Rhinitis

The effect of nasal steroid administration on intraocular pressure

June 30, 2007     Christos Spiliotopoulos, MD; Nicholas S. Mastronikolis, MD, PhD; Ioannis K. Petropoulos, MD; Ephigenia K. Mela, MD, PhD; Panos D. Goumas, MD, PhD; Sotirios P. Gartaganis, MD, PhD
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Abstract
The effect of systemic steroid administration on intraocular pressure (IOP) is well established. However, less attention has been paid to the effect of steroids when administered in a nasal spray. We conducted a study to investigate a possible association between nasal steroids and elevated IOP in 54 patients who were being treated for allergic rhinitis. IOP was measured before the patients started therapy and thereafter every 5 days during that therapy. Follow-up ranged from 27 to 35 days (mean: 31). Statistical analysis revealed no significant elevation in IOP after nasal steroid administration. It seems that short-term administration of nasal steroids does not cause significant IOP elevation. Nevertheless, their long-term effects on this pressure should be investigated.

Cell-mediated immunity in nasopharyngeal carcinoma and allergic rhinitis: A controlled study

April 30, 2007     Hsien Teik Wong, MS; Tengku A. Shahrizal, MS; Narayanan Prepageran, FRCS; Wye Keat Lim, FRCS; Rajagopalan Raman, MS
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Nasal septal perforation secondary to rhinitis medicamentosa

May 31, 2006     Harold F. Keyserling, MD; John D. Grimme, MD; Daniel L.A. Camacho, MD; Mauricio Castillo, MD
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Abstract
Nasal septal perforation is a rarely reported complication of rhinitis medicamentosa. We describe such a complication in a 54-year-old man, and we discuss the clinical, pathologic, and imaging aspects of this case.

Comparison of intranasal hypertonic Dead Sea saline spray and intranasal aqueous triamcinolone spray in seasonal allergic rhinitis

June 30, 2005     Scott Cordray, DO, FAOCO; Jim B. Harjo, DO; Linda Miner, PhD
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Abstract
Intranasal corticosteroids are well known to be efficacious in the treatment of allergic rhinitis. Nasal irrigation with saline, including hypertonic saline, has long been recommended for the treatment of sinonasal disease, and it has been shown to have a positive effect on the physiology of the nasal mucosa. Until now, no study of the clinical efficacy of intranasal hypertonic Dead Sea saline as a monotherapy for seasonal allergic rhinitis has been reported. We conducted a prospective, randomized, single-blind, placebo-controlled comparison of intranasal hypertonic Dead Sea saline spray and intranasal aqueous triamcinolone spray in 15 patients with seasonal allergic rhinitis. Results were based on a 7-day regimen. Based on Rhinoconjunctivitis Quality of Life Questionnaire scores, clinically and statistically significant (p < 0.0001) improvements were seen in both active-treatment groups; as expected, the corticosteroid spray was the more effective of the two treatments. No significant improvement occurred in the control group. Our preliminary results not only confirm the efficacy of intranasal corticosteroid therapy in moderate-to-severe allergic rhinitis, they also suggest that the Dead Sea saline solution can be an effective alternative in mild-to-moderate allergic rhinitis, particularly with respect to nasal and eye symptoms. The hypertonicity of the Dead Sea solution may have a positive effect on the physiology of the nasal mucosa by improving mucociliary clearance. In addition, the dominant cation in the Dead Sea solution''magnesium''probably exerts anti-inflammatory effects on the nasal mucosa and on the systemic immune response.

Pediatric allergic rhinitis: Factors affecting treatment choice

March 1, 2005     Erwin W. Gelfand, MD
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Abstract
Allergic rhinitis is the most prevalent chronic allergic disease in children. Although it is not life-threatening, it can have a significantly detrimental effect on a child's quality of life, and it may exacerbate a number of common comorbidities, including asthma and sinusitis. The Allergic Rhinitis and its Impact on Asthma guidelines, an evidence-based algo-rithm for the treatment of allergic rhinitis, advocate the use of antihistamines for the treatment of the broad spectrum of the disease. However, first-generation antihistamines are associated with a number of adverse events, including central nervous system impairment and anticholinergic and cardiovascular effects. Moreover, these agents have not been rigorously tested in the pediatric population. Nevertheless, first-generation antihistamines remain the most frequently prescribed agents in this class of drugs. This is despite the fact that the second-generation antihistamines are largely free of the undesirable side effects associated with their predecessors and the fact that they have been shown to be effective in relieving allergic rhinitis symptoms in children in a number of large-scale clinical trials. Therefore, when selecting an antihistamine for a child, it would be prudent to consider the full range of antihistamines and to base the selection of a particular drug on its efficacy, onset and duration of action, and safety profile.

Charcot-Leyden crystals: Pathology and diagnostic utility

June 30, 2004     Liron Pantanowitz, MD; Karoly Balogh, MD
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