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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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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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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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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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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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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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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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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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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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La Mantia I, Varricchio A, Di Girolamo S, Minni A, Passali GC, Ciprandi G. The role of bacteriotherapy in the prevention of adenoidectomy. Eur Rev Med Pharmacol Sci 2020; 23:44-47. [PMID: 30920631 DOI: 10.26355/eurrev_201903_17348] [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 Adenoidectomy is a surgical procedure with potential adverse events. Effective nonsurgical therapy could reduce patient risk and harm. The aim of this study was to evaluate the role of bacteriotherapy to reduce the necessity of adenoid surgery. PATIENTS AND METHODS This experimental study was conducted as an open study in 44 children (30 males and 14 females, mean age 4.9 years) who were candidates for adenoidectomy and tympanocentesis as treatment for adenoidal hypertrophy and otitis media with effusion. Twenty-two children were treated with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray, administered as 2 puffs per nostril twice a day for a week for 3 months (study group). The other half of the children was treated with hypertonic saline nasal lavage on the same schedule (control group). Tympanometry and adenoid size assessment were evaluated throughout the intervention period. RESULTS In the study group, 6/22 children required surgery, compared to 20/22 children in the study group (p<0.0001). The clinical change in the treated children was a significant reduction of adenoid size (p<0.0001) and improvement of middle ear effusion measured with tympanometry (p<0.0001). CONCLUSIONS Bacteriotherapy with Streptococcus salivarius 24SMB and Streptococcus oralis 89a nasal spray could significantly reduce the need for adenoid surgery.
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Affiliation(s)
- I La Mantia
- Associazione Italiana Vie Aeree Superiori, Naples, 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: 4] [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] [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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Castagnola M, Scarano E, Passali GC, Messana I, Cabras T, Iavarone F, Di Cintio G, Fiorita A, De Corso E, Paludetti G. Salivary biomarkers and proteomics: future diagnostic and clinical utilities. Acta Otorhinolaryngol Ital 2018; 37:94-101. [PMID: 28516971 PMCID: PMC5463528 DOI: 10.14639/0392-100x-1598] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Accepted: 12/12/2016] [Indexed: 12/16/2022]
Abstract
Saliva testing is a non-invasive and inexpensive test that can serve as a source of information useful for diagnosis of disease. As we enter the era of genomic technologies and -omic research, collection of saliva has increased. Recent proteomic platforms have analysed the human salivary proteome and characterised about 3000 differentially expressed proteins and peptides: in saliva, more than 90% of proteins in weight are derived from the secretion of three couples of "major" glands; all the other components are derived from minor glands, gingival crevicular fluid, mucosal exudates and oral microflora. The most common aim of proteomic analysis is to discriminate between physiological and pathological conditions. A proteomic protocol to analyze the whole saliva proteome is not currently available. It is possible distinguish two type of proteomic platforms: top-down proteomics investigates intact naturally-occurring structure of a protein under examination; bottom-up proteomics analyses peptide fragments after pre-digestion (typically with trypsin). Because of this heterogeneity, many different biomarkers may be proposed for the same pathology. The salivary proteome has been characterised in several diseases: oral squamous cell carcinoma and oral leukoplakia, chronic graft-versus-host disease Sjögren's syndrome and other autoimmune disorders such as SAPHO, schizophrenia and bipolar disorder, and genetic diseases like Down's Syndrome and Wilson disease. The results of research reported herein suggest that in the near future human saliva will be a relevant diagnostic fluid for clinical diagnosis and prognosis.
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Affiliation(s)
- M Castagnola
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Istituto di Chimica del Riconoscimento Molecolare C.N.R. Rome, Italy
| | - E Scarano
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
| | - G C Passali
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
| | - I Messana
- Life and Enviromental Sciences Department, University of Cagliari, and Istituto di Chimica del Riconoscimento Molecolare C.N.R. Rome, Italy
| | - T Cabras
- Life and Enviromental Sciences Department, University of Cagliari, Italy
| | - F Iavarone
- Institute of Biochemistry and Clinical Biochemistry, Catholic University, Rome, Italy
| | - G Di Cintio
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
| | - A Fiorita
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
| | - E De Corso
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
| | - G Paludetti
- Department of Head and Neck Surgery, "A. Gemelli" Hospital Foundation, Catholic University, Rome, Italy
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehne A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2018. [PMID: 29528615 DOI: 10.4193/rhino16.248] [Citation(s) in RCA: 373] [Impact Index Per Article: 62.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major
health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following:
• Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy
with small diameter endoscopes.
• Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability.
• Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour
threshold, and/or one of odour identification or discrimination.
• Comprehensive chemosensory assessment should include gustatory screening.
• Smell training can be helpful in patients with olfactory loss of several aetiologies. Conclusions We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.
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Passali D, Corallo G, Yaremchuk S, Longini M, Proietti F, Passali GC, Bellussi L. Oxidative stress in patients with obstructive sleep apnoea syndrome. Acta Otorhinolaryngol Ital 2017; 35:420-5. [PMID: 26900248 PMCID: PMC4755047 DOI: 10.14639/0392-100x-895] [Citation(s) in RCA: 48] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Obstructive sleep apnoea syndrome (OSAS) is a disorder that leads to metabolic abnormalities and increased cardiovascular risk. The aim of this study was to identify early laboratory markers of cardiovascular disease through analysis of oxidative stress in normal subjects and patients with OSAS. A prospective study was designed to compare outcomes of oxidative stress laboratory tests in 20 adult patients with OSAS and a control group of 20 normal subjects. Laboratory techniques for detecting and quantifying free radical damage must be targeted to assess the pro-oxidant component and the antioxidant in order to obtain an overall picture of oxidative balance. No statistical differences in age, sex distribution, or BMI were found between the two groups (p>0.05). There were significant differences in the apnoea/hypopnoea index (AHI) between OSAS patients and the control group (p<0.05). Statistically significant differences in isoprostane, advanced oxidation protein products (AOPP) and non-protein bound iron (NPBI) levels were found between the study and control groups. No significant difference in the levels of thiol biomarkers was found between the two groups. The main finding of the present study was increased production of oxidative stress biomarkers in OSAS patients. The major difference between thiols and other oxidative stress biomarkers is that thiols are antioxidants, while the others are expressions of oxidative damage. The findings of the present study indicate that biomarkers of oxidative stress in OSAS may be used as a marker of upper airway obstructive episodes due to mechanical trauma, as well as a marker of hypoxaemia causing local oropharyngeal inflammation.
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Affiliation(s)
- D Passali
- Department of Otolaryngology, University of Siena, Siena, Italy
| | - G Corallo
- Department of Otolaryngology, University of Siena, Siena, Italy
| | - S Yaremchuk
- Institute of Otolaryngology NAMS of Ukraine, Kiev, Ukraine
| | - M Longini
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - F Proietti
- Department of Molecular and Developmental Medicine, University of Siena, Siena, Italy
| | - G C Passali
- Department of Head and Neck Surgery-Institute of Otorhinolaryngology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - L Bellussi
- Department of Otolaryngology, University of Siena, Siena, Italy
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De Corso E, Bastanza G, Di Donfrancesco V, Guidi ML, Morelli Sbarra G, Passali GC, Poscia A, de Waure C, Paludetti G, Galli J. Radiofrequency volumetric inferior turbinate reduction: long-term clinical results. Acta Otorhinolaryngol Ital 2017; 36:199-205. [PMID: 27214831 PMCID: PMC4977007 DOI: 10.14639/0392-100x-964] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 12/18/2015] [Indexed: 11/23/2022]
Abstract
The aim of our study was to assess long-term results of radiofrequency volumetric tissue reduction of inferior turbinates (RVTR). We performed a prospective long-term longitudinal evaluation of 305 patients affected by rhinitis (114 allergic and 191 non-allergic) who were unresponsive to medical treatment and underwent RVTR (January 2004 - December 2010). Subjects were followed for a mean period of 39.70 ± 19.41 months (range 24-60). Patients completed the NOSE-scale questionnaire pre- and post-operatively after 1 month and yearly for 5-years. Recurrence was assumed if the post-operative total NOSE score increased by at least 75% during follow-up and the patient restarted medical treatments. Estimation of relapse over time was performed by Kaplan-Meyer analyses. We documented overall good satisfaction of patients regarding the procedure, with a good rate of pain control and a low rate of complications. Post-operatively there was a significant improvement in nasal stuffiness, nasal obstruction and mouth breathing (p < 0.05). We observed a worsening trend for symptoms after 36 months with progressive increasing rate of recurrences that were significantly higher in allergic than non-allergic patients (p < 0.05). We also observed a slight worsening trend of global satisfaction of patients. Our study confirms the minor discomfort and low risk of side effects of RVTR. Our data showed good efficacy of the procedure in the majority of patients for at least 36 months after surgery, and in fact in this time period the cumulative probability to remain relapse-free was up to 0.8. In the following 2 years, we observed a worse temporal trend in term of recurrence rate, and in particular in allergic patients with a significant difference vs non-allergic individuals (p < 0.05).
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Affiliation(s)
- E De Corso
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
| | - G Bastanza
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
| | - V Di Donfrancesco
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
| | - M L Guidi
- Department of Intensive Care and Anesthesiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - G Morelli Sbarra
- Department of Intensive Care and Anesthesiology, Catholic University School of Medicine and Surgery, Rome, Italy
| | - G C Passali
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
| | - A Poscia
- Department of Public Health, Catholic University School of Medicine and Surgery, Rome, Italy
| | - C de Waure
- Department of Public Health, Catholic University School of Medicine and Surgery, Rome, Italy
| | - G Paludetti
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
| | - J Galli
- Department of Head and Neck Surgery - Otorhinolaryngology, Catholic University of the Sacred Heart Rome, Italy
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehner A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2017. [PMID: 28623665 DOI: 10.4193/rhin16.248] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: - Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. - Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. - Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. - Comprehensive chemosensory assessment should include gustatory screening. - Smell training can be helpful in patients with olfactory loss of several aetiologies. CONCLUSIONS We hope the current manuscript will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency and generalisability of work in this field.
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Affiliation(s)
- T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - P Andrews
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - A Altundag
- Department of Otorhinolaryngoglogy, Istanbul Surgery Hospital, Istanbul, Turkey
| | - C Cinghi
- Department of Otolaryngology; Eskisehir Osmangazi University, Istanbul, Turkey
| | - R M Costanzo
- Smell and Taste Disorders Center, Department of Otolaryngology Head and Neck Surgery, VCU School of Medicine, Richmond, VA, USA
| | - M Damm
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center, Cologne, Germany
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, QC, Canada
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - E Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - S C Hong
- Department of Otorhinolaryngology, Konkuk University Medical Center, Hwayang-dong, Gwangjin-gu, Seoul, South Korea
| | - D Hornung
- Dept. of Biology, St. Lawrence University, Canton, NY, USA
| | | | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - D A Leopold
- Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont, USA
| | - A Macchi
- ENT Clinic, University of Insubria, ASST, sette laghi, Varese, Italy
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - R Moesges
- Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - J Mullol
- Rhinology Unit and Smell Clinic, IDIBAPS, University of Barcelona, Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - G C Passali
- Head and Neck section, Department of Aging, Neurosciences, Head and Neck and Orthopedic; Catholic University of Sacred heart, A. Gemelli Hospital Foundation, Rome, Italy
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V J Ramakrishnan
- Departments of Otolaryngology and Neurosurgery, University of Colorado, Aurora, CO, USA
| | - P Rombaux
- Universite Catholique de Louvain, Institute of Neurosciences, Unit of Otorhinolaryngology, Brussels, Belgium
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R A Schlosser
- Department of Otolaryngology, Head and Neck Surgery, Medical Univeristy of South Carolina, Charleston, SC, USA
| | - B Shu
- Department of Otolaryngology, Taipei Veterans General Hospital, National Yang Ming University School of Medicine Faculty of Medicine, Taipei, Taiwan
| | - G Soler
- Division of Otorhinolaryngology, Area of Smell and Taste, Hospital de Clinicas, University of Buenos Aires, Buenos Aires City, Argentina
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - B A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Germany
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
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Abstract
The paranasal sinus epithelium is exposed to the environment and therefore to a variety of biological, chemical and mechanical insults. Surfactant protein A (SP-A) is a 34-36 kD pulmonary surfactant-associated protein that appears to play an important role in mammalian first-line host defence. Recent studies have reported the possibility of local production of SP-A in the extrapulmonary organs and tissues of the human body. However, the presence of SP-A in the human paranasal sinus mucosa is not well known. The purpose of this study was to investigate the expression of SP-A protein in human turbinate mucosa and to compare the expression of SP-A mRNA in normal turbinate mucosa and turbinate mucosa of chronic rhinosinusitis patients. Reverse transcriptase polymerase chain reaction was used to detect SP-A mRNA. Student's t test was used for statistical comparison of the SP-A/GAPDH-mRNA ratio (GAPDH: glycerinaldehyde-3-phosphate dehydrogenase) of cases and controls. We found expression of SP-A mRNA in mucosa lining the inferior turbinates of healthy patients and its up-regulation in mucosa lining the inferior turbinates of patients with chronic rhinosinusitis. These results may provide targets for new therapies for chronic rhinosinusitis.
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Affiliation(s)
- D Passali
- Department of Otorhinolaryngology, University of Siena, Siena, Italy.
| | - S Astore
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
| | - S Boccuzzi
- Department of Otorhinolaryngology, "Misericordia" Hospital of Grosseto, Grosseto, Italy
| | - M Loglisci
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
| | - A Cannatelli
- Department of Medical Biotechnologies, University of Siena, Siena, Italy
| | - G C Passali
- Department of Otorhinolaryngology, "Catholic University of Sacred Hearth", Rome, Italy
| | - L Bellussi
- Department of Otorhinolaryngology, University of Siena, Siena, Italy
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Chen D, Bellussi LM, Cocca S, Wang J, Passali GC, Hao X, Chen L, Passali D. Glycyrrhetinic acid suppressed hmgb1 release by up-regulation of Sirt6 in nasal inflammation. J BIOL REG HOMEOS AG 2017; 31:269-277. [PMID: 28685526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
To extend our understanding of previous studies on the pathogenesis and mechanism of high mobility group box 1 (HMGB1) in chronic rhinosinusitis with nasal polyps (CRSwNP), here we show that Sirtuin 6 (Sirt6), one of the Sirtuin family members which are widely studied in aging, DNA repair, metabolism, inflammation and cancer, was expressed in normal nasal mucosa using immunohistochemical staining and Western blot assay. Sirt6 expression levels were decreased in CRSwNP tissue. Sirt6 expression levels were modulated by small interfering RNA transfection in human nasal epithelial cells (HNE). We found that depletion of Sirt6 suppressed the number of human nasal epithelial cell cilia, and dramatically induced HMGB1 translocation from nucleus to cytoplasm in the HNE cells. Glycyrrhizic acid (GA) and glycyrrhetinic acid (GTA) are specific chemical compounds that may be isolated from the licorice plant. GTA has been shown to have anti-inflammatory and anti-allergic activity: it binds selectively to HMGB1 protein released extra-cellularly and inhibits its cytokine activities through a scavenger mechanism on the protein accumulation. In an in vitro study we used the 18-β-stereoisomer of GTA to enhance Sirt6 expression levels, inhibiting through this mechanism the translocation of HMGB1 protein from nucleus and reversing its extracellular accumulation stimulated by lipopolysaccharides. These findings reveal a previously unknown role for nasal mucosa steady-state conditions in the control of Sirt6 activity, and provide evidence for a relationship between HMGB1 and Sirt6 in CRSwNP, and promising benefits of glycyrrhetinic acid for CRSwNP patients.
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Affiliation(s)
- D Chen
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
- Department of Neurosurgery, Medical Faculty of the Friedrich Alexander University of Erlangen-Nurnberg (FAU)
| | - L M Bellussi
- Department of Medical-Surgical Sciences and Neurosciences, ENT Clinic, University of Siena, Siena, Italy
| | - S Cocca
- Department of Medical-Surgical Sciences and Neurosciences, ENT Clinic, University of Siena, Siena, Italy
| | - J Wang
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - G C Passali
- Sacred Heart University, ENT Clinic, Rome, Italy
| | - X Hao
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - L Chen
- Department of Otolaryngology Head and Neck Surgery, Chinese PLA General Hospital, Chinese PLA Medical School, Beijing, China
| | - D Passali
- Department of Medical-Surgical Sciences and Neurosciences, ENT Clinic, University of Siena, Siena, Italy
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Passali GC, Bove F, Vargiu L, Bentivoglio AR, Anzivino R, De Corso E, Galli J, Rigante M, Pandolfini M, Sergi B, Giuliani M, Cianfrone F, Paludetti G, Fasano A. New olfactometric findings in Parkinson's disease. Clin Otolaryngol 2017; 42:837-843. [PMID: 28004533 DOI: 10.1111/coa.12816] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/19/2016] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To investigate in Parkinson's disease-affected patients a correlation between hyposmia and gastrointestinal dysfunction and their possible identical etiopathogenesis. DESIGN Retrospective cohort study. SETTING ENT and neurology departments (Gemelli Hospital, Rome, Italy). PARTICIPANTS A total of 78 patients with diagnosis of PD according to the UK Brain Bank criteria. INCLUSION CRITERIA informed consent and olfactory testing executed; exclusion criteria: signs of dementia according to the DSM-IV criteria; Mini Mental State Examination score ≤26; head trauma; central neurological disorders, nasal or systemic diseases potentially affecting olfactory function. Motor condition was assessed by means of Hoehn and Yahr staging and by section III of the Unified PD Rating Scale, performed off and on medications. MAIN OUTCOME MEASURES The patients underwent olfactory evaluation (TDI score), after rhinomanometry with nasal decongestion. A total of 25 non-motor symptoms were evaluated through an interview. RESULTS Olfactory dysfunction was objectively found in 91.0% of patients, a percentage higher than the subjective hyposmia reported (55.1%) P = 0.0001. Seven patients (9.0%) were normosmic, 49 (62.8%) hyposmic and 22 (28.2%) anosmic. Subjective hyposmia, constipation, bloating and dyspepsia differed across groups, being higher in anosmic and hyposmic ones than in the normosmic group. P value was ≤0.05 for each symptom. Despite the original results, this study has the limitation of being based on subjective ratings by a relatively limited group of patients. CONCLUSIONS Hyposmia and gastrointestinal symptoms are correlated, and this would support a possible common origin; the CNS could be reached through two different pathways, both starting in the peripheral nervous system.
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Affiliation(s)
- G C Passali
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - F Bove
- Department of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - L Vargiu
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - A R Bentivoglio
- Department of Neurology, Catholic University of Sacred Heart, Rome, Italy
| | - R Anzivino
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - E De Corso
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - J Galli
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - M Rigante
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - M Pandolfini
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - B Sergi
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - M Giuliani
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - F Cianfrone
- Institute of Otorhinolaryngology, Head and Neck Surgery, S. Camillo Hospital, Rome, Italy
| | - G Paludetti
- Institute of Otorhinolaryngology, Head and Neck Surgery, Catholic University of Sacred Heart, Rome, Italy
| | - A Fasano
- Movement Disorders Centre - Toronto Western Hospital, University of Toronto, Toronto, ON, Canada
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Passali GC, Politi L, Crisanti A, Loglisci M, Anzivino R, Passali D. Tau Protein Detection in Anosmic Alzheimer’s Disease Patient’s Nasal Secretions. CHEMOSENS PERCEPT 2015. [DOI: 10.1007/s12078-015-9198-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Passali D, Loglisci M, Politi L, Passali GC, Kern E. Managing turbinate hypertrophy: coblation vs. radiofrequency treatment. Eur Arch Otorhinolaryngol 2015; 273:1449-53. [PMID: 26321749 DOI: 10.1007/s00405-015-3759-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 08/21/2015] [Indexed: 11/27/2022]
Abstract
The role of inferior turbinate hypertrophy in the reduction of nasal airflow is well established. Although chronic nasal obstruction is not life- threatening, it significantly impairs patients' quality of life, affecting many aspects of daily activities; therefore, patients seek medical intervention. 40 patients were selected (27 males and 13 females) between 27 and 64 years of age with a symptom of nasal obstruction. The patients were divided in two groups: Group 1: coblation, 25 patients (18 males and 7 females); Group 2: radiofrequency, 15 patients (7 males and 6 females). These 40 patients were followed for 3 years. Patients were analyzed using both subjective and objective methods. The visual analog scale (VAS) subjective data and objective data including both active anterior rhinomanometry and acoustic rhinometry were recorded and analyzed. Data were collected pre-operatively and at 1 and 3 years post-operatively. According to our data, both coblation and radiofrequency turbinate reduction benefit patients with good results. The complications, found during the follow-up, are limited to minimal bleeding and crusting. Coblation and radiofrequency were significantly less painful than others procedures during the early post-operative period. In our study, both coblation and radiofrequency provide an improvement in nasal airflow with a reduction in nasal obstructive symptoms in the short term, but their efficacy tended to decrease within 3 years.
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Affiliation(s)
- D Passali
- ENT Department, University of Siena, Siena, Italy.
| | - M Loglisci
- ENT Department, University of Siena, Siena, Italy
| | - L Politi
- ENT Department, University of Siena, Siena, Italy
| | - G C Passali
- ENT Department, Catholic University of Sacred Heart, Rome, Italy
| | - E Kern
- Mayo Clinic, Rochester, USA
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de Corso E, Battista M, Pandolfini M, Liberati L, Baroni S, Romanello M, Passali GC, Fetoni AR, Sergi B, Di Nardo W, Paludetti G. Role of inflammation in non-allergic rhinitis. Rhinology 2014; 52:142-9. [PMID: 24932626 DOI: 10.4193/rhino13.102] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To investigate the role of inflammation in non-allergic rhinitis (NAR) patients in a large series to establish the prevalence of different NAR-subtypes, clinical features and the role of nasal cytology in the diagnostic algorithm. METHODOLOGY Patients were selected out of 3650 individuals who spontaneously presented at our institution. We consecutively enrolled 519 NAR-patients in an analytical cross-sectional study between November 2007 and June 2013 (level of evidence: 3b). All patients underwent rhinological evaluation including symptoms questionnaire, endoscopy, CT scan, allergy tests and nasal cytology. RESULTS The inflammatory cell infiltrate affects the severity of symptoms differently, allowing for identification of different phenotypes of NAR. We distinguished two groups: “NAR without inflammation”(NAR-) and “NAR with inflammation”(NAR+), in addition to different NAR-subtypes with inflammation. A significant difference was observed in terms of clinical symptoms and association with comorbidities (previously diagnosed asthma and aspirin intolerance) between NAR–, NAR+ and between different NAR+ subtypes. CONCLUSION Our data suggest that NAR- and NAR with neutrophils behave similarly, showing lower symptom score values and a lower risk of association with comorbidities compared to NAR with eosinophils and mast cells (singularly or mixed). In our belief it is very important to establish the presence and type of inflammation in non-allergic rhinitis patients and nasal cytology is a very useful test in correct differential diagnosis.
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Foltran F, Caruso G, Gregori D, Pitkäranta A, Slapak I, Jakubíková J, Passali GC, Bellussi L, Passali D. Risk posed to children by stationery items in the upper airways. Minerva Pediatr 2012; 64:371-376. [PMID: 22728608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
AIM The aim of the present study is to characterize the risk of complications and prolonged hospitalization due to stationery items according to age and gender of patients, FB characteristics and foreign body (FB) location, circumstances of the accident, as emerging from the ESFBI study. METHODS A retrospective study in major hospitals of 19 European countries was realized on children aged 0-14 having inhaled/aspired or ingested a stationery item. In the years 2000-2003 a total of 2094 FB injuries occurred in children aged 0-14 years. The characteristics of the child, the FB consistency and the occurrence of complications were analyzed. RESULTS Among FB injuries, 62 (3%) were due to a stationery item: 32 were due to objects insertion in the ears while 30 occurred in the upper and lower respiratory tract. Objects most frequently involved are parts of pens in children younger than 3 years and eraser in older. 39% of children needed hospitalization. The most documented complication was inflammation of external ear. Almost 24% of injuries happened under adults' supervision. CONCLUSION Injuries are events that in many cases can be prevented with appropriate strategies. Passive environmental strategies, including product modification by manufacturers, are the most effective. Our study testifies that stationary is involved in a non negligible percentage of FB injuries. This results confirm the fact that when passive preventive strategies are not practical, active strategies that promote behaviour change are necessary and information about this issue should be included in all visits to family pediatricians.
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Affiliation(s)
- F Foltran
- Department of Surgery, University of Pisa, Pisa, Italy
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Passali D, De Corso E, Platzgummer S, Streitberger C, Lo Cunsolo S, Nappi G, Passali GC, Bellussi L. Spa therapy of upper respiratory tract inflammations. Eur Arch Otorhinolaryngol 2012; 270:565-70. [PMID: 22588193 DOI: 10.1007/s00405-012-2024-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2012] [Accepted: 04/19/2012] [Indexed: 11/25/2022]
Abstract
The upper airway respiratory diseases (i.e. common cold, allergic rhinitis, nonallergic/vasomotor rhinitis, acute and chronic rhinosinusitis and nasal polyposis) in which nasal congestion is a common symptom are often undertreated due to the frequent inadequate efficacy and safety concern with current therapies. In scientific literature, few studies seem to support the hypothesis that nasal inhalatory treatment with thermal water promotes the improvement of nasal symptoms, even if the mechanisms by which the improvement from SPA therapy can be expected remain debated. A prospective comparative study with a pre-post design has been performed consecutively enrolling 33 (males 70 %) patients of both genders older than 12 years of age, affected by chronic sinonasal inflammation. All patients underwent a 14-days course of radioactive water warm vapour inhalations followed by nasal aerosol of the same thermal water 10 min each once/day at Merano Therme. At the beginning and end of the study, in all the subjects, nasal function evaluation by active anterior rhinomanometry, mucociliary transport time (MCTt) determination and nasal cytology were performed. After the inhalatory treatment, the mucociliary function was improved and the pathologic mucociliary transport times recorded at the beginning of the study being significantly reduced to physiologic ones. Besides, before treatment, the cytologic picture showed an inflammatory cell infiltration (eosinophils, neutrophils with/without bacteria, mast cells) in 37 % of patients; after therapy in 66 % of these patients, the rhinocytogram was normal. Our results suggest, according to the literature data, that SPA therapy with radioactive water could represent an alternative choice in chronic inflammatory diseases of the upper airways, nonresponsive to pharmacological therapy.
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Affiliation(s)
- D Passali
- University of Siena Medical School, Siena, Italy.
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De Corso E, Baroni S, Romitelli F, Luca L, Di Nardo W, Passali GC, Paludetti G. Nasal lavage CCL24 levels correlate with eosinophils trafficking and symptoms in chronic sino-nasal eosinophilic inflammation. Rhinology 2011; 49:174-9. [PMID: 21743872 DOI: 10.4193/rhino10.133] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVES The aim of our study was to measure CCL24 (eotaxin-2) levels in nasal lavage fluid of patients with different forms of sinonasal chronic eosinophilic inflammation to verify the relationship with nasal hypereosinophilia and symptoms. METHODS Patients with nasal hypereosinophilia were randomly recruited and grouped in persistent allergic rhinitis, non-allergic rhinitis with eosinophilia syndrome (NARES) and chronic rhinosinusitis with polyps. Non rhinitic volunteers were recruited as controls. CCL24 concentration was measured by `Quantikine Human CCL24 Immunoassay`. Differential cell counts were performed by microscopic cytological examination of nasal tissue scraped by inferior turbinate. RESULTS CCL24 levels measured in patient groups were significantly higher compared to control group with the highest levels in NARES patients. Eotaxin- 2 levels were significantly correlated to severity of symptoms and to the percentage of eosinophils in nasal tissue. CONCLUSIONS We revealed high levels of CCL24 in all patient groups showing a significant correlation with the degree of eosinophilia and clinical symptoms. A prolonged accumulation of CCL24 inside the nasal mucosa may sustain the process of unspecific self-perpetuating eosinophil recruitment pathognomonic of these patients.
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Affiliation(s)
- E De Corso
- Institute of Otorhinolaryngology, Catholic University of Medicine and Surgery, Rome, Italy.
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26
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Passali D, Mösges R, Passali GC, Passali FM, Ayoko G, Bellussi L. Safety, tolerability and efficacy of sublingual allergoid immunotherapy with three different shortened up-dosing administration schedules. Acta Otorhinolaryngol Ital 2010; 30:131-137. [PMID: 20948588 PMCID: PMC2914521] [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] [Subscribe] [Scholar Register] [Received: 02/28/2010] [Accepted: 04/10/2010] [Indexed: 05/30/2023]
Abstract
Sublingual immunotherapy with monomeric allergoid, given according to the standard schedule, was reported to be effective and safe in many clinical trials. However, a long period of time may elapse before achievement of a clinical benefit. This study was thus performed using two different shortened (4-day) induction (= up-dosing) schedules, which allowed a rapid achievement of the maintenance dosage. Overall, 86 patients suffering from rhinitis and oculorhinitis have been recruited, none of whom had received immunotherapy before. The study design was prospective, randomized, with three parallel groups receiving, according to a randomization list, one of the three induction (two up-dosing one no-up-dosing) phase schedules under study. A fourth group of patients served as controls, and did not receive any sublingual immunotherapy but only rescue medications if and when necessary. All patients were evaluated to assess their baseline conditions, and thereafter at 3 and 6 months. The evaluation parameters were: Visual Analogue Scale, symptom-medication scores, nasal provocation test. All three induction schedules under study were well accepted by the patients, with very few adverse reactions. The clinical efficacy, evaluated with Visual Analogue Scale (p < 0.001), symptom-medication scores (p < 0.02) and nasal provocation tests (p < 0.01), was found to be significant in all three sublingual immunotherapy-treated groups of 64 (n86) patients, but was not significant in controls 22 (n86). According to the Authors, with this simplified schedule process, sublingual immunotherapy is a therapeutic option that is becoming increasingly well-accepted not only by allergy specialists but also by patients.
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Affiliation(s)
- D Passali
- Ear, Nose, and Throat Clinic, University of Siena, Siena, Italy.
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Scarano E, Fiorita A, Picciotti PM, Passali GC, Calò L, Cabras T, Inzitari R, Fanali C, Messana I, Castagnola M, Paludetti G. Proteomics of saliva: personal experience. Acta Otorhinolaryngol Ital 2010; 30:125-130. [PMID: 20948587 PMCID: PMC2914523] [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] [Subscribe] [Scholar Register] [Received: 12/27/2009] [Accepted: 04/20/2010] [Indexed: 05/30/2023]
Abstract
The salivary proteome is a complex protein mixture resulting from the activity of salivary glands with the contribution of other components that form the oral environment such as oral tissues and micro-organisms. For diagnosis purposes, saliva collection has the great advantage of being an easy and non-invasive technique. Human saliva proteomics have proven to be a novel approach in the search for protein biomarkers for detection of different local and systemic diseases. Currently, more than 1400 salivary proteins have been identified. In the last few years, our research group has extensively studied the salivary proteomics in order to analyse the salivary composition, investigating the major families of proteins present in human and mammalian saliva, the post-translational modifications, the different contributions of glands, the physiological and pathological modifications of saliva. The aim of this report is to present our personal experience in salivary proteomics. In conclusion, salivary proteome analysis represents an important field both for diagnosis and monitoring of various diseases and could be considered a novel approach to prevention of various pathological conditions.
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Affiliation(s)
- E Scarano
- Department of Otolaryngology, Catholic University, Rome, Italy.
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Testa R, Morra B, Connal D, Lingua D, Passali GC, Passali D. Choking injuries and food products containing inedibles: a survey on mothers' perception in the United Kingdom. Acta Otorhinolaryngol Ital 2010; 30:100-102. [PMID: 20559480 PMCID: PMC2882144] [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] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 12/02/2009] [Indexed: 05/29/2023]
Abstract
Although recent investigations showed no specific hazard resulting from Food Products Containing Inedibles as compared to the wider category of toys, in view of recent findings and subsequent study of the European Registry of Foreign Bodies Injuries, a potential threat has been identified in a lack of parental supervision in the event of injury. Indeed, according to the report of the European Registry of Foreign Bodies Injuries, almost 80% of the injuries occur under parental supervision, which is obviously inadequate. The aim of this short contribution is to present the results of a Computer Assisted Personal Interviewing survey in the UK focused on the knowledge that mothers, fathers and other adults have on the issue of choking. A total of 1946 interviews have been conducted in the UK, in January 2001, all of which directed to subjects over 15 years of age. Data are presented as percentages and absolute numbers. The statistical significance of group differences has been evaluated with the chi-square test with continuity correction. All analyses have been performed using the R system. Those replying to the interview comprised 804 males and 1102 females. Of these, 10% had a child between 0 and 36 months, 9% between 3 and 4 years, 16% between 5-10 years and 13% between 11-15 years. Of those responding, 7% had bought Kinder Surprise within the last two weeks before the interview, 14% within the last three months, and the remaining 53% before, while 26% had never bought Kinder Surprise. These findings would appear to offer a confirmation that mothers tend to balance potential risks with the benefits of exposing the child to a stimulating activity. This mechanism of a controlled exposure to risk, has already been identified as one of the important mechanisms in the psychological development of the child.
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Affiliation(s)
- R Testa
- Safety of Toys Department, Soremartec Italia Srl, Alba, Italy
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29
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Passàli D, Lauriello M, Bellussi L, Passali GC, Passali FM, Gregori D. Foreign body inhalation in children: an update. Acta Otorhinolaryngol Ital 2010; 30:27-32. [PMID: 20559470 PMCID: PMC2881610] [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] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 11/30/2009] [Indexed: 05/29/2023]
Abstract
Accidental inhalation of both organic and non-organic foreign bodies continues to be a cause of childhood morbidity and mortality, requiring prompt recognition and early treatment to minimize the potentially serious and sometimes fatal consequences. In the past, the majority of data on foreign body injuries in children came from single-centre retrospective studies, covering a range of about 3-10 years. Recently, several review papers have discussed the main clinical aspects, Country-specific experiences have been presented, and systematic collections of foreign bodies have been started. Fully aware of the difficulty in meta-analysing data, in an observational context, the aim of the present report is: an attempt to synthesize the epidemiological data published in the literature presenting the evidence on foreign body distribution in a review of the meta-analyses of papers focusing on European and North-American data; improve our ability to prevent and to treat these complex and high risk situations.
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Affiliation(s)
- D Passàli
- ENT Department, Medical School, University of Siena, Policlinico Le Scotte, viale Bracci, Siena, Italy.
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30
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Calò L, Rabini A, Picciotti PM, Laurino S, Passali GC, Ferrara PE, Maggi L, Piazzini DB, Specchia A, Frasca G, Ronconi G, Bertolini C, Scarano E. Postural control in patients with total hip replacement. Eur J Phys Rehabil Med 2009; 45:327-334. [PMID: 19209135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
AIM The aim of this study was to investigate the balance of the standing position and the motor responses by means of dynamic posturography (DP) in patients affected by hip osteoarthritis and treated by total hip replacement (THR). METHODS Data obtained from THR patients were compared with those of control adult groups ofage-matched subjects with normal hearing and no history of audio-vestibular symptoms. The statistical tests used were paired and unpaired Student's t-test. Significance was set for P<0.05. The study was carried out at the Department of Otorhinolaryngology and Department of Physiatrics and Rehabilitation of the A. Gemelli University Hospital of Rome (Italy). Twenty-three consecutive patients, without cochleo-vestibular or neurological pathologies (screened by accurate case-history), affected by hip osteoarthritis and treated by THR were enrolled. The main outcome measure were Sensory Organization Test (SOT), Motor control test (MCT) and Adaptation test (AT) obtained by means of Equi-Test Dynamic Posturography System by NeuroCom (Int. Inc., Clackamas, OR, USA). RESULTS When analysing the SOT and MCT, no statistically significant differences were observed between patients and controls. In the AT, the sway energy score decreased in the course of the test in an up and down perturbation both in healthy and in THR patients. CONCLUSIONS These data confirm a normal postural control and symmetrical responses in THR patients and confirm the absence of a detectable relationship between balance problems and fall risk. These results could be justified by an irrelevant role of intracapsular proprioceptors in maintaining balance. Moreover DP could be useful in osteo-articular diseases for understanding balance, evaluating surgical outcome and monitoring the rehabilitation program.
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Affiliation(s)
- L Calò
- A. Gemelli University Hospital, Università Cattolica del Sacro Cuore, Rome, Italy
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Passali FM, Crisanti A, Passali GC, Cianfrone F, Bocchi M, Messineo G, Bellussi L, Passali D. [Efficacy of inhalation therapy with water of Salsomaggiore (Italy) in chronic and recurrent nasosinusal inflammation treatment]. Clin Ter 2008; 159:175-180. [PMID: 18594748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Aim of the research was the demonstration of the efficacy of thermal water vs saline in the recurrent and chronic nasosinusal pathologies treatment. MATERIALS AND METHODS 120 patients randomized into 2 groups of 60 subjects each, all affected by recurrent or chronic rhinosinusitis with/without I degree nasal polyposis. At the beginning and at the end of the study, in all the subjects the clinical history, objective examination and the instrumental analysis of nasal functions by active anterior rhinometry, acustic rhinometry, nasal mucociliary transport time determination and nasal mucosa scraping were performed. Patients of the study group underwent crenotherapy treatment (vapour inhalation, aerosol and nasal douching) with thermal water for 14 days at Salsomaggiore Thermal baths. Other patients underwent nasal douching and aerosol with saline twice a day for 14 days at the Rhinologic Centre of the ENT Clinic of Siena University. RESULTS At the end of the study, only the patients undergone to crenothrapic treatment with salt-bromine-iodic water showed a significant improvement of nasal obstruction, rinorrea and number of nocturnal arousals. The improvement, even if present, was not significant in the control group. Same positive variations were observed concerning nasal mucosa congestion, nasal secretion and mucociliary transport time reaching the significance in the study group. CONCLUSIONS Crenotherapy with salt-bromine-iodic water should be considered as efficacious therapeutic tool in the management of chronic and recurrent rhinosinusitis.
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Affiliation(s)
- F M Passali
- Università degli Studi Siena Dottorando di Ricerca.
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32
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Passali D, Lauriello M, Passali GC, Passali FM, Cassano M, Cassano P, Bellussi L. [Clinical evaluation of the efficacy of Salsomaggiore (Italy) thermal water in the treatment of rhinosinusal pathologies]. Clin Ter 2008; 159:181-188. [PMID: 18594749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
OBJECTIVES Aim of the research was to demonstrate the efficacy of a treatment with thermal water as nasal spray (Salsomaggiore Italy) vs saline on chronic rhinosinusitis with/out nasal polyps. MATERIALS AND METHODS 55 patients affected by chronic rhinosinusitis with/out I degree nasal polyposis randomised into two groups were enrolled. 30 patients of the study group were treated with thermal water nasal spray 4 times/day for 4 weeks. 25 patients of the control group were treated, with the same protocol, with saline. At the beginning and at the end of the study, in all the subjects the clinical history, objective examination and the instrumental analysis of nasal functions by active anterior rhinomanometry, mucociliary transport (MCT) time determination and nasal cytology were performed. RESULTS At the end of the treatment patients in the study group showed an improvement statistically significant, with respect to the control group, of headache, rhinorrea and hiposmia. Significant differences were also observed between the study and control group concerning objective examination (nasal mucosa appearance and crusts) and instrumental analysis (rhinomanometric values and mucociliary transport times). Nasal cytology (epithelial and goblet cells, neutrophils, eosinophils, bacteria) improved in both groups without any statistical difference. CONCLUSIONS Thermal water (Salsomaggiore Italy) nasal spray showed a greater efficacy with respect to saline in the treatment of patients affected by chronic rhinosinusitis.
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Affiliation(s)
- D Passali
- Università degli Studi di Siena Istituto di Discipline ORL, Italia.
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Galli J, Calò L, Ardito F, Imperiali M, Passali GC, Carnevale N, Fadda G, Paludetti G. [Bacterial biofilm identification in the rhinopharingeal mucosa of children with recurrent infection of the upper respiratory tract and otitis media]. Pediatr Med Chir 2008; 30:31-34. [PMID: 18491676] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023] Open
Abstract
OBJECTIVE The objective of the present study was to identify bacterial biofilms in tissue samples obtained from paediatric patients undergoing surgical treatment, for recurrent upper airway infections, frequently associated to effusive otitis media, unresponsive to repeated cycles of selective medical antibiotic and anti-inflammatory therapy and assay the ability of Haemophilus influenzae strains, most frequently identified in our cultural examinations, to grow as biofilm in vitro. METHODS We examined 18 surgical specimens (18 adenoids) from the upper respiratory tract, obtained from 18 paediatric patients. Tissues were cultured using conventional methods and subjected to scanning electron microscopy for detection of biofilm. Haemophilus influenzae strains, were cultured on 96-sterile well polystyrene microtiter plates (CELLSTAR-greiner bio-one) and stained with 1% crystal violet to quantify biofilm production. RESULTS Bacterial cocci attached to the tissue surface and organized in colonies, with a morphology consistent with bacterial coccoid biofilms, were observed in all adenoid (18/18) samples. Haemophilus influenzae isolates from 11/18 (61.1%) of our tissue samples scored a percentual transmittance (%Tbloc) > 50, identifying a high capacity to form biofilms (level 4). CONCLUSIONS Bacterial biofilms identified in adenoid tissue of paediatric patients with recurrent upper airway inflammatory processes, associated to chronic effusive otitis media, may represent a bacterial "reservoir" responsible of the maintenance of chronic inflammatory mucosal reactions, resistant to selective antibiotic therapy and requiring surgical treatment.
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Affiliation(s)
- J Galli
- Institute of Otorhinolaryngology, Catholic University of the Sacred Heart, Rome.
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Galli J, Cammarota G, Rigante M, De Corso E, Parrilla C, Passali GC, Almadori G, Paludetti G. High resolution magnifying endoscopy: a new diagnostic tool also for laryngeal examination? Acta Otorhinolaryngol Ital 2007; 27:233-236. [PMID: 18198752 PMCID: PMC2640033] [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] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Accepted: 07/30/2007] [Indexed: 05/25/2023]
Abstract
Aim of this report is to introduce the use of a new high resolution magnifying endoscope in the endoscopic examination of the upper aerodigestive tract and discuss the usefulness of this tool in the diagnosis of laryngeal lesions. A total of 26 patients presenting various laryngeal disorders were examined by means of an electronic videoendoscope and a high resolution magnifying endoscope. The images obtained were examined and compared. High resolution high magnification endoscopic examination allowed a better description of the laryngeal lesions (colour, extension and thickness of the lesion, irregularities in surface and borders) with easy characterisation of aspect of neighbouring laryngeal mucosa especially in pre-malignant lesions. Furthermore, the optical magnifying zoom does not require a close approach to the laryngeal mucosa, therefore, local anaesthesia is not required. In conclusion, the high resolution magnified images obtained with this new tool provide important information on the characteristics of the laryngeal structures. This new endoscopic technology, as already occurred in gastric, oesophageal and colorectal disorders, could also be improved by using chromo-endoscopy and other vital stain techniques in order to provide useful information concerning pre-neoplastic lesions of the larynx.
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Affiliation(s)
- J Galli
- Institute of Otolaryngology and Gastroenterology, Catholic University of the Sacred Heart, Rome, Italy.
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Bellussi L, De Benedetto M, Lauriello M, Passali GC, Passali D. [Bacterial internalization and intracellular activity of quinolones and macrolides]. Acta Otorhinolaryngol Ital 2007; 27:1-11. [PMID: 17702375] [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] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Affiliation(s)
- L Bellussi
- Clinica ORL, Università degli Studi, Siena
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Gregori D, Morra B, Snidero S, Scarinzi C, Passali GC, Rinaldi Ceroni A, Corradetti R, Passali D. Foreign bodies in the upper airways: the experience of two Italian hospitals. J Prev Med Hyg 2007; 48:24-6. [PMID: 17506234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVE To study the pattern of foreign bodies in the upper airways as emerging from the hospital records in the Bologna and Siena hospitals in Italy 1997-2002. METHODS A retrospective review of hospital records was performed using a standardized protocol. All injuries with ICD9 (International Classification of Diseases, 9'h revision) codes ranging from 931 to 934 which occurred in children age 0-14 were considered for the database. RESULTS One hundred ninety seven patients were included in the database with a diagnosis of Foreign Bodies (FB) over the study period, 78 with ICD931, 105 with ICD932, 12 with ICD933 and 2 with ICD934 discharge diagnosis. Of the 197 patients, 51.90% of the patients were males and the 48.10% were female. Median age was 4 (2, 6). At the moment of the injury, the child was eating (11%), playing (83%) or studying (4%) or cleaning ears (2%). The child was supervised by an adult in doing his/her activities at the moment of injury in the 84.2% of the cases. The child reached the hospital using always private transport (100%), never by using an emergency transport (0%). Most commonly, FB were extracted in ambulatory (95.4%), more rarely using an endoscopic procedure (4.1%), and never using surgery. Hospitalization was required in the 0.5% of cases (1). CONCLUSIONS Our study showed the substantial epidemiological similarity of the Italian data with the experience of other center in the world. The burden of chocking was very limited in our country, as proven by the limited access to emergency and more invasive procedures. Nevertheless, some consideration can be made from the preventive point of view. Quite surprisingly, the majority of injuries occurred under the supervision of an adult in playing or recreational activities.
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Affiliation(s)
- D Gregori
- Department of Public Health and Microbiology, University of Torino, Italy.
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Passali D, Fiorella R, Camaioni A, Villari G, Mora E, Passali GC, Passali FM, Crisanti A, Bellussi L. [Glucan solution nasal spray vs saline in the treatment of chronic rhinosinusitis: a multi-centric double blind randomised clinical trial]. Clin Ter 2007; 158:139-45. [PMID: 17566515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVES The aim of our study was to evaluate the efficacy of 30 days treatment with glucan solution nasal spray vs. saline in the treatment of signs and symptoms of chronic rhinosinusitis. MATERIALS AND METHODS 100 patients affected by chronic rhinosinusitis were enrolled. At the beginning and at the end of the study were evaluated: nasal congestion, headache, rhinorrea, facial pain, rhinopharyngeal exudate, inferior turbinate hypertrophy; a complete instrumental analysis of nasal functions by Active Anterior Rhinomanometry, nasal Muco-Ciliary Transport time and scraping of nasal mucosa was also performed. The patients were randomized 1:1 for receiving intranasal saline or intranasal glucan solution spray. Treatment was administered as follows: 2 puffs/nostril 3 times a day for 30 days. RESULTS The patients in therapy with the glucan solution showed a significant improvement concerning rhinorrea facial pain, intensity of headache, inferior turbinate hypertrophy, rhinopharyngeal exudates, inspiratory/expiratory nasal resistences, Muco-ciliary transport time, normalization of nasal mucosas and rhinocytogram; saline lavage didn't show this effects. Both treatment improved rhinorrea, instead both treatment didn't affect nasal congestion. CONCLUSIONS According to the results of our multicentric double blind randomized study, we suggest the use of glucan solution nasal spray as an efficacious therapeutic tool in the management of nasal symptoms in patients affected by chronic rhinosinusitis.
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Affiliation(s)
- D Passali
- Istituto di Otorinolaringoiatria, Università di Siena, Policlinico Le Scotte, Siena, Italia.
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38
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De Benedetto M, Salerni L, De Benedetto L, Passali GC, Passali D. [Rhinosinusitis: etiopathogenesis and antimicrobial therapy, an update]. Acta Otorhinolaryngol Ital 2006; 26:5-22. [PMID: 16752855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
The aim of the current study is to underline once again the etiopathogenetic aspects of rhinosinusitis, by a revision of most significative and updated study in otorhinolaryngologic literature to guide the right management of this disease. The focal role of ostio-meatal complex is reported; epidemiological data on old and emergent pathogens are described together with their role on acute or chronic or recurrent rhinosinusitis pathogenesis. According to recent evidence based medicine documents, diagnostic criteria and methodologies are reported to control surgical and medical long-term results. On the bases of the current etiopathogenetic concepts, medical treatment is suggested. The central role of medical management is based on the choice of antimicrobial treatment. The fundamental concepts on pharmacocinetic and pharmacodinamic are reported, togther with updated data on antimicrobial resistance.
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Affiliation(s)
- M De Benedetto
- Dipartimento di Discipline Otorinolaringologiche, Università degli Studi di Siena, Italy
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Bellussi L, Marcucci F, Sensi LG, Passali GC, Lauriello M, Passali FM, Giannuzzi AL, Passali D. Do tryptase, ECP and specific IgE measurement by nasal incubation increase the specific nasal provocation test sensitivity? Int J Immunopathol Pharmacol 2004; 17:201-8. [PMID: 15171821 DOI: 10.1177/039463200401700212] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
The specific Nasal Provocation Test (sNPT) is a third level diagnostic tool. Fitted to reproduce natural exposure condition to pick the responsible allergen for nasal symptoms out, it is applied when prick test and RAST responses are doubtful. SNPT results have been evaluated measuring nasal resistance (anterior rhinomanometry) and nasal symptoms (clinical score), reaching 50% of sensitivity. This study focused on the determination of allergic response markers, triggered by nasal challenge: tryptase levels in the nose, specific IgE and ECP (Eosinophil Cationic Protein). The aim was to increase sNPT sensitivity. Twenty patients suffering from allergic rhinitis and 16 age-matched-nonallergic subjects were enrolled in the study. Tryptase, specific IgE and ECP were determined in nasal mucosa applying a new method, based on in situ incubation, before and after sNPT. The latter was performed following a standardized method. Tryptase levels increased in 13 patients (65%), were unchanged in four patients (20%), and slightly decreased in three patients (15%). The increase recorded was significant in mite allergic patients (p=0.005), but not significant (p> 0.05) in pollen allergic patients. ECP values increased in 13 patients (65%), were unchanged in two patients (10%), and highly decreased in five patients (25%). ECP increase was not significant (p> 0.05). Specific IgE levels increased in seven patients (35%), were unchanged in 11 patients (55%) and decreased in two patients (10%). The IgE increase was significant in pollen-allergic patients (p<0.05), while it was not significant in mite-allergic patients (p>0.05). Tryptase, ECP, and specific IgE were not detected in the control group. The data obtained showed a positive sNPT response in 12 patients (60%). Comparing our results with those derived from classical-parameter employment, we gathered an improvement of 10%. On the basis of the usual parameters, in fact, we recorded 50% positivity, while the use of mediators provided an additional 10% improvement in sNPT sensitivity: taking together the usual parameters and nasal allergic mediators values, we reached an sNPT over-all sensitivity of 85%.
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Passali D, Bellussi L, Damiani V, Passali GC, Passali FM, Celestino D. Allergic rhinitis in Italy: epidemiology and definition of most commonly used diagnostic and therapeutic modalities. Acta Otorhinolaryngol Ital 2003; 23:257-64. [PMID: 15046414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/29/2023]
Abstract
Allergic rhinitis is classically defined as an IgE-mediated inflammation of nasal mucosa, characterised by nasal obstruction, rhinorrhea, sneezing and nasal itching. It is certainly a high-prevalence disease and an important social and medical problem in many industrialised Countries, affecting about 20% of the general population; moreover, it is diagnosed with increasing frequency, both in adults and children in many developing countries. In view of the high medical and social costs, a correct diagnostic approach to allergic rhinitis is a fundamental need for the otorhinolaryngologist, also considering the severe complications (asthma, rhinosinusitis, rhino-otitis, rhinosinusal polyposis) which could develop if this disease is not recognised and adequately treated in its early phases. In order to evaluate not only the present epidemiological characteristics of allergic rhinitis in Italy but also the most commonly used diagnostic and therapeutic approaches in the management of this disease, 145 Italian otorhinolaringologists were selected to take part in the investigation. Each was invited to complete a questionnaire, divided into 8 different sections, to be answered according to their daily clinical practice. The significance of the results has been compared with those of the international samples comprised in the ARIA Document and in the epidemiologic survey of the Standing Committee on Rhinology and Allergy of the International Federation of Otorhinolaryngological Societies. A critical analysis of these data leads to some interesting epidemiological and therapeutic considerations.
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Affiliation(s)
- D Passali
- Institute of Otorhinolaryngology, University of Siena, Italy.
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Sartorelli P, Pistolesi P, Cioni F, Napoli R, Sisinni AG, Bellussi L, Passali GC, Cherubini Di Simplicio E, Flori L. [Skin and respiratory allergic disease caused by polyfunctional aziridine]. Med Lav 2003; 94:285-95. [PMID: 12918320] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 03/04/2023]
Abstract
BACKGROUND Polyfunctional aziridine (PFA) hardener is increasingly used in water-based paints and inks as a replacement for organic solvents. Allergic contact dermatitis, contact urticaria, respiratory allergy in occupationally exposed patients with hypersensitivity to PFA are reported. OBJECTIVES The aim was to study a population of adhesive tape printers for occupational respiratory and skin sensitisation to PFA hardener. Also 2 cases of occupational asthma in workers exposed to PFA in tanneries are reported. METHODS A standard series prick and patch tests was carried out on 15 workers with skin symptoms out of 36 adhesive tape printers exposed to PFA. Prick tests with a 1% PFA water solution and patch tests with a dilution series (0.1-0.32-0.5-1%) of PFA in petrolatum were performed. Lung and nasal provocation tests with PFA hardener were also carried out on 4 subjects with skin and respiratory symptoms. RESULTS Skin sensitivity to PFA prick tests was demonstrated in 8.3% of the exposed population; 22.2% of the exposed workers suffered from allergic contact dermatitis due to PFA with positive patch tests for this compound. One case of occupational rhinitis due to PFA was diagnosed. CONCLUSIONS PFA is a strong sensitizer and the use of gloves and protective clothing appears to be insufficient to prevent occupational allergic diseases. Elimination of PFA from production processes is desirable.
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Affiliation(s)
- P Sartorelli
- Divisione di Medicina del Lavoro, Dipartimento di Medicina Clinica e Scienze Immunologiche, Università degli Studi di Siena, Via dei Tufi, 1-53100 Siena
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Mora E, Mora R, Passali GC, Chiarlone M, Bernardini A, Mora F, Casale S, Cordone MP, Barbieri M. [Computerized modification of Fukuda test]. Acta Otorhinolaryngol Ital 2002; 22:268-72. [PMID: 12510337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/28/2023]
Abstract
OBJECTIVES To study a new method to apply to Fukuda test in order to overcome the interpretational difficulty associated with a subjective evaluation of the exam. MATERIALS AND METHODS During the exam, the patient wears a specially-designed headpiece, with a band at the back fitted with a sensor accommodating both a gyroscope and a bi-axial accelerometer. When asked to step in place, he does so in the Romberg position, eyes closed, successively rotating his head to the right and to the left. RESULTS On analyzing the data obtained through the laterality variable (right/left oscillation) and time variable, it resulted that the difference between the averages referring to the laterality variable of right-handed and left-handed subjects was statistically significant (P = 0.001), while the difference between the averages of the time variable was not. CONCLUSIONS To be able to propose an evaluation of the clinical validity of the test, further research must be carried out on pathological subjects, thus verifying the applicability of the method to the full.
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Affiliation(s)
- E Mora
- Clinica ORL, Ospedale San Martino, Università di Genova
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Mora R, Barbieri M, Passali GC, Sovatzis A, Mora F, Cordone MP. A preventive measure for otitis media in children with upper respiratory tract infections. Int J Pediatr Otorhinolaryngol 2002; 63:111-8. [PMID: 11955602 DOI: 10.1016/s0165-5876(01)00649-8] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Recurrent upper respiratory tract infections (URTI) are very common in patients of all ages. Rhinitis, bronchitis, chronic sinusitis and otitis appear to be the prevalent forms of recurrent respiratory infections in the paediatric population. The aim of treatment is so the solution of the respiratory pathology and the also the prevention of their complications. Antibacterial therapy is still the classical treatment approach in patients both with respiratory tract infections and with otitis media, despite the fact that antibacterials have several well known drawbacks, especially when used to treat recurrent infections. Eighty-four paediatric patients of both sexes (range: 4-14 years) with otitis were enrolled in the study. Patients were included if they had a >2 years' history of recurrent or chronic respiratory infections, and/or had experienced at least three episodes requiring medical consultations and/or treatment during the winter prior to the study. The young patients were randomised to receive Immucytal (group A) or placebo (group B) treatment according to the following protocol: (1) starting therapy (1 month): one tablet daily in the morning 4 days per week for 3 consecutive weeks; (2) maintenance period (5 months): one tablet daily in the morning 4 days per week for 1 week every month. Placebo and Immucytal tablets were identical in shape and size, in order to maintain double-blind conditions. Patients of group A with recurrent URTI had a significantly decreased incidence of ENT infections, fever and shorter duration of illness, decreased requirement for ancillary medications and fewer work-days lost. The reduction in the incidence of infectious episodes became significant vs. placebo. A significantly improved outcome vs. placebo was also observed on the incidence of fever, frequency and duration of infectious episodes, ancillary therapies. Immucytal treatment was associated with significant changes in both immunological and auditory function parameters. Serum concentrations of immunoglobulins were significantly increased in Immucytal. For both evaluations, a significant difference between treatment groups was found (P>0.001). Preventive strategies, such as ribosomal immunotherapy, may represent a valid alternative approach.
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Affiliation(s)
- R Mora
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Genoa, Italy.
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Cozzolino A, Piane R, Passali GC, Ruggiero G. [Use of PTFE membranes in the orbital floor fractures]. Minerva Stomatol 2001; 50:373-9. [PMID: 11744883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/22/2023]
Abstract
BACKGROUND Because the orbital-malar complex has a peculiar anatomic constitution and position, it is at the third place for frequency of the fractures especially if we compare it with another skeleton's parts. Till now have been tested numerous materials with advantages but also some disadvantages used to rebuild the orbital floor. We thought it right to test a material with biocompatibility, easy handiness, chemical stability and elasticit, as PTFE membrane. METHODS We studied 40 cases of both sexes (age between 19 and 70 years) of orbital-malar complex fractures: 14 with isolated fractures, 20 with complexes fractures and 6 politraumatized. They show various degree prolapse of the orbital contents in the maxillary sinus. We make clinic examination and orthoptic analysis by Hess's screen, test of forced traction, axial and coronal TC. In all patients, surgery approach and methodology of plate application were the same. RESULTS All the floors had a optimal and immediate functional renewal; there wasn't any inflammatory reaction neither immediately nor after a two years follow-up. CONCLUSIONS In conclusion, the results show a lot of clinical and practical advantages of the PTFE membrane: the extreme biocompatibility and the easy handiness, the ductility and the low cost.
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Affiliation(s)
- A Cozzolino
- Cattedra di Chirurgia Maxillo-Facciale, Università degli Studi, Siena, Italy.
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Salerni L, De Campora L, Passali GC. [Acoustic rhinometry: proposal for the standardization of the examination method]. Acta Otorhinolaryngol Ital 2000; 20:165-70. [PMID: 11139874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Acoustic Rhinometry is a rhinological test essential to evaluate nasal fossae geometry. The test requires that the patient be positioned so that a 120 degrees angle is formed between the nasal adapter and the floor of the nasal fossa. The use of a craniostat ensures that the patient is actually in this condition and that the position remains unvaried throughout subsequent tests. The purpose of the present study has been to evaluate the reproducibility and reliability of craniostat-aided acoustic rhinometry in routine clinical practice. A total of 33 patients with hypertrophy of the lower turbinates were enrolled in the study. Rhinometry was performed in the basal conditions and after decongestion with a vasoconstrictor spray. Statistical analysis was performed on the sampling and showed that acoustic rhinometry performed with the craniostat was more reproducible and more reliable than those readings taken without the aid of the craniostat.
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Affiliation(s)
- L Salerni
- Istituto di Discipline Otorinolaringologiche, Università di Siena
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