nasal response has been studied only in adults. A correlation between nasal obstruction and asthma or allergic rhinitis has been previously found. This study evaluates the influences of atopy and asthma on nasal patency and the changes in nasal patency induced by physical exercise in preschool children. METHODS An 8-minute exercise challenge test was conducted in 31 children aged between 4.1 and 6.4 years: 13 children had asthma, 17 were atopic, and 13 had neither asthma nor atopy. Nasal patency was measured with acoustic rhinometry at baseline and 10 minutes after the exercise. RESULTS At baseline, the total acoustic values were 17-25% larger in nonasthmatic children than in asthmatic children. Accordingly, the acoustic values in nonatopic children were 16-35% larger than in atopic children. After physical exercise, there was an overall increase in mean total nasal volume from 2.973 (SD = 0.647) to 3.405 cm(3) (SD = 0.705), indicating an improvement of 15% in nasal volume (p = 0.025). The increase in nasal patency was similar in asthmatic and nonasthmatic children, as well as in atopic and nonatopic children. CONCLUSION A significant increase in total nasal volume after physical exercise was found in all preschool children. The minimal cross-sectional areas remained smaller in asthmatic and atopic children after exercise, indicating partly irreversible nasal mucosal congestion in these children.
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Affiliation(s)
- Lotta E Haavisto
- Department of Otorhinolaryngology, Turku University Hospital, Turku, Finland
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17
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Biringerova Z, Gavliakova S, Brozmanova M, Tatar M, Hanuskova E, Poliacek I, Plevkova J. The effects of nasal irritant induced responses on breathing and cough in anaesthetized and conscious animal models. Respir Physiol Neurobiol 2013; 189:588-93. [PMID: 23994043 DOI: 10.1016/j.resp.2013.08.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2013] [Revised: 08/02/2013] [Accepted: 08/06/2013] [Indexed: 11/28/2022]
Abstract
There is little evidence to support the down-regulation of coughing from the nose. The cough response to citric acid (CA) was studied in anesthetized and conscious guinea pigs after nasal pretreatment with saline, 1% DMSO, allylisothiocyanate (TRPA1 agonist) and allylisothiocyanate +AP-18 (TRPA1 antagonist). Cough was induced by adding citric acid (CA) to the tracheal perfusion in anaesthetized animals, or by inhaling 0.4M CA in conscious animals. The cough response was counted from the dose response curves, airflow traces and cough sound analysis. In conscious animals, nasal allylisothiocyanate induced reproducible, dose dependent nasal symptoms and a significant drop in respiratory rate. Cough induced by CA was suppressed after nasal allylisothiocyanate (p<0.05), and this effect was prevented by AP-18 (1mM). In anaesthetized animals, nasal allylisothiocyanate induced a significant drop in respiratory rate. Cough induced subsequently by CA was suppressed when compared to baseline and vehicle responses (p<0.05). The reasons for the suppression of CA induced cough by TRPA1 agonist applied to the nose are not clear and remain to be elucidated.
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Affiliation(s)
- Z Biringerova
- Department of Pathophysiology, Comenius University, Jessenius Faculty of Medicine, Martin, Slovak Republic; Clinic of Anesthesiology and Emergency Medicne, University hospital in Martin, Comenius University, Jessenius Faculty of Medicine, Martin, Slovak Republic
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18
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Beule AG. Physiology and pathophysiology of respiratory mucosa of the nose and the paranasal sinuses. GMS CURRENT TOPICS IN OTORHINOLARYNGOLOGY, HEAD AND NECK SURGERY 2011; 9:Doc07. [PMID: 22073111 PMCID: PMC3199822 DOI: 10.3205/cto000071] [Citation(s) in RCA: 60] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
In this review, anatomy and physiology of the respiratory mucosa of nose and paranasal sinuses are summarized under the aspect of its clinical significance. Basics of endonasal cleaning including mucociliary clearance and nasal reflexes, as well as defence mechanisms are explained. Physiological wound healing, aspects of endonasal topical medical therapy and typical diagnostic procedures to evaluate the respiratory functions are presented. Finally, the pathophysiologies of different subtypes of non-allergic rhinitis are outlined together with treatment recommendations.
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Affiliation(s)
- Achim G Beule
- Department of Otorhinolaryngology, Head and Neck Surgery, University Greifswald, Germany
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19
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Pinto JM, Jeswani S. Rhinitis in the geriatric population. ALLERGY, ASTHMA, AND CLINICAL IMMUNOLOGY : OFFICIAL JOURNAL OF THE CANADIAN SOCIETY OF ALLERGY AND CLINICAL IMMUNOLOGY 2010; 6:10. [PMID: 20465792 PMCID: PMC2885381 DOI: 10.1186/1710-1492-6-10] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/20/2009] [Accepted: 05/13/2010] [Indexed: 01/09/2023]
Abstract
The current geriatric population in the United States accounts for approximately 12% of the total population and is projected to reach nearly 20% (71.5 million people) by 20301. With this expansion of the number of older adults, physicians will face the common complaint of rhinitis with increasing frequency. Nasal symptoms pose a significant burden on the health of older people and require attention to improve quality of life. Several mechanisms likely underlie the pathogenesis of rhinitis in these patients, including inflammatory conditions and the influence of aging on nasal physiology, with the potential for interaction between the two. Various treatments have been proposed to manage this condition; however, more work is needed to enhance our understanding of the pathophysiology of the various forms of geriatric rhinitis and to develop more effective therapies for this important patient population.
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Affiliation(s)
- Jayant M Pinto
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago, Chicago, IL, USA
| | - Seema Jeswani
- Section of Otolaryngology-Head and Neck Surgery, Department of Surgery, The University of Chicago, Chicago, IL, USA
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20
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Abstract
The population of Americans over 65 years of age is growing at an unprecedented rate. Rhinitis is a common and burdensome complaint in this group, and physicians should be aware of the diagnosis and management of the disease. Geriatric rhinitis is a nasal disorder of older persons that presents with a constellation of nasal symptoms. The etiologies of this condition include both inflammatory diseases and the effects of aging on physiology of the upper airway. Possible causes include allergic rhinitis, nonallergic rhinitis (vasomotor rhinitis and gustatory rhinitis), adverse effects of medications, hormonal changes, postnasal drip syndrome, chronic rhinosinusitis and atrophic rhinitis. Nasal symptoms in the older patient present a clinical challenge because of the physiologic effects of the aging nose, the unusual clinical presentation, the presence of multiple comorbidities and the problem of polypharmacy. A number of therapeutic options exist for this disorder, although definitive studies of effective regimens are needed.
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Affiliation(s)
- Cheryl C Nocon
- The Section of Otolaryngology – Head & Neck Surgery, The Department of Surgery, The University of Chicago Medical Center, 5841 S Maryland Ave, MC 1035, Chicago, IL 60637, USA
| | - Jayant M Pinto
- The Section of Otolaryngology – Head & Neck Surgery, The Department of Surgery, The University of Chicago Medical Center, 5841 S Maryland Ave, MC 1035, Chicago, IL 60637, USA
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