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Passali D, Passali GC, Damiani V, Ciprandi G. Azelastine/fluticasone and allergic rhinitis in clinical practice. Eur Arch Otorhinolaryngol 2023; 280:4713-4714. [PMID: 37277684 DOI: 10.1007/s00405-023-08006-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 06/07/2023]
Affiliation(s)
| | - Giulio Cesare Passali
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma-Università Cattolica del Sacro Cuore, Rome, Italy
| | | | - Giorgio Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Via Boselli 5, 16146, Genoa, Italy.
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De Corso E, Pipolo C, Cantone E, Ottaviano G, Gallo S, Trimarchi M, Torretta S, Cavaliere C, Lucidi D, Seccia V, Settimi S, Canevari FRM, Pasquini E, La Mantia I, Garzaro M, Bellocchi G, De Benedetto M, Lombardo N, Macchi A, Malvezzi L, Motta G, Vicini C, Maselli A, Dell’Era V, Dragonetti A, Asprea F, Lupato V, Ghidini A, Masieri S, Mattavelli D, Salzano FA, Passali D, Galli J, Pagella F. Practical recommendations for managing severe chronic rhinosinusitis with nasal polyps in the era of biologics. Acta Otorhinolaryngol Ital 2023; 43:324-340. [PMID: 37224173 PMCID: PMC10551726 DOI: 10.14639/0392-100x-n2422] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/09/2022] [Accepted: 03/09/2023] [Indexed: 05/26/2023]
Abstract
Objective We conducted a national survey to understand how rhinology practice has changed with the advent of biologics and how this affected patients with uncontrolled, severe chronic rhinosinusitis with nasal polyps (CRSwNP). We aimed to analyse the results of the survey and infer practical recommendations for clinical practice. Methods A group of ear, nose, and throat specialists (ENTs) experienced in the management of CRSwNP developed a 74-question survey. ENTs from rhinology centres authorised to prescribe biologics in the context of the national health system were invited to answer it between 01/05/2022 and 31/07/2022. The responses underwent descriptive analyses, and the authors discussed the results and derived practical recommendations for clinical practice. Results ENTs working in rhinology centres changed their practices coinciding with the advent of biologics. CRSwNP evaluations have become more complex because they involve diagnostic confirmation, determining the patients' immunologic profile, and other factors. We observed heterogenous behaviours in practice that may be conditioned by the novelty of the topic. The results of the survey were used to develop practical recommendations for ENTs and are summarised herein. Conclusions Clinical practice in rhinology outpatient clinics has changed profoundly in the era of biologics. Our practical recommendations for clinicians working in rhinology centres are expected to help standardise practice and improve care.
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Affiliation(s)
- Eugenio De Corso
- Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy
| | - Carlotta Pipolo
- Otorhinolaryngology Unit, Head and Neck Department, Dipartimento di Scienze della Salute, Università degli Studi di Milano, ASST Santi Paolo e Carlo Hospital, Milan, Italy
| | - Elena Cantone
- Department of Neurosciences, Reproductive and Odontostomatologic Sciences, Unit of Ear, Nose and Throat, “Federico II” University, Naples, Italy
| | - Giancarlo Ottaviano
- Department of Neuroscience DNS, Otolaryngology Section, University of Padua, Padua, Italy
| | - Stefania Gallo
- Otorhinolaryngology Unit, Head and Neck Department, ASST Sette Laghi and UPLOAD Research Center, University of Insubria, Varese, Italy
| | - Matteo Trimarchi
- Division of Head and Neck Department, Otorhinolaryngology Unit, IRCCS San Raffaele Scientific Institute, Milan, Italy
| | - Sara Torretta
- Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Carlo Cavaliere
- Dipartimento di scienze odontostomatologiche e maxillo facciali. Sapienza University of Rome, Rome, Italy
| | - Daniela Lucidi
- Department of Otolaryngology – Head and Neck Surgery, University Hospital of Modena, Modena, Italy
| | - Veronica Seccia
- Otolaryngology, Audiology, and Phoniatric Operative Unit, Department of Surgical, Medical, Molecular Pathology, and Critical Care Medicine, Pisa University Hospital, Pisa, Italy
| | | | - Frank Rikki Mauritz Canevari
- UOC di Otorinolaringoiatria IRCCS Policlinico San Martino Genova, Dipartimento DISC Università di Genova, Genoa, Italy
| | - Ernesto Pasquini
- ENT Unit “Bellaria” Hospital – Specialized Dep AUSL Bologna, Italy
| | | | | | | | | | - Nicola Lombardo
- ENT Unit Department of Medical and Surgical Sciences, University Magna Græcia Catanzaro, Italy
| | - Alberto Macchi
- ENT University of Insubria, ASST Settelaghi, Varese, Italy
| | - Luca Malvezzi
- IRCCS Humanitas Research Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Rozzano (MI), Italy
| | - Gaetano Motta
- Otorhinolaryngology – Head and Neck Surgery, University of Campania “L. Vanvitelli”, Naples, Italy
| | - Claudio Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
| | - Alessandro Maselli
- Department Otorhinolaryngology, Hospital of Barletta, Barletta (BT), Italy
| | - Valeria Dell’Era
- ENT Division, Maggiore Hospital, Eastern Piedmont University – Novara, Italy
| | | | - Francesco Asprea
- Otorinolaringoiatria e audiologia. Università degli studi di Messina, Messina, Italy
| | - Valentina Lupato
- Division of Otolaryngology, Ospedale Civile di Pordenone, Azienda Sanitaria Friuli Occidentale (ASFO), Pordenone, Italy
| | - Angelo Ghidini
- Otorinolaringoiatria Azienda USL di Reggio Emilia/IRCCS, Italy
| | - Simonetta Masieri
- Dipartimento di scienze odontostomatologiche e maxillo facciali. Sapienza University of Rome, Rome, Italy
| | - Davide Mattavelli
- Unit of Otorhinolaryngology – Head and Neck Surgery, Department of Medical and Surgical Specialties, Radiological Sciences, and Public Health, ASST Spedali Civili di Brescia – University of Brescia, Brescia, Italy
| | | | | | - Jacopo Galli
- Otorhinolaryngology Unit, Head and Neck Department, A. Gemelli Universitary Hospital Foundation IRCCS, Rome, Italy
- Catholic University of The Sacred Heart, Rome, Italy
| | - Fabio Pagella
- Department of Clinical, Surgical, Diagnostic, and Pediatric Sciences, University of Pavia, Pavia, Italy
- Otorhinolaryngology Unit, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy
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Passali D, Cesare Passali G, Damiani V, Ciprandi G. Ten years of azelastine/fluticasone: The point of view of some rhinologists. An international survey. Revue Française d'Allergologie 2023; 63:103685. [DOI: 10.1016/j.reval.2023.103685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2023]
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Bellussi LM, Passali FM, Passali D. Local allergic rhinitis: considerations. Multidiscip Respir Med 2023; 18:939. [PMID: 38322132 PMCID: PMC10772855 DOI: 10.4081/mrm.2023.939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 12/06/2023] [Indexed: 02/08/2024] Open
Abstract
The term "local allergic rhinitis" has gained popularity as a clinical entity in recent years. Despite the apparent contradiction in the definitions of "nasal" and "local," we offer insights based on our extensive experience in the field. Local allergic rhinitis has been recognized and treated for many years, so it is not a new discovery. The nasal provocation test, which was introduced in the 1980s, was critical in identifying allergic rhinitis cases with suggestive symptoms but negative allergy tests. Our reflections aim to contribute to a precise terminological decision that is consistent with various points of view.
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Affiliation(s)
| | | | - Desiderio Passali
- IFOS Former President, Department for ORL Head and Neck Surgery, University of Siena, Italy
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Ulusoy S, Bayar Muluk N, Scadding GK, Passali GS, Dilber M, Gevaert P, Passali D, Resuli AS, Van Gerven L, Kalogjera L, Prokopakis E, Rombaux P, Hellings P, Cingi C. The intranasal trigeminal system: roles in rhinitis (allergic and non-allergic). Eur Rev Med Pharmacol Sci 2022; 26:25-37. [PMID: 36524908 DOI: 10.26355/eurrev_202212_30479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this paper is to review intranasal trigeminal system and associated reflexes. The literature survey was performed on PubMed, ProQuest Central database of Kirikkale University and Google Scholar. The intranasal trigeminal system and associated reflexes play an important role in humans in both health and disease, including in rhinitis of non-allergic and mixed type. The intranasal trigeminal nerve provides sensory perception to the lining of the nose, supplying information on how patent the nasal airway is and responding to various chemical signals. The reflexes known to exist within the intranasal trigeminal system are nasobronchial reflex, trigemino-cardiac reflex, nasogastric reflex, and nasal cycle. The intranasal trigeminal system and its reflexes play a vital role in normal human physiology. Alterations in how this system operates may underlie multiple forms of rhinitis and more research is needed to fully understand the mechanisms involved.
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Affiliation(s)
- S Ulusoy
- Department of Otorhinolaryngology, Medical Faculty, Halic University, Istanbul, Turkey.
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Ulusoy S, Bayar Muluk N, Karpischenko S, Passali GC, Negm H, Passali D, Milkov M, Kopacheva-Barsova G, Konstantinidis I, Dilber M, Cingi C. Mechanisms and solutions for nasal drug delivery - a narrative review. Eur Rev Med Pharmacol Sci 2022; 26:72-81. [PMID: 36524914 DOI: 10.26355/eurrev_202212_30487] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
The aim of this paper is to review mechanisms and solutions for nasal drug delivery. Literature survey was performed via PubMed, Google Scholar, Google, and ProQuest Central database of Kirikkale University. The nasal lining presents a large area of endothelium of variable permeability and with a rich vascular supply. Advantages of this route include eliminating first-pass metabolism and being easily accessible. The nasal route enables some agents which are otherwise difficult to administer to enter the systemic circulation, for example, low molecular mass compounds with high polarity, peptides, or proteins. There are three principal factors that influence the extent to which drugs can be absorbed through the nasal lining, namely the physico-chemical characteristics of the drug molecule itself, the action of the mucociliary system within the nose, and the presence of any factors increasing nasal absorption. A key factor limiting the use of the intranasal route of administration is insufficient absorption through the nasal mucosa. A number of drugs in development cannot be administered intranasally because their bioavailability following nasal administration is too low. There has been considerable research focus on methods to enhance absorption via the nasal mucosa. In this chapter, we review the literature related to this problem and discuss potential solutions.
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Affiliation(s)
- S Ulusoy
- Department of Otorhinolaryngology, Medical Faculty, Halic University, Istanbul, Turkey.
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Passali D, Arezzo MF, De Rose A, De Simone G, Forte G, Jablko-Musial M, Mösges R. Benzydamine hydrochloride for the treatment of sore throat and irritative/inflammatory conditions of the oropharynx: a cross-national survey among pharmacists and general practitioners. BMC Prim Care 2022; 23:154. [PMID: 35715725 PMCID: PMC9205545 DOI: 10.1186/s12875-022-01762-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Accepted: 06/03/2022] [Indexed: 11/17/2022]
Abstract
Background Benzydamine for oromucosal use is indicated in the relief of pain and irritation of the mouth and throat. It is an indazole derivative, non-steroidal anti-inflammatory drug, with combined local anesthetic and analgesic properties, and antiseptic activity, marketed under the brand name “Tantum Verde”. The aim of this study was to explore knowledge and prescriptive/advising attitudes among general practitioners (GPs) and pharmacists (PHs) with regard to the topical treatment of sore throat and other irritative/inflammatory conditions of the oropharynx, with a focus on benzydamine. These findings could be important to increase awareness on benzydamine efficacy in sore throat and stomatological conditions, and to reinforce knowledge on the characteristics of benzydamine and its mechanisms of action among healthcare professionals (pediatricians, otolaryngologists, oncologists, etc.). Materials and methods An online questionnaire survey was performed among PHs and GPs in four European countries (Italy, Germany, Russia and Poland). Results Both GPs and PHs proved to have an excellent knowledge and mastery of the constituents effective against oral symptoms. Among all the principles, benzydamine hydrochloride is the most recognized as certainly suitable for the topical treatment of sore throat symptoms and various inflammatory/irritative conditions of the oral cavity. It is recommended by about 90% of PHs and prescribed by 80% of GPs, mainly to solve the ailments caused by sore throats and stomatitis, especially for its anti-inflammatory, analgesic and anesthetic characteristics. Also in the pediatric field, benzydamine hydrochloride is recommended: among GPs, a high percentage (about 40%) prescribes it like the remedies based on dichlorobenzyl alcohol-sodium benzoate, which are instead more often recommended by PHs (44% against 37%). Conclusion Although the public has a lot of confidence in this treatment, GPs and PHs do not recommend/prescribe benzydamine as a first-line treatment of sore throat and other irritative/inflammatory conditions of the oropharynx. To increase the knowledge of benzydamine among these healthcare professionals, it would be important to emphasize its characteristics and the different irritative/inflammatory conditions of the oropharynx in which it can be used. Supplementary Information The online version contains supplementary material available at 10.1186/s12875-022-01762-3.
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Passali D, Barat V, Cadevall O, Freire HM, Grattagliano I, Gutu I, Mösges R, Pavlysh A. International Delphi-based consensus on the appropriate use and effect of Benzydamine hydrochloride in the treatment of sore throat. BMC Prim Care 2022; 23:296. [PMID: 36419002 PMCID: PMC9685970 DOI: 10.1186/s12875-022-01901-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 11/04/2022] [Indexed: 11/25/2022]
Abstract
BACKGROUND Benzydamine hydrochloride is a locally-acting Non-Steroidal Anti-Inflammatory Drug (NSAID) with combined local anesthetic and analgesic properties, indicated for the symptomatic relief of pain in acute sore throat. The aim of this study was to obtain an European Consensus among pharmacists, general practitioners and pediatricians on the appropriate use of benzydamine hydrochloride in the treatment of sore throat. METHODS The authors developed a Delphi questionnaire organized into 15 statements focused on 4 topics: the mechanism of action of benzydamine, the benzydamine treatment in an adult patient and in a pediatric patient, and the advantages of benzydamine over other topical treatments. The survey was administered to a panel of to 320 participants including general practitioners, pediatricians, and pharmacists from 6 European countries (Italy, Germany, Portugal, Romania, Russia, and Spain), who rated their level of agreement or disagreement with each statement on a 6-point Likert scale. Consensus was predefined as more than 66% of the panel agreeing/disagreeing with each statement. RESULTS Panelists' agreement on statements was very high. Consensus was reached for all 15 statements in the Delphi survey, with more than 98% positive agreement on topic 4, suggesting a shared view among European healthcare professionals (HCPs) about the advantages of benzydamine over other topical treatments. A strong consensus (> 99%) was reached for all the statements of topic 1 regarding the mechanism of action of benzydamine, except for its anesthetic properties (79%). Strong agreement was reached for all statements in topics 2 and 3 regarding the treatment of acute sore throat symptoms in the adult and pediatric patient, except for one on the efficacy of benzydamine in preventing post-operative sore throat, for which it was 67%. CONCLUSION Because all relevant publications on benzydamine are dated and there are no recommendations on its use for the symptomatic treatment of sore throat in European guidelines, this Delphi-based international consensus may be important in reinforcing the appropriate use and effect of benzydamine in the treatment of sore throat among health care professionals.
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Affiliation(s)
- Desiderio Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - Veronica Barat
- grid.415778.80000 0004 5960 9283AOU Città della Salute e della Scienza di Torino, Regina Margherita Children’s Hospital, Turin, Italy
| | - Olga Cadevall
- grid.497607.b0000 0004 1808 0870Clínica Rotger, Quirónsalud, Palma de Mallorca, Spain
| | - Hugo Miguel Freire
- Sociedade Portuguesa de Farmacêuticos dos Cuidados de Saúde, Coimbra, Portugal
| | | | - Ioan Gutu
- General Practitioner, Vaslui, Romania
| | - Ralph Mösges
- grid.6190.e0000 0000 8580 3777Institute of Medical Statistics, and Computational Biology (IMSB), Medical Faculty, University at Cologne, Cologne, Germany
| | - Andrey Pavlysh
- grid.445925.b0000 0004 0386 244XNorth-Western State Medical University named after I.I. Mechnikov, Saint Petersburg, Russia
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Passali GC, Passali D, Ciprandi G. Postinfectious Olfactory Complaints: A Follow-up Study. Int Arch Otorhinolaryngol 2022; 26:e657-e660. [DOI: 10.1055/s-0042-1742761] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 12/14/2021] [Indexed: 10/18/2022] Open
Abstract
Abstract
Introduction Acute upper respiratory infection (AURI) is the most common cause of postinfectious olfactory dysfunction (PIOD).
Objective We investigated the prevalence of PIOD in a large group of patients reporting persistent smell impairment perception after the AURI resolution.
Methods Olfactometry was performed within 1 month after the common cold resolution and after 1 year in 467 (299 males, mean age 41.7 years) outpatients. The Sniffin' Sticks olfactory test (Burghart instruments, Wedel, Germany) was used.
Results Anosmia was documented in 28 (6%) patients, hyposmia in 33 (7%), and cacosmia in 55 (11.7%). After 1 year, PIOD improved in 82 (79.6%) patients re-tested.
Conclusion The current study demonstrated that persistent olfactory dysfunction is a relevant symptom in patients with AURI, even though many patients had normal olfactometry. Thus, smell impairment deserves careful attention and requires objective documentation.
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Affiliation(s)
- Giulio Cesare Passali
- Otorhinolaryngology Clinic, Fondazione Policlinico Universitario A. Gemelli IRCSS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Desiderio Passali
- Outpatient Departement, International Federation ORL Societies (IFOS), Rome, Italy
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Passali D, Bellussi LM, Passali FM, Ciprandi G. Rhinosinusitis: clinical-based phenotyping. Acta Biomed 2022; 93:e2022211. [PMID: 36300245 PMCID: PMC9686162 DOI: 10.23750/abm.v93i5.12633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/17/2021] [Indexed: 01/25/2023]
Abstract
Rhinosinusitis (RS) is a common disease and is currently classified into two main types: acute RS (ARS) and chronic RS (CRS), which in turn includes CRS with or without nasal polyps. Different guidelines consider this classification. However, in clinical practice, other phenotypes exist. The current article would propose new clinical-based phenotyping of RS, including the following clinical phenotypes: simple catarrhal RS, Acute RS, acute bacterial RS, severe (complicated) acute RS, chronic RS, and recurrent chronic RS. Treatment strategy should be tailored considering the clinical phenotype and could include phytomedicines, intranasal non-pharmacological remedies, and local bacteriotherapy. In conclusion, RS requires thorough diagnostic work-up, and the therapeutic approach should be mainly based on appropriate management.
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Passali GC, Passali D, Ciprandi G, International ENT Study Group. The impact of COVID-19 pandemic on otolaryngologic practice. Acta Biomed 2022; 93:e2022266. [PMID: 36043971 PMCID: PMC9534245 DOI: 10.23750/abm.v93i4.12632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022]
Affiliation(s)
- Giulio Cesare Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy, Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - Desiderio Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | | | - International ENT Study Group
- International ENT Study Group: Luisa Maria Bellussi Luisa (Italy), Pasquale Cassano (Italy), Valerio Damiani (Italy), Ignazio La Mantia (Italy), Nicola Lombardo Nicola (Italy), Francesco Maria Passali (Italy), Marco Piemonte (Italy), Felice Scasso (Italy), Ahluwalia Hemant (India), Tomas Balsevicius (Lithuania), Ricardo De Hoios (Mexico), Amarilis Menedez (Panama), Juan David Carvajal (Venezuela)
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Passali FM, Passali D, Ciprandi G. The impact of infections in the otolaryngologist's practice. Acta Biomed 2022; 93:e2022215. [PMID: 36300246 PMCID: PMC9686181 DOI: 10.23750/abm.v93i5.12630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 01/30/2022] [Indexed: 12/14/2022]
Affiliation(s)
| | - Desiderio Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | | | - International ENT Study Group
- International ENT Study Group: Luisa Maria Bellussi Luisa (Italy), Pasquale Cassano (Italy), Valerio Damiani (Italy), Ignazio La Mantia (Italy), Nicola Lombardo Nicola (Italy), Giulio Cesare Passali (Italy), Marco Piemonte (Italy), Felice Scasso (Italy), Ahluwalia Hemant (India), Tomas Balsevicius (Lithuania), Ricardo De Hoios (Mexico), Amarilis Menedez (Panama), Juan David Carvajal (Venezuela)
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Passali GC, Passali D, Ciprandi G, and the Italian Study Group on Vasomotor Rhinitis. Vasomotor Rhinitis: an Italian survey in clinical practice. Acta Biomed 2022; 93:e2022296. [PMID: 36533770 PMCID: PMC9828923 DOI: 10.23750/abm.v93i6.13218] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Accepted: 07/21/2022] [Indexed: 01/02/2023]
Affiliation(s)
- Giulio Cesare Passali
- Fondazione Policlinico Universitario A. Gemelli IRCSS, Clinica di Otorinolaringoiatria, Roma - Università Cattolica del Sacro Cuore, Rome, Italy
| | | | | | - and the Italian Study Group on Vasomotor Rhinitis
- Members of the Italian Study Group on Vasomotor Rhinitis: Albera R, Bellocchi G, Berettini S, Celebrini G, Crisanti A, Damiani V, De Corso E, Di Girolamo S, Galletti F, Lauriello M, Leone CA, Magnato R, Mezzedimi C, Motta G, Pasqualini P, Passali FM, Passali GC, Piemonte M, Ralli M, Salamanca G, Salzano F, Scasso F
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Passali D, La Rosa R, Passali GC, Ciprandi G. The Empty Nose Syndrome: a pragmatic classification in clinical practice. Acta Biomed 2021; 92:e2021288. [PMID: 34738597 PMCID: PMC8689295 DOI: 10.23750/abm.v92i5.9835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/23/2022]
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Ciprandi G, Bellussi LM, Damiani V, Passali D. HMGB1-antagonism exerted by glycyrrhizin could be fruitful against COVID-19. Acta Biomed 2021; 92:e2021455. [PMID: 34739475 PMCID: PMC8851008 DOI: 10.23750/abm.v92is6.12111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Accepted: 08/30/2021] [Indexed: 11/23/2022]
Abstract
The COVID-19 pandemic era is causing a relevant issue for the health. There is no specific drug able to antagonize the SARS-CoV-2 infection. As a consequence, there is growing interest about potential molecules able to contrast infection. In this regard, HMGB, an alarmin, may play a relevant role in pathogenic mechanisms induced by SARS-CoV-2. As HMGB1 is antagonized by glycyrrhizin, this substance could be potentially useful as ancillary treatment in COVID-19.
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Affiliation(s)
- Giorgio Ciprandi
- Consultant Allergist, Casa di Cura Villa Montallegro, Genoa, Italy.
| | - Luisa Maria Bellussi
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy.
| | | | - Desiderio Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy.
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De Corso E, Bellocchi G, De Benedetto M, Lombardo N, Macchi A, Malvezzi L, Motta G, Pagella F, Vicini C, Passali D. Biologics for severe uncontrolled chronic rhinosinusitis with nasal polyps: a change management approach. Consensus of the Joint Committee of Italian Society of Otorhinolaryngology on biologics in rhinology. ACTA ACUST UNITED AC 2021; 42:1-16. [PMID: 34297014 PMCID: PMC9058929 DOI: 10.14639/0392-100x-n1614] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2021] [Accepted: 06/16/2021] [Indexed: 02/07/2023]
Abstract
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous inflammatory condition of nasal mucosa and paranasal sinuses, predominantly mediated by type 2 inflammation and often associated with comorbid asthma and/or Exacerbated Respiratory Disease (N-ERD). The standard of care involves local and systemic corticosteroids and/or sinonasal surgery, although these options may be associated with recurrences and patients may require revision surgery. Difficult-to-treat patients, in fact, have a more severe disease requiring high systemic corticosteroid use and/or multiple sinonasal surgeries. Literature data suggests that biologic agents targeting specific key effectors of type 2 inflammation may offer supplemental therapy for patients with severe and uncontrolled CRSwNP, leading to significant improvement in several outcomes. For these reasons, over the years the endotyping of the disease has become increasingly important. Herein, we provide not only an update on the existing studies about the most promising biologics in CRSwNP, but also critical discussion on controversies about the use of biologics in severe uncontrolled CRSwNP. We finally provide consensus on strategic issues gathered among experts of the Joint Committee of Italian Society of Otorhinolaryngology on biologics in order to offer the best care for difficult to treat patients.
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Affiliation(s)
- Eugenio De Corso
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Head and Neck Surgery - Otorhinolaryngology, Rome, Italy
| | | | | | - Nicola Lombardo
- ENT Unit Department of Medical and Surgical Sciences, University Magna Græcia Catanzaro, Italy
| | - Alberto Macchi
- ENT University of Insubria, Varese, ASST Settelaghi, Italy
| | - Luca Malvezzi
- IRCCS Humanitas Research Hospital, Department of Otorhinolaryngology and Head and Neck Surgery, Rozzano, Milan, Italy
| | - Gaetano Motta
- Otorhinolaryngology-Head and Neck Surgery, University of Campania L. Vanvitelli, Napoli, Italy
| | - Fabio Pagella
- ENT Department, I.R.C.C.S. Policlinico San Matteo- University of Pavia, Italy
| | - Claudio Vicini
- Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy
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17
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Dobretsov KG, Kolenchukova O, Sipkin A, Bellussi LM, Ciprandi G, Passali D. A randomized, double-blind, placebo- -controlled study to investigate the use of bacteriophages in patients with chronic rhinosinusitis with nasal polyps. Otolaryngol Pol 2021; 75:33-37. [PMID: 35175218 DOI: 10.5604/01.3001.0015.0084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Background A randomized, double-blind placebo-controlled study investigated the use of bacteriophages in the treatment of chronic rhinosinusitis with nasal polyps. Materials and Methods 40 adult patients with сhronic rhinosinusitis with nasal polyps were examined. All patients underwent functional endoscopic sinus surgery. After the surgery, 20 patients got the intranasal gel with a bacteriophages mixture (Otofag, Micromir, Russia) twice a day for ten weeks, and 20 patients got a placebo. Results On the 10th day, IL-1β secretion diminished (63 mg/ml versus 440 mg/ml in control). There was a decrease in the total number of microorganisms and Enterobacteriaceae (5.7 x 106 CFU/ml versus 1.2 x 109 CFU/ml in control), and the absence of Streptococci (versus 2.1 x 109 CFU/ml in control) on the 30th day of the treatment in the group with the bacteriophages. On the 10th day, a decrease in the activity of secretory IL-1β and IL-8 strongly and very strongly correlated with a total number of microorganisms (r = 0.7; r = 0.9 respectively), as well as secretory IL-8 with Enterobacteriaceae (r = 0.72) and Staphylococci (r = 0.65) in the active group treated with the bacteriophages. On the 30th day, the decrease in serum IL-1β significantly correlated with the total number of microorganisms (r = 0.80) and enterobacteria (r = 0.90) in the active group. Conclusions The administration of bacteriophages restored the balance of microorganisms in the nasal cavity and decreased the inflammatory response in chronic rhinosinusitis with nasal polyps. These changes, such as an inflammation dampening, could theoretically reduce the recurrent growth of polyp tissue in the future.
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Affiliation(s)
| | - Oxana Kolenchukova
- Federal Siberian Scientific and Clinical Center of Federal Medical-Biological Agency of Russia, Krasnoyarsk, Russia
| | - Alexander Sipkin
- Federal Research Center "Krasnoyarskii Scientific Center" of the Siberian branch of the Russian Academy of Sciences, Scientific Research Institute of Medical Problems of the North, Russia
| | | | - Giorgio Ciprandi
- Outpatients Clinics Dept., Casa di Cura Villa Montallegro, Genoa, Italy
| | - Desiderio Passali
- IFOS, International Federation of Otorhinolaryngological Societies, Rome, Italy
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18
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La Rosa R, Passali D, Passali GC, Ciprandi G. A practical classification of the Empty Nose Syndrome. J BIOL REG HOMEOS AG 2021; 35:51-54. [PMID: 33982539 DOI: 10.23812/21-1supp2-10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- R La Rosa
- ENT Clinic, Casa di Cura Villalba, Bologna, Italy
| | - D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento,Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS,Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
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19
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Abstract
Laryngopharyngeal reflux (LPR) is a common disease caused by the leaking beck of gastric material out of the esophagus. The main symptoms are dysphonia, dysphagia, and cough. There is an established use of proton pump inhibitors (PPI) in patients with suspected LPR in common practice. This habit is translated by the standard strategy to use PPI in treating patients with gastroesophageal reflux. However, PPI can not wholly inhibit all types of reflux and are burden by adverse effects. Alginate, a derivative from algae, is devoid of side effects and effectively counteracts gastric material reflux forming a foaming gel in the stomach. The current study enrolled 100 outpatients with LPR. Alginate treatment was administered for two months. Patients underwent four visits (at baseline and 15, 30, and 60 days after treatment). A visual analog scale assessed the perception of dysphonia, dysphagia, and cough. Alginate significantly (p<0.0001) reduced all parameters. Therefore, the current study demonstrated that magnesium alginate was effective and safe in LPR treatment.
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Affiliation(s)
- G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
| | - V Damiani
- Medical Department, D.M.G. Italia, Pomezia, Italy
| | - F M Passali
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
| | - A Crisanti
- Clinical Medicine Department, Regina Apostolorum Hospital, Albano Laziale, Rome, Italy
| | - G Motta
- ENT Clinic, University Vanvitelli, Naples, Italy
| | - D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
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20
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Ciprandi G, Passali D, Damiani V, Mezzedimi C, Bellussi LM, Passali GC. Laryngopharyngeal reflux management in clinical practice. J BIOL REG HOMEOS AG 2021; 35:55-59. [PMID: 33982540 DOI: 10.23812/21-1supp2-11] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Laryngopharyngeal reflux (LPR) is an inflammatory reaction of the mucosa of the pharynx, larynx, and other associated upper respiratory organs, caused by a reflux of stomach contents outside the esophagus. LPR is considered a relatively new clinical entity with a vast number of clinical manifestations that are sometimes treated empirically and without a correct diagnosis. Alginate is a reasonable therapeutic option as a first-line or add-on option. A survey included 35 Italian otorhinolaryngologists. The survey considered ten practical queries. LPR is a common disease in clinical practice. History and fiber-optic endoscopy constitute the main diagnostic tools. Alginates represent a frequent medication to treat LPR both as first-line and add-on. The mean effectiveness rate is 44% for first-line choice and 76% for the add-on. In conclusion, the current survey provided exciting information about the management of LPR in clinical practice.
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Affiliation(s)
- G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
| | - D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | - V Damiani
- Medical Deparment, DMG Italy, Pomezia, Italy
| | | | - L M Bellussi
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
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21
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Passali D, Passali GC, Damiani V, Passali FM, Cingi C, Di Girolamo S, Ciprandi G. The impact of Allergic Rhinitis in clinical practice: An International Survey. J BIOL REG HOMEOS AG 2021; 35:39-43. [PMID: 33982537 DOI: 10.23812/21-1supp2-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Allergic rhinitis (AR) is a frequent disease caused by an IgE-mediated inflammation of the nose and characterized by typical symptoms. Diagnostic workup is directed to document the production of specific IgE (sensitization). Clinical management aims to relieve symptoms, resolve allergic inflammation, use medications, and potentially induce allergen tolerance, using allergen immunotherapy (AIT). The current survey was conducted in 17 International ear nose throat experts using a questionnaire with 20 questions concerning the practical management of AR patients. It was administered in the 2020 summer. The large majority (94%) of participants use the ARIA classification in clinical practice. On average, subjects with suspected AR represent half of the patients who turn to the ENT experts; 80% have the confirmed diagnosis. Most of the experts use both cutaneous and serum assay to document IgE production. Antihistamines are prescribed in 59% of AR patients, intranasal corticosteroids in 69%, non-adrenergic decongestants in 88%, nasal lavage in 88%, and AIT in 22%. About 68% of AR patients had turbinate hypertrophy, which requires surgery in 62% (mostly surgical decongestion). In conclusion, the current International Survey demonstrated that AR is a common disorder worldwide, the diagnostic workup is mainly based on IgE assessment, and the therapeutic approach is also based on non-pharmacological remedies.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - V Damiani
- Medical Deparment, DMG Italy, Pomezia, Italy
| | - F M Passali
- Department of Clinical Sciences and Translational Medicine, University of Tor Vergata, Rome, Italy
| | - C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - S Di Girolamo
- 5Department of Clinical Sciences and Translational Medicine, University Tor Vergata, Rome, Italy
| | - G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
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22
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Ciprandi G, Passali D. The management of upper airway diseases: an ongoing challenge for the clinician. J BIOL REG HOMEOS AG 2021; 35:1-2. [PMID: 33982530 DOI: 10.23812/21-1supp2-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Upper airway diseases are widespread in clinical practice. However, some aspects are still debated. The current supplement presents and discusses the most common disorders encountered in daily medical activity. The COVID-19 dramatic pandemic requires an urgent solution. Promising non-pharmacological agents are discussed. Chronic diseases are frequent in childhood, so to know risk factors is useful in their management. Allergic rhinitis and chronic rhinosinusitis should be treated with anti-inflammatory drugs, but complementary compounds should be alternated to preserve health. Empty nose syndrome is a frequent complication of nasal surgery and requires adequate staging and hydrating procedure. Lastly, laryngopharyngeal reflux is an intriguing challenge for the clinician. Alginates represent a safe and effective way to relieve LPR symptoms.
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Affiliation(s)
- G Ciprandi
- Consultant allergist, Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
| | - D Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
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23
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Passali D, Bellussi LM, Passali FM, De Hoyos R, Di Girolamo S, Ciprandi G. Prevention and treatment of upper respiratory diseases in the pandemic COVID-19 era. J BIOL REG HOMEOS AG 2021; 35:3-8. [PMID: 33982531 DOI: 10.23812/21-1supp2-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
In the pandemic coronavirus disease 2019 (COVID-19) era, the need to use preventive-curative treatments is compelling. A series of non-pharmacological compounds, including oligo-elements, vitamins, nutraceuticals, and bacteriotherapy, might affect the risk of COVID-19, both reinforcing the immune system and improving the inflammation resolution during respiratory infections. Non-pharmacological remedies are very popular and usually have no relevant side effects. Bacterial and natural products may potentiate the immune system against respiratory viruses. Moreover, these compounds also exert antiinflammatory and antioxidant activity. Consequently, these non-chemical remedies could be prescribed to build up the immune defence and adequately treat the upper respiratory infection. In this way, natural compounds could be used to manage people in the pandemic COVID-19 era.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - L M Bellussi
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - F M Passali
- ENT Department, University Tor Vergata, Rome, Italy
| | - R De Hoyos
- Departamento de Ciencias Clínicas (Escuela de Medicina), Tecnológico de Monterrey, Monterrey, Mexico
| | | | - G Ciprandi
- Consultant allergist, Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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24
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Passali D, Ionescu A, Brambilla E, Bellussi LM, Ciprandi G, Mattina R, Passali GC. Can Pseudomonas aeruginosa growth be modulated by natural compounds? J BIOL REG HOMEOS AG 2021; 35:21-25. [PMID: 33982534 DOI: 10.23812/21-1supp2-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Pseudomonas aeruginosa is an opportunistic human pathogen that frequently induces antibiotic resistance, as it mainly tends to form biofilms. Iron chelation may be an intriguing strategy to contrast bacterial growth. Lactoferrin is a natural compound able to chelate iron. A new multi-component medical device also contains lactoferrin. This study analyzed this compound investigating the in vitro capacity to inhibit Pseudomonas aeruginosa growth. In conclusion, this study demonstrated that a multicomponent medical device (Saflovir), also containing lactoferrin, could inhibit the in vitro growth of P. aeruginosa. This activity could be positively used in the prevention of respiratory nasal infections.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - A Ionescu
- Department of biomedical, surgical,and dental sciences, University of Milan, Milan, Italy
| | - E Brambilla
- Department of biomedical, surgical,and dental sciences, University of Milan, Milan, Italy
| | - L M Bellussi
- International Federation ORL Societies (IFOS), Rome, Italy
| | - G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
| | - R Mattina
- Department of biomedical, surgical,and dental sciences, University of Milan, Milan, Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento,Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
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25
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Passali D, Damiani V, Cianfrone F, Passali GC, Bellussi LM, Ciprandi G. Lactoferrin: a potential candidate to fight respiratory infections in the pandemic COVID-19 era. J BIOL REG HOMEOS AG 2021; 35:9-13. [PMID: 33982532 DOI: 10.23812/21-1supp2-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Respiratory infections are a significant burden at any age, but especially in childhood and aging. The COVID-19 pandemic has worsened the issue since there is no specific treatment and vaccine is not available. Moreover, respiratory symptoms cause social stigma in subjects suffering from an infection of any kind. As new drugs require a very long time to be marketed, a natural compound's interest is growing. In this regard, lactoferrin is a multifunctional protein present in secretions, mainly in breast milk. Lactoferrin has marked antimicrobial activity, including antibacterial, antiviral, antiparasitic, and antifungal. Moreover, lactoferrin strongly affects immune response and cellular control activity. Therefore, this natural component could provide a promising effect in preventing respiratory infections and potentially also for COVID-19.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - V Damiani
- Medical Department, DMG Italy, Pomezia, Rome
| | - F Cianfrone
- ENT Clinic , ASL RM1, San Filippo Neri Hospital, Rome, Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - L M Bellussi
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - G Ciprandi
- Consultant allergist, Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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26
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Passali D, Passali GC, Piemonte M, Cingi C, Ciprandi G. The management of chronic rhinosinusitis in clinical practice: An International Survey. J BIOL REG HOMEOS AG 2021; 35:45-50. [PMID: 33982538 DOI: 10.23812/21-1supp2-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Chronic rhinosinusitis (CRS) is a common disease and is currently classified in two main phenotypes: CRS with nasal polyps (CRSwNP) and CRS without nasal polyps (CRSsNP). A panel of international experts conducted the present survey. A questionnaire, containing 25 questions, was completed by each member of the panel. About half of patients with suspected CRS had confirmed diagnosis. CRSwNP affected 31% of CRS patients. Endoscopy and CT were ever performed. Rhinitis and asthma were frequent comorbidities. Intranasal corticosteroids were prescribed on average in 86% of patients. Nonadrenergic compounds were prescribed by 71% of experts. Surgery for CRSwNP was performed in about half of patients; repeated intervention occurred in about one/third. In conclusion, the current survey demonstrated that CRS requires thorough diagnostic work-up, and the most common therapeutic approach is mainly based on intranasal corticosteroids, non-adrenergic decongestants, and surgery.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members Rome Italy
| | - G C Passali
- UOC di Otorinolaringoiatria, Dipartimento Scienze dell'Invecchiamento, Neurologiche, Ortopediche e della testa collo. Fondazione Policlinico Universitario A. Gemelli IRCCS, Roma, Italy.,Institute of Otolaryngology, Università Cattolica del Sacro Cuore, Policlinico Agostino Gemelli, Rome, Italy
| | - M Piemonte
- ENT Clinic, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy
| | - C Cingi
- Department of Otorhinolaryngology, Eskisehir Osmangazi University, Eskisehir, Turkey
| | - G Ciprandi
- Consultant allergist, Casa di Cura Villa Montallegro, Genoa, Italy
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27
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Passali D, Ciprandi G, Damiani V, De Marco AM, Cianfrone F, Passali FM. Glycyrrhizin for topical use and prophylaxis of COVID-19: an interesting pharmacological perspective. J BIOL REG HOMEOS AG 2021; 35:15-19. [PMID: 33982533 DOI: 10.23812/21-1supp2-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
COVID-19, the disease caused by the SARS - CoV - 2 pathogen, is currently a pandemic. At the moment there is not an available vaccine, so, scientific community is looking for strategies and drugs to implement prevention and prophylaxis. Several compounds are examined for this purpose. Glycyrrhizin, an alkaloid extracted from licorice plant (glycyrriza glabra), is one of the most studied molecules, both for its peculiar biological functions and for its pharmacological effects. This brief review aims to highlight the characteristics of glycyrrhizin for topical use on the nasal and ocular surfaces. The anti-inflammatory activity, the ability to inhibit the accumulation of ROS, the antiviral property, but, above all, the ability to bind the ACE receptor and the SARS - CoV-2 protein S in the extracellular environment make Glycyrrhizzin for topical use a compound with a high prophylactic potential for SARS - CoV - 2 infection, also due to its low cost and the absence of significant side effects.
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Affiliation(s)
- D Passali
- International Federation ORL Societies (IFOS) Executive Board members, Rome, Italy
| | - G Ciprandi
- Consultant Allergist, Casa di Cura Villa Montallegro, Genoa, Italy
| | - V Damiani
- Medical Department, DMG Italy, Pomezia, Rome
| | | | - F Cianfrone
- ENT Clinic, ASL RM1, San Filippo Neri Hospital, Rome, Italy
| | - F M Passali
- Department, University Tor Vergata, Rome, Italy
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28
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Mösges R, Passali D, Di Gioacchino M. Worldwide surveys on anaphylaxis to sublingual immunotherapy with house dust mite tablets are urgently needed. Clin Transl Allergy 2021; 11:e12012. [PMID: 33900053 PMCID: PMC8099305 DOI: 10.1002/clt2.12012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In the 1980s, a global number of 72 fatalities were reported in the UK and the USA following the application of subcutaneous immunotherapy (SCIT). This resulted in a significant limitation of SCIT use and in the search of other routes of administration, among which sublingual immunotherapy (SLIT) showed the best balance between efficacy and safety. Data from controlled studies suggest that tablets‐related anaphylaxis is an uncommon event. However, in the Eudravigilance (European database of suspected adverse drug reactions from Europe) we found reports of life‐threatening events or severe local reactions under SLIT increasing over the last few years. Therefore, all efforts to minimize the related risk have to be strongly encouraged.
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Affiliation(s)
- Ralph Mösges
- IMSB (Institute of Computational Biology and Medical Statistics), University at Cologne, Cologne, 50924, Germany.,Clinical Research International Limited, Mühlenberg 64, Hamburg, 22587, Germany
| | - Desiderio Passali
- Istituto di Discipline Otorinolarinogologiche, Universita degli Studi, Siena, 53100, Italy
| | - Mario Di Gioacchino
- Department of Medicine and Science of Ageing, G. d'Annunzio University Chieti-Pescara, Chieti, 66100, Italy.,Institute for Clinical Immunotherapy and Advanced Biological Treatments, Pescara, 65100, Italy
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29
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Passali FM, Passali GC, Passali D, Ciprandi G. Smell impairment in patients with allergic rhinitis. Int Forum Allergy Rhinol 2021; 11:1031-1032. [PMID: 33728747 DOI: 10.1002/alr.22786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 01/30/2021] [Accepted: 02/03/2021] [Indexed: 11/06/2022]
Affiliation(s)
| | | | - Desiderio Passali
- International Federation Oto-Rhino-Laryngological (ORL) Societies (IFOS), Rome, Italy
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Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang DY, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 2021; 11:213-739. [PMID: 33236525 DOI: 10.1002/alr.22741] [Citation(s) in RCA: 357] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
I. EXECUTIVE SUMMARY BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. METHODS ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. CONCLUSION This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.
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Affiliation(s)
| | | | | | | | | | - Amber U Luong
- University of Texas Medical School at Houston, Houston, TX
| | | | - Zachary Soler
- Medical University of South Carolina, Charleston, SC
| | - Kevin C Welch
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | | | - Claus Bachert
- Ghent University, Ghent, Belgium.,Karolinska Institute, Stockholm, Sweden.,Sun Yatsen University, Gangzhou, China
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- Columbia University Irving Medical Center, New York, NY
| | - Daniel L Hamilos
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Richard Harvey
- University of New South Wales and Macquarie University, Sydney, New South Wales, Australia
| | | | | | | | | | - Amin R Javer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Kevin C McMains
- Uniformed Services University of Health Sciences, San Antonio, TX
| | | | - Joaquim Mullol
- IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Alkis J Psaltis
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Luke Rudmik
- University of Calgary, Calgary, Alberta, Canada
| | - Raymond Sacks
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | - De Yun Wang
- National University of Singapore, Singapore, Singapore
| | | | | | | | - Carol Yan
- University of California San Diego, La Jolla, CA
| | - Luo Zhang
- Capital Medical University, Beijing, China
| | - Bing Zhou
- Capital Medical University, Beijing, China
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Ciprandi G, La Mantia I, Damiani V, Passali D. Local Bacteriotherapy - a promising preventive tool in recurrent respiratory infections. Expert Rev Clin Immunol 2020; 16:1047-1052. [PMID: 33022191 DOI: 10.1080/1744666x.2021.1833720] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
INTRODUCTION Children with recurrent respiratory infections (RRI) represent a social issue for the economic burden and the negative family impact. Local Bacteriotherapy is an attractive therapeutic strategy that could be potentially effective in preventing infections. The current article remarks on the existing evidence of preventing RRI by Local Bacteriotherapy. AREAS COVERED The literature search methodology was based on the articles cited by PubMed from 1980 to 2020. Respiratory infections include rhino-pharyngitis, otitis media, rhinosinusitis, pharyngo-tracheitis, bronchitis, and pneumonia. Several studies were performed to investigate the effects of Local Bacteriotherapy in children with RRI. Both intranasal and oral Local Bacteriotherapy were evaluated. The findings showed that Local Bacteriotherapy significantly reduced the number of RI episodes, their severity, the use of antibiotics, and school absences. EXPERT OPINION Local Bacteriotherapy is a promising approach to RRI prevention and could be a profitable strategy to contrast infections in the future.
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Affiliation(s)
| | | | - Valerio Damiani
- Medical Department, Drugs Minerals and Generics , Pomezia, Italy
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Motta G, Passali D, Passali GC, Cantone E. The Italian Society Indication for Rhinologists during Covid-19: Italy Phase 2. Int Arch Otorhinolaryngol 2020; 24:e388-e390. [PMID: 32754253 PMCID: PMC7394651 DOI: 10.1055/s-0040-1713141] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 05/11/2020] [Indexed: 12/02/2022] Open
Affiliation(s)
- Gaetano Motta
- Otorhinolaryngology, Head and Neck Surgery Unit, Department of Mental and Physical Health and Preventive Medicine, Università degli Studi della Campania Luigi Vanvitelli, Naples, Italy
| | | | - Giulio Cesare Passali
- ENT Clinic, Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Università Cattolica del Sacro Cuore, Rome, Italy
| | - Elena Cantone
- Department of Neuroscience, Reproductive and Odontostomatological Sciences - ENT Section, Università degli Studi di Napoli Federico II, Naples, Italy
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Passali D, Motta G, Passali FM, Nunziata M, Ciprandi G. Oral quail egg homogenate in the treatment of allergic rhinitis: a first experience in clinical practice. J BIOL REG HOMEOS AG 2020; 34:1593-1596. [PMID: 32933233 DOI: 10.23812/20-235-l] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
| | - G Motta
- ENT Clinic, University of Campania L. Vanvitelli, Naples, Italy
| | - F M Passali
- ENT Clinic, Uni¬versity Tor Vergata ENT, Rome, Italy
| | - M Nunziata
- ENT Clinic, University of Campania L. Vanvitelli, Naples, Italy
| | - G Ciprandi
- Allergy Clinic, Casa di Cura Villa Montallegro, Genoa, Italy
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Toraldo DM, Di Michele L, Ralli M, Arigliani M, Passali GC, De Benedetto M, Passali D. Obstructive sleep apnea syndrome in the pediatric age: the role of the pneumologist. Eur Rev Med Pharmacol Sci 2020; 23:15-18. [PMID: 30920630 DOI: 10.26355/eurrev_201903_17342] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE This review paper aims to summarize the current state of knowledge on the role of the pneumologist in the diagnosis and respiratory treatment of children affected by obstructive Sleep Disordered Breathing (SDB). MATERIALS AND METHODS A literature review has been performed on the following topics: obstructive SDB and its clinical entities, indications for respiratory treatment of pediatric SDB, and Continuous Positive Airway Pressure (CPAP) and Noninvasive Positive Pressure Ventilation (NIPPV) treatment approach to obstructive SDB. RESULTS OSDB is related to obesity, craniofacial pathologies, neuromuscular disorders and, most commonly, oadenotonsillar hypertrophy. Adenotonsillectomy is the first-choice treatment in children with obstructive apnea secondary to adenotonsillar hypertrophy. CPAP and NIPPV are recommended in cases where Obstructive Sleep Apnea (OSA) persists after surgery or when surgery is contraindicated. Treatment interventions are usually implemented gradually by separately addressing each abnormality that would predispose to obstructive SDB, then reevaluating after each intervention to detect any residual disease and to assess the need for additional treatment. CONCLUSIONS Many pediatric patients continue to experience problems and symptoms such as hypersomnia and apnea after adenotonsillectomy and need CPAP/NIPPV treatment. Current knowledge is still incomplete, especially with regard to the mechanisms of pathogenesis of pediatric OSA, the factors affecting pediatric OSA, and the phenotypic variability of the disease. A better understanding of these aspects would contribute to the development of new therapies.
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Affiliation(s)
- D M Toraldo
- Department of Rehabilitation, Cardiorespiratory Rehabilitation Unit, Vito Fazzi Hospital, ASL Lecce, Lecce, Italy.
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Bellussi LM, Passali FM, Ralli M, De Vincentiis M, Greco A, Passali D. An overview on upper respiratory tract infections and bacteriotherapy as innovative therapeutic strategy. Eur Rev Med Pharmacol Sci 2020; 23:27-38. [PMID: 30920638 DOI: 10.26355/eurrev_201903_17345] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of this review is to describe the most common recurring and chronic upper respiratory tract infections (URTI) in children and discuss the role of bacterial interference and bacteriotherapy in their prevention and treatment. MATERIALS AND METHODS A literature review has been performed on the following topics: acute otitis media, adenoiditis, tonsillitis, rhinosinusitis, microbiotics and the role of bacterial interference, and bacteriotherapy in the prevention and treatment of URTI. RESULTS Research studies into the characteristics of the microbiological flora and its role in the pathogenesis of URTI have focused on a single pathogen, on resistance to and ineffectiveness of antibiotic therapies, or on the persistence of bacterial biofilm. Recent evidence supports a central role of the existing microbial ecosystem in the pathogenesis of respiratory disease. In light of this, new therapeutic approaches include the implantation and persistence within the normal microflora of relatively innocuous "effector" bacteria that can competitively exclude or prevent the outgrowth of potentially disease-causing bacteria. Recently, a retrospective and observational study demonstrated that S. salivarius 24SMB and S. oralis 89a nasal spray could be effective in the prevention of recurrent otitis media in a real-life setting. Other studies have focused on the role of bacteriotherapy in children with beneficial effects in the prevention of URTI. CONCLUSIONS The results of previous studies on the role of bacteriotherapy in paediatric URTI suggest that the use of bacterial interference phenomena through bacteriotherapy is a feasible, safe approach and deserves proper consideration as a promising therapeutic strategy against URTI.
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Affiliation(s)
- L M Bellussi
- Department of Medicine, Surgery and Neuroscience, ENT Clinic, University of Siena, Siena, Italy.
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Passali D, Passali GC, Vesperini E, Cocca S, Visconti IC, Ralli M, Bellussi LM. The efficacy and tolerability of Streptococcus salivarius 24SMB and Streptococcus oralis 89a administered as nasal spray in the treatment of recurrent upper respiratory tract infections in children. Eur Rev Med Pharmacol Sci 2020; 23:67-72. [PMID: 30920629 DOI: 10.26355/eurrev_201903_17352] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Nasal administration of Streptococcus salivarius 24SMB and Streptococcus oralis 89a has been proposed to reduce the risk of new episodes of adenoiditis, tonsillitis and acute rhinosinusitis in children. PATIENTS AND METHODS We enrolled 202 children with a recent diagnosis of recurrent upper respiratory tract infection. All the patients were treated twice daily for 7 days each month for 3 consecutive months with a nasal spray whose active agents were two specific bacterial strains: Streptococcus salivarius 24SMB and Streptococcus oralis 89a. Evaluation was performed at the end of treatment and at follow-up at 3, 6, and 12 months. RESULTS Patients who completed the entire 90-day course of bacteriotherapy and the follow-up period showed a 64.3% reduction in their episodes of upper respiratory tract infections compared to the number of episodes recorded in the previous year. Treatment decreased the reported incidence of infection events by 52.4% in the first 3 months, 31.2% at 6-month follow-up, and 20.8% after 12 months. Enrolled patients tolerated the product well, and there were no dropouts. CONCLUSIONS Prophylactic bacteriotherapy by administration of Streptococcus salivarius 24SMB and Streptococcus oralis 89a in children with a history of recurrent upper respiratory tract infection could reduce the number of episodes of otolaryngologic infections. Bacteriotherapy can be even more clinically important due to increasing difficulty in finding new effective antibiotic compounds. New alternative therapeutic approaches must be found with, in comparison to antibiotics, greater specificity and safety with respect to patients' native beneficial flora; lack of drug interactions; the ability to leverage complementary systemic modes of action; and drastically reduced risk of developing resistance within the patient population and the environment.
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Affiliation(s)
- D Passali
- Department of Medicine, Surgery and Neuroscience, ENT Clinic, University of Siena, Siena, Italy.
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Dobretsov K, Negm H, Ralli M, Passali D. The theory of a "staphylococcus superantigen" in chronic rhinosinusitis with nasal polyps: myth or reality? Eur Rev Med Pharmacol Sci 2020; 23:48-54. [PMID: 30920632 DOI: 10.26355/eurrev_201903_17349] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE The aim of our study was to search for evidence of a "staphylococcus superantigen" in chronic rhinosinusitis with nasal polyps. PATIENTS AND METHODS Sixty-nine patients with chronic rhinosinusitis with nasal polyps and 45 healthy controls were included in the study. All patients in the study and control groups underwent bacteriological and immunological examination on nasal smear samples. Total IgE and the following cytokines were tested in all patients: tumor necrosis factor (TNF), interleukin-1 (IL1), interleukin-6 (IL6), interleukin-8 (IL8). RESULTS The concentration of bacteria in the nasal cavity was much higher in patients in the study group compared to those in the control group, mainly due to staphylococci. In species identification of staphylococci, bacteria most represented were S. aureus and S. epidermidis. The greater the concentration of S. aureus, the lower the level of IgE. Proinflammatory cytokines were uniformly increased in patients with nasal polyps. The level of IgE was maximal in patients with chronic rhinosinusitis with nasal polyps with a poor growth of culture and minimal in patients with abundant growth, suggesting that in the latter the effect of eosinophilic inflammation on the disease was reduced, and conversely, the activity of eosinophilic inflammation was maximal with a poor seeding of the nasal cavity. CONCLUSIONS Although this study has some limits, our findings do not support the theory of a staphylococcus superantigen in which the IgE level and eosinophilic inflammation should increase with increasing activity of Staphylococcus aureus. Further research supported by a larger sample of patients is required to better delineate the role of a staphylococcus superantigen in the pathogenesis of patients with chronic rhinosinusitis with nasal polyps.
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Affiliation(s)
- K Dobretsov
- Center of Otorhinolaryngology of Federal Siberian Scientific Clinical Centre of FMBA of Russia, Moscow, Russia.
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De Benedetto M, Arigliani M, Ballacchino A, Cassano P, Toraldo DM, Ralli M, Passali FM, Passali D. Obstructive sleep apnea syndrome in the pediatric age: the role of the otorhinolaryngologist. Eur Rev Med Pharmacol Sci 2020; 23:3-8. [PMID: 30920635 DOI: 10.26355/eurrev_201903_17340] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Obstructive sleep apnea (OSA) is the primary indication for tonsillectomy, one of the most common pediatric surgical procedures, commonly performed in association with adenoidectomy. The objective of this review article is to evaluate the role of the otorhinolaryngologist in pediatric OSA. MATERIALS AND METHODS A literature review has been performed on the following topics: peculiarities of sleep-disordered breathing in pediatric age; discrimination of sleep disorders; adenotonsillar hypertrophy; surgical techniques; adjuvant surgical procedures. RESULTS The role of the otorhinolaryngologist in pediatric OSA is important for the evaluation of the upper airways and of essential biometric and polysomnographic data and for indication and execution of appropriate surgical treatment. In the majority of healthy children, adenotonsillectomy for OSA results in a dramatic improvement in respiratory parameters as measured by polysomnography. When post-surgical residual OSA occurs, it is essential to monitor patients by means of drug-induced sleep endoscopy (DISE). CONCLUSIONS Otolaryngologic assessment is of paramount importance to correctly classify a child with OSA. Correct inspection of the upper airway and quantification of the quality of sleep through polysomnography lead to the right therapeutic choice. Knowledge of different surgical techniques helps to deal with residual OSA after studying the obstruction sites by drug-induced sedation endoscopy.
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Bellucci R, Campo F, Ralli M, Buonopane C, Di Girolamo S, Passali D, Minni A, Greco A, De Vincentiis M. Obstructive sleep apnea syndrome in the pediatric age: the role of the anesthesiologist. Eur Rev Med Pharmacol Sci 2020; 23:19-26. [PMID: 30920637 DOI: 10.26355/eurrev_201903_17343] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Childhood obstructive sleep disordered breathing (SDB) is a sleep-related upper airway obstruction that degrades sleep quality, ventilation and/or oxygenation; obstructive sleep apnea syndrome (OSAS) is one of the most common causes of SDB in children. The aim of this review is to evaluate the role of the anesthesiologist in pediatric OSAS. MATERIALS AND METHODS A literature review has been performed on the following topics: clinical aspects of pediatric OSAS, preoperative investigations including questionnaires, clinical parameters, laboratory polysomnography and home sleep apnea testing, anesthesiologic preoperative management, anesthesiologic perioperative management, anesthesiologic postoperative management including postoperative analgesia, postoperative nausea and vomiting (PONV), and post-tonsillectomy bleeding. RESULTS OSAS in children is a distinct disorder from the condition that occurs in adults; adenoidectomy and tonsillectomy are the first line of therapy in these patients. Even if these surgical procedures are frequently performed, they represent a great challenge for surgeons and anesthesiologists and are associated with a substantially increased risk of morbidity and mortality. CONCLUSIONS The role of the anesthesiologist is pediatric OSAS is crucial before, during and after surgery, as pediatric patients are at higher risk of preoperative, perioperative and postoperative adverse events including airway obstruction, PONV, and bleeding.
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Affiliation(s)
- R Bellucci
- Department of Anesthesiology, Sapienza University of Rome, Rome, Italy.
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Ciprandi G, Bellussi LM, Passali GC, Damiani V, Passali D. HMGB1 in nasal inflammatory diseases: a reappraisal 30 years after its discovery. Expert Rev Clin Immunol 2020; 16:457-463. [PMID: 32252560 DOI: 10.1080/1744666x.2020.1752668] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Affiliation(s)
| | | | | | - Valerio Damiani
- Medical Department, Drugs Minerals and Generics, Pomezia, Italy
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Passali D, Damiani V, Passali GC, Cassano P, Piemonte M, Ciprandi G. The impact of rhinosinusitis in clinical practice: an Italian Survey. Acta Biomed 2020; 91:28-35. [PMID: 32073558 PMCID: PMC7947734 DOI: 10.23750/abm.v91i1-s.9247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/01/2020] [Indexed: 11/23/2022]
Abstract
Rhinosinusitis is a common disease that is classified in acute (ARS) and chronic (CRS). The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. RS affects about 20% of the general population. The most common diagnostic test was the skull x-ray. Antibiotics were the most frequently prescribed therapy. In conclusion, the current Survey demonstrated that RS is a common disorder in Italy, the diagnostic work-up is still incorrect, and the therapeutic approach does not adhere to the guidelines. Therefore, there is a need to implement adequate information on this topic in Italy.
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Affiliation(s)
| | | | | | | | - Marco Piemonte
- ENT Department, Azienda Sanitaria Universitaria Integrata di Udine, Udine, Italy.
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Passali D, Damiani V, Passali FM, Tosca MA, Motta G, Ciprandi G. An International Survey on the pragmatic management of epistaxis. Acta Biomed 2020; 91:5-10. [PMID: 32073555 PMCID: PMC7947736 DOI: 10.23750/abm.v91i1-s.9241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Indexed: 11/23/2022]
Abstract
Epistaxis is one of the most common ear, nose and throat emergencies. The management of epistaxis has evolved significantly in recent years, including the use of nasal cautery and packs. However, a correct treatment requires the knowledge of nasal anatomy, potential risks, and complications of treatment. Epistaxis is often a simple and readily treatable condition, even though a significant bleed may have potentially severe consequences. At present, there are very few guidelines concerning this topic. The current Survey explored the pragmatic approach in managing epistaxis. A questionnaire, including 7 practical questions has been used. The current International Survey on epistaxis management reported a relevant prevalence (21.7%), mainly during childhood and senescence, an important hospitalization rate (11.8%), the common use of anterior packing and electrocoagulation, and the popular prescription of a vitamin supplement and intranasal creams. (www.actabiomedica.it)
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Affiliation(s)
| | | | | | | | - Gaetano Motta
- ENT Department, Univerisity Luigi Vanvitelli, Naples, Italy.
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Passali D, Bellussi LM, Damiani V, Tosca MA, Motta G, Ciprandi G. Chronic rhinosinusitis with nasal polyposis: the role of personalized and integrated medicine. Acta Biomed 2020; 91:11-18. [PMID: 32073556 PMCID: PMC7947745 DOI: 10.23750/abm.v91i1-s.9243] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Indexed: 02/06/2023]
Abstract
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a frequent disorder. From a clinical and an immunopathological point of view, different phenotypes and endotypes have been identified. The frequent comorbidity with asthma allowed to pave the way to the use of biological agents for the treatment of CRSwNP. Biological agents are targeted to antagonize IgE, interleukin (IL) 4, IL-5, and IL-13 at present. However, a correct and appropriate workup is mandatory, mainly concerning the exact definition of the specific pheno-endotype. The preliminary outcomes are promising, even though there is a need for well-established indications, criteria of responsiveness, duration, and safety. On the other hand, this personalized medicine could be fruitfully integrated with gold-standard medications, such as intranasal corticosteroids. As CRSwNP is a chronic disorder, treatment should be long-lasting, so complementary anti-inflammatory treatments could be opportunely integrated and/or alternated to steroids. (www.actabiomedica.it)
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Affiliation(s)
| | | | | | | | - Gaetano Motta
- ENT Department, University Luigi Vanvitelli, Naples, Italy.
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Abstract
Acute mastoiditis is the most common complication of acute otitis media. Although rare, the disease is carefully studied by otolaryngologists because it usually affects very young children with severe clinical course and sometimes causes serious complications. Most important risk factors are the young age (often>2 years), high fever, alteration of the laboratory findings (very high values of WBC count, absolute neutrophil count and C-reactive protein), while less important are previous antibiotic therapy or previous middle ear infections. The main pathogen of the acute mastoiditis is Streptococcus pneumoniae, followed by Streptococcus piogenes, Haemophilus influentiae, and Staphylococcus aureus. The finding of Pseudomonas aeruginosa is not uncommon, but often its presence is often considered a contamination or simultaneous infection. The complications can be extracranial (subperiosteal abscess, Bezold's abscess); intratemporal (facial nerve palsy, labyrinthitis) and intracranial (subdural abscess). The complications have often a very serious clinical course and potentially life-threatening. Antibiotic therapy is the main treatment in not complicated forms. Considering the prevalence of Streptococcus pneumoniae, cephalosporins are the antibiotic of choice, but they have to be administrated intravenously in hospitalized patients. Combinations with other antibiotic are suggested when multibacterial flora is present. In complicated forms of acute mastoiditis, the antibiotic treatment can be particularly important, in combination with other specific drugs (i.e. anticoagulants and/or corticosteroids). Surgical treatments, such as incision of abscesses, mastoidectomy, and neurosurgical procedures, are sometimes performed in combination with medical therapy in very severe complications. Data from our experience are briefly reported.
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Gariuc L, Sandul A, Rusu D, Passali D, Bellussi LM, Damiani V, Ciprandi G. A comparison between mometasone furoate nasal spray and intranasal glycyrrhetic acid in patients with allergic rhinitis: a preliminary study in clinical practice. Acta Biomed 2020; 91:65-72. [PMID: 32073564 PMCID: PMC7947735 DOI: 10.23750/abm.v91i1-s.9229] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/31/2020] [Indexed: 11/23/2022]
Abstract
Allergic rhinitis (AR) is caused by an IgE-mediated inflammatory reaction consequent to the exposure to the causal allergen. Glycyrrhetic acid (GlyAc) is a natural compound extracted from the liquorice that exerts anti-inflammatory activity. This real-life study compared intranasal GlyAc, present in a medical device containing also glycerol and mannitol, with mometasone furoate nasal spray (MFNS) in 50 adult outpatients with AR. Both treatments lasted 2 months. Endoscopic signs, perception of symptom severity, assessed by VAS, and nasal function measured by rhinomanometry were evaluated at baseline (T0), after one (T1) and two (T2) months. The intergroup analysis showed that at T1 there was no significant difference between groups about the use of decongestants and antihistamines, turbinate hypertrophy and pale mucosa, perception of olfaction and snoring. At T2 there was no significant difference between groups about use of relievers, all endoscopic signs, and perception of nasal discomfort, nasal obstruction, olfaction, and snoring. The intragroup analysis showed that in MFNS group there was a significant change during the entire period of treatment for all parameters except watery rhinorrhea (sign) and ocular discomfort; in GlyAc group there was a significant change during the entire period of treatment for all parameters. In conclusion, this preliminary study, conducted in clinical practice, evidenced that intranasal CysAC plus mannitol was able to significantly improve nasal endoscopic signs, perception of symptoms, and nasal function in patients with AR. Therefore, GlyAc could be a reasonable therapeutic option to control allergic inflammation. (www.actabiomedica.it)
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Affiliation(s)
- Lucia Gariuc
- Clinical Republican Hospital, Chisinau, Republic of Moldova.
| | | | - Daniela Rusu
- Clinical Republican Hospital, Chisinau, Republic of Moldova.
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Passali D, Bellussi LM, Damiani V, Passali FM, Motta G, Ciprandi G. The impact of allergic rhinitis in clinical practice: an Italian Survey. Acta Biomed 2020; 91:19-27. [PMID: 32073557 PMCID: PMC7947741 DOI: 10.23750/abm.v91i1-s.9246] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 02/01/2020] [Indexed: 11/23/2022]
Abstract
Allergic rhinitis (AR) is a very common disorder. The current Survey was conducted on a sample of about 5,000 adult subjects in 5 Italian cities. A questionnaire, containing 15 questions, was administered on the road. AR affects about 20% of the general population. The most common diagnostic test was the skin prick test, but only 12% of patients performed an allergy test to confirm the diagnosis. About 50% of patients did not take any medicine. Even about 40% of treatments were suggested by friends or pharmacists. In conclusion, the current Survey demonstrated that AR is a common disorder in Italy, the diagnostic work-up is still incorrect, and the therapeutic approach does not adhere to the guidelines. Therefore, there is a need to implement adequate information on this topic in Italy.
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Affiliation(s)
| | | | | | | | - Gaetano Motta
- ENT Department, Univerisity Luigi Vanvitelli, Naples, Italy.
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Balestrazzi A, Passali GC, Passali D, Damiani V, Ciprandi G, Balestrazzi E. A new therapeutic approach for the Dry Eye Syndrome in patients with laryngopharyngeal reflux: first data. Acta Biomed 2020; 91:36-42. [PMID: 32073559 PMCID: PMC7947740 DOI: 10.23750/abm.v91i1-s.9250] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Indexed: 11/04/2022]
Abstract
Laryngopharyngeal reflux (LPR) is a common disorder. Pepsin has been detected also at eye level, this was a starting point for newest theories about LPR impact on Dry Eye Syndrome. The current preliminary study compared two treatments in patients with Dry Eye Syndrome and LPR. Patients were treated with Gastroftal eye drops and Gastroftal tablets or hyaluronic acid eye drops for 3 months. The following parameters were evaluated: Ocular Surface Disease Index (OSDI), OSDI categories, Reflux Symptom Index (RSI), Reflux Finding Score (RFS), Fluorescein Tear Breakup Time (B-TUT), and Schirmer test before and after treatment. On the whole, 21 patients were enrolled: 10 were treated with hyaluronic acid Atlantis (Group A) and 11 with Gastroftal eye drops and tablets (Group B). After treatment, in Group A only OSDI significantly diminished (p=0.029); in Group B there were significant reductions concerning OSDI (p=0.0277), OSDI categories (p=0.0211), RSI (p=0.0172), Schirmer test (p=0.0172), T-BUT (p=0.0265), and RFS (p=0.0205). The current preliminary demonstrated that the combined ocular and systemic therapy with hyaluronic acid, Magnesium alginate, Simethicone, and Camelia sinensis may be considered a promising treatment in patients with Dry Eye Syndrome due to LPR.
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Passali D, Ralli M. Editorial - Obstructive sleep apnea syndrome and recurrent upper airway disease in children. Eur Rev Med Pharmacol Sci 2019; 23:1-2. [PMID: 30920640 DOI: 10.26355/eurrev_201903_17339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
- D Passali
- Department of Medicine, Surgery and Neuroscience, ENT Clinic, University of Siena, Siena, Italy.
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Passali D, Passali GC, Bellussi LM, Sarafoleanu C, Loglisci M, Manea C, Iosif C, Passali FM. Bromelain's penetration into the blood and sinonasal mucosa in patients with chronic rhinosinusitis. ACTA ACUST UNITED AC 2019; 38:225-228. [PMID: 29984799 DOI: 10.14639/0392-100x-1693] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2017] [Accepted: 06/23/2017] [Indexed: 11/23/2022]
Abstract
SUMMARY The aim of this research is to investigate penetration of Bromelain into sinonasal mucosa in patients with chronic rhinosinusitis (CRS) versus a control group. Bromelain is derived from pineapple (Ananas comosus) and has various pharmacological effects. 40 patients (20 patients and 20 controls) were enrolled in the study. Bromelain 500 mg tablet twice daily was administered for 30 days. We scored bromelain presence in turbinate and ethmoid mucosas and in the serum of both the groups. Bromelain has an excellent distribution from blood to rhinosinusal mucosa. Its diffusion ability may allow the use of bromelain as an anti-inflammatory agent in paranasal sinus pathologies.
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Affiliation(s)
- D Passali
- ENT Department, University of Siena, Italy
| | - G C Passali
- ENT Section Catholic University of the Sacred Hearth, Rome, Italy
| | | | - C Sarafoleanu
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - M Loglisci
- ENT Department, University of Siena, Italy
| | - C Manea
- "Carol Davila" University of Medicine and Pharmacy, Bucharest, Romania
| | - C Iosif
- "CESITO" Centre, "Sfanta Maria" Clinical Hospital, Bucharest, Romania
| | - F M Passali
- ENT Department, University of Rome "Tor Vergata", Rome, Italy
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Tatti P, Tahrani A, Passali D, Reutrakul S, Kanagasabai T. The Relationship between Disturbed Sleep, OSAS, and Metabolic Diseases. J Diabetes Res 2019; 2019:1463045. [PMID: 31641672 PMCID: PMC6766588 DOI: 10.1155/2019/1463045] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2019] [Accepted: 06/18/2019] [Indexed: 01/05/2023] Open
Affiliation(s)
- Patrizio Tatti
- Department of Endocrinology and Diabetes, INI Institute, Rome, Italy
| | - Abd Tahrani
- Institute of Metabolism and Systems Research, University of Birmingham, Birmingham, UK
| | | | - Sirimon Reutrakul
- Division of Endocrinology, Diabetes and Metabolism, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Thirumagal Kanagasabai
- Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montreal, Quebec, Canada
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