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Carvalho T, Salgado DC, Mion ODG, de Mello JF, Voegels RL. The Effect of Turbinate Injection of Botulinum Toxin A on the Symptoms of Idiopathic Rhinitis. Int Arch Otorhinolaryngol 2021; 26:e191-e198. [PMID: 35602280 PMCID: PMC9122764 DOI: 10.1055/s-0041-1730307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Accepted: 12/29/2020] [Indexed: 11/28/2022] Open
Abstract
Introduction
Idiopathic rhinitis is a nonallergic and noninfectious rhinitis characterized mainly by nasal obstruction and rhinorrhea, resulting from an autonomic imbalance. Botulinum toxin type A (BTX-A) demonstrated its action in reducing rhinorrhea and nasal obstruction when injected into the nasal turbinates or septum.
Objective
To analyze the effects of intranasal BTX-A injection to control the symptoms of idiopathic rhinitis and its possible adverse effects.
Method
Patients with idiopathic rhinitis were divided into two groups. Group A had 15 participants (8 female and 6 male), of ages from 47 to 84 years (mean 66.57 years), and these received 60 U of Dysport (Ipsen Ltd, Maidenhead, Berkshire, UK) in each inferior nasal turbinate; group B had 12 participants (1 male and 11 female), of ages from 50 to 76 years (mean 60 years), and they received 1 ml of 0.9% saline. The individuals were reevaluated in the 1
st
, 2
nd
, 4
th
, 8
th
, and 12
th
weeks after injection by a questionnaire, accompanied by nasal inspiratory peak flow and acoustic rhinometry.
Results
Group A showed significant improvement, mainly regarding the symptoms of sneezing/itching and nasal obstruction, over time and when compared to group B. Acoustic rhinometry confirmed the improvement in nasal obstruction. There was no relationship between the nasal peak flow data and the nasal obstruction score. No major adverse effects have been reported.
Conclusion
The injection of botulinum toxin in the inferior nasal turbinates of patients with idiopathic rhinitis reduces the symptoms of sneezing, itching, nasal obstruction, and runny nose without significant adverse effects, suggesting that it is an option in the treatment of these patients.
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Affiliation(s)
- Thiago Carvalho
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil
| | - Daniel Calduro Salgado
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil
| | - Olavo de Godoy Mion
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil
| | - João Ferreira de Mello
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil
| | - Richard Louis Voegels
- Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo , São Paulo, SP, Brazil
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Mion ODG, Mello JFD, Dutra DL, Andrade NAD, Almeida WLDC, Anselmo-Lima WT, Filho LLB, Carvalho E Castro JD, Guimarães REDS, Lessa MM, Maniglia SF, Meireles RC, Nakanishi M, Pignatari SSN, Roithmann R, Romano FR, Santos RDP, Santos MCJD, Tamashiro E. Position statement of the Brazilian Academy of Rhinology on the use of antihistamines, antileukotrienes, and oral corticosteroids in the treatment of inflammatory sinonasal diseases. Braz J Otorhinolaryngol 2017; 83:215-227. [PMID: 28216249 PMCID: PMC9442683 DOI: 10.1016/j.bjorl.2017.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2016] [Accepted: 12/21/2016] [Indexed: 12/12/2022] Open
Abstract
Introduction Inflammatory conditions of the nose and paranasal sinuses are very prevalent in the general population, resulting in marked loss of quality of life in affected patients, as well as significant work, leisure, and social activity losses. These patients require specific and specialized treatment. A wide range of oral medications are available. Objective The present document is aimed to clarify, for professionals treating patients with inflammatory sinonasal diseases, both specialists and general practitioners, specific oral therapies in noninfectious nasal inflammatory conditions. Methods The methodology used to create this article included the search for the key words: oral corticosteroids, antihistamines, antileukotrienes, rhinitis, rhinosinusitis in the MEDLINE and EMBASE databases in the last 5 years. Since no relevant article was found for the text on the subject of interest in the last 5 years, the search was extended for another 5 years, and so on, according to the authors’ needs. Results Relevant literature was found regarding the use of antihistamines, antileukotrienes and oral corticosteroids in these conditions. The Brazilian Academy of Rhinology emphasizes, after extensive discussion by the collegiate, key points in the treatment with these drugs. Conclusion There is support in the literature for the use of these drugs; however, final considerations about the role of each of them have been made.
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Affiliation(s)
- Olavo de Godoy Mion
- Universidade de São Paulo (USP), Disciplina de Otorrinolaringologia, São Paulo, SP, Brazil.
| | | | - Daniel Lorena Dutra
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Nilvano Alves de Andrade
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | | | - Wilma Teresinha Anselmo-Lima
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Otorrinolaringologia, Ribeirão Preto, SP, Brazil
| | | | | | - Roberto Eustáquio Dos Santos Guimarães
- Universidade Federal de Minas Gerais (UFMG), Faculdade de Medicina, Belo Horizonte, MG, Brazil; Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Marcus Miranda Lessa
- Universidade Federal da Bahia (UFBA), Faculdade de Medicina, Disciplina de Otorrinolaringologia, Salvador, BA, Brazil
| | - Sérgio Fabrício Maniglia
- Hospital Instituto Paranaense de Otorrinolaringologia, Centro de Rinite e Alergia, Curitiba, PR, Brazil
| | | | - Márcio Nakanishi
- Universidade de São Paulo (USP), Disciplina de Otorrinolaringologia, São Paulo, SP, Brazil; Universidade de Brasília (UnB), Faculdade de Medicina, Brasília, DF, Brazil
| | | | - Renato Roithmann
- Universidade Luterana do Brasil (ULBRA), Faculdade de Medicina, Otorrinolaringologia, Canoas, RS, Brazil; Mount Sinai Hospital, Department of Othorhinolaryngology, Toronto, Canada
| | - Fabrizio Ricci Romano
- Universidade de São Paulo (USP), Faculdade de Medicina, Ciências, São Paulo, SP, Brazil
| | | | - Marco César Jorge Dos Santos
- Universidade de São Paulo (USP), Faculdade de Medicina, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Edwin Tamashiro
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
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Mello JFD, Mion ODG, Andrade NAD, Anselmo-Lima WT, Stamm AEC, Almeida WLDC, Cavalcante Filho PO, Castro JDCE, Padua FGDM, Romano FR, Santos RDP, Roitmann R, Voegels RL, Meirelles RC, Sá LCB, Moacyr MT, Santos MCJD, Guimarães RES. Brazilian Academy of Rhinology position paper on topical intranasal therapy. Braz J Otorhinolaryngol 2013; 79:391-400. [PMID: 23743757 PMCID: PMC9443840 DOI: 10.5935/1808-8694.20130067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 10/07/2012] [Indexed: 11/20/2022] Open
Abstract
This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.
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Baldaçara RPDC, Fernandes MDFM, Baldaçara L, Aun WT, de Mello JF, Pires MC. Prevalence of allergen sensitization, most important allergens and factors associated with atopy in children. SAO PAULO MED J 2013; 131:301-8. [PMID: 24310798 PMCID: PMC10876323 DOI: 10.1590/1516-3180.2013.1315502] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2012] [Accepted: 12/26/2012] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Knowledge of the profile of allergen sensitization among children is important for planning preventive measures. The objective of this study was to assess the prevalence and profile of sensitization to inhaled allergens and food among children and adolescents in an outpatient population in the city of Palmas. DESIGN AND SETTING Cross-sectional study at outpatient clinics in Palmas, Tocantins, Brazil. METHODS Ninety-four patients aged 1-15 years who were attending two pediatric outpatient clinics were selected between September and November 2008. All of the subjects underwent clinical interviews and skin prick tests. RESULTS A positive skin prick test was observed in 76.6% of the participants (72.3% for inhalants and 28.9% for food allergens). The most frequent allergens were Dermatophagoides pteronyssinus (34%), cat epithelium (28.7%), dog epithelium (21.3%), Dermatophagoides farinae (19.1%), Blomia tropicalis (18.1%), cow's milk (9.6%) and grasses (9.6%). A positive skin prick test correlated with a history of atopic disease (odds ratio, OR = 5.833; P = 0.002), a family history of atopic disease (OR = 8.400; P < 0.001), maternal asthma (OR = 8.077; P = 0.048), pet exposure (OR = 3.600; P = 0.012) and cesarean delivery (OR = 3.367; P = 0.019). CONCLUSION Dermatophagoides pteronyssinus was the most frequent aeroallergen and cow's milk was the most prevalent food allergen. There was a positive correlation between a positive skin prick test and several factors, such as a family history of atopic disease, maternal asthma, pet exposure and cesarean delivery.
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Affiliation(s)
| | - Maria de Fátima Marcelos Fernandes
- MD, MSc. Head of the Diagnostic and Therapeutic Division, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - Leonardo Baldaçara
- MD, PhD. Associate Professor in the Department of Medicine, Universidade Federal do Tocantins (UFT), Palmas, Tocantins, Brazil.
| | - Wilson Tartuce Aun
- MD. Head of the Immunology Section, Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - João Ferreira de Mello
- MD, PhD. Director of the Department of Allergy and Immunology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
| | - Mario Cesar Pires
- MD, PhD. Head of the Diagnostic and Therapeutic Division, Department of Dermatology, Hospital do Servidor Público Estadual de São Paulo (HSPE), São Paulo, Brazil.
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Mion ODG, Campos RA, Antila M, Rapoport PB, Rosario N, de Mello Junior JF, Guimarães RES, Mocellin M, Di Gesu G, Solé D, Wexler L, de Mello JF, Castro FM, Chavarria ML. Futura study: evaluation of efficacy and safety of rupatadine fumarate in the treatment of persistent allergic rhinitis. Braz J Otorhinolaryngol 2010; 75:673-9. [PMID: 19893935 DOI: 10.1590/s1808-86942009000500011] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2008] [Accepted: 07/02/2009] [Indexed: 11/21/2022] Open
Abstract
UNLABELLED Allergic rhinitis affects 10-30% of the population, negatively impacting one's quality of life and productivity. It has been associated with sinusitis, otitis media, sleep disorders, and asthma. Rupatadine is a second generation antihistamine with increased affinity to histamine receptor H1; it is also a potent PAF (platelet-activating factor) antagonist. It starts acting quite quickly, offers long lasting effect, and reduces the chronic effects of rhinitis. AIM this study aims to assess the efficacy and safety of rupatadine in the treatment of persistent allergic rhinitis. MATERIALS AND METHOD this is a multi-centric open prospective study. This study included 241 patients from 13 centers in Brazil and was held between October of 2004 and August of 2005. Signs and symptoms of rhinitis and tolerance to medication were analyzed after one and two weeks of treatment. RESULTS reduction on general scores from 8.65 to 3.21 on week 2 (p<0.001). All signs and symptoms improved significantly in the first day of treatment (p<0.001), except for nasal congestion and secretion, which improved from the second day of treatment (p<0.001). Adverse events occurred in 19.9% of the cases, 27.7% on week 1. CONCLUSION rupatadine effectively controls persistent allergic rhinitis; it is safe and presents low incidence of side effects.
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de Godoy Mion O, Campos RA, Antila M, Bogar Rapoport P, Rosario N, de Mello JF, Santos Guimarães RE, Mocellin M, Di Gesu G, Solé D, Wexler L, de Mello JF, Morato Castro F, Chavarria ML. FUTURA STUDY-Evaluation of efficacy and safety of rupatadine fumarate in the treatment of persistent allergic rhinitis. Braz J Otorhinolaryngol 2009. [PMID: 19893935 PMCID: PMC9442186 DOI: 10.1016/s1808-8694(15)30517-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Allergic rhinitis affects 10-30% of the population, negatively impacting one's quality of life and productivity. It has been associated with sinusitis, otitis media, sleep disorders, and asthma. Rupatadine is a second generation antihistamine with increased affinity to histamine receptor H1; it is also a potent PAF (platelet-activating factor) antagonist. It starts acting quite quickly, offers long lasting effect, and reduces the chronic effects of rhinitis. Aim this study aims to assess the efficacy and safety of rupatadine in the treatment of persistent allergic rhinitis. Materials and method this is a multi-centric open prospective study. This study included 241 patients from 13 centers in Brazil and was held between October of 2004 and August of 2005. Signs and symptoms of rhinitis and tolerance to medication were analyzed after one and two weeks of treatment. Results reduction on general scores from 8.65 to 3.21 on week 2 (p<0.001). All signs and symptoms improved significantly in the first day of treatment (p<0.001), except for nasal congestion and secretion, which improved from the second day of treatment (p<0.001). Adverse events occurred in 19.9% of the cases, 27.7% on week 1. Conclusion rupatadine effectively controls persistent allergic rhinitis; it is safe and presents low incidence of side effects.
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Abstract
FUNDAMENTOS: Alergia ao látex é comum em trabalhadores da saúde, resultando em absenteísmo e afastamento das atividades profissionais. Há no Brasil poucos estudos publicados sobre o assunto. Enquanto na população geral a prevalência de alergia ao látex é menor que 2%, nos profissionais de saúde pode chegar a 30%. OBJETIVO: Estudar a prevalência de alergia ao látex em profissionais de saúde do Hospital do Servidor Público Estadual de São Paulo. MÉTODOS: Foi aplicado questionário aberto a profissionais que têm contato com luvas de borracha em todos os serviços do hospital. Foi colhido sangue daqueles que referiram sintomas e dosado anticorpo IgE específico por meio do ImmunoCAP. Para análise estatística utilizaram-se porcentagens, tabelas e teste qui-quadrado. RESULTADOS: Foram distribuídos 2.349 questionários, e respondidos 1.045, dos quais 129 referiram correlação entre uso de látex e sintomas sugestivos de alergia, e 54 permitiram a coleta de sangue para determinação de IgE específica. Neste grupo houve dois casos em que foi demonstrado anticorpo específico, estabelecendo-se prevalência de 3,7% de alergia ao látex. Fatores como gênero, profissão, freqüência de contato com luvas, setor de trabalho e antecedentes de atopia foram relacionados com maior prevalência de alergia ao látex. CONCLUSÃO: A prevalência de alergia ao látex encontrada foi de 3,7%.
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Affiliation(s)
| | - Mario Cezar Pires
- Hospital do Servidor Público Estadual de São Paulo; Complexo Hospitalar Padre Bento de Guarulhos, Brasil
| | - João Ferreira de Mello
- Universidade Federal de São Paulo; Hospital do Servidor Público Estadual de São Paulo, Brasil
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Ferreira de Mello J. Our future. Braz J Otorhinolaryngol 2007. [PMCID: PMC9450575 DOI: 10.1016/s1808-8694(15)31166-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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Abstract
UNLABELLED Nowadays, the World Wide Web (Internet) is an information source for non-experts and physicians. AIM To evaluate, based on ethical principles, Brazilian web sites information about "allergic rhinitis". Allergic rhinitis is a very common disease, effecting more than 10% of the general population, leading to decrease in quality of life. STUDY DESIGN Review. MATERIAL AND METHOD We performed the evaluation of 173 Brazilian web sites, which were obtained from four search engines (Google, Yahoo, AltaVista and Radar Uol). The web sites were evaluated according to the Manual of Ethical Principles, Regional Council of Medicine of the state of Sao Paulo (CREMESP), regarding transparency, honesty, quality, privacy, medical ethics, informed consent, responsibility and origin. RESULTS Among the analyzed web sites, 149 (86.1%) were not in accordance with the Manual of Ethical Principles of Regional Council of Medicine of the state of Sao Paulo (CREMESP). According to the analyzed items, the irregularities that were found were quality (84.4%), privacy (46.2%), honesty (18.5%), informed consent (15.6%), responsibility and origin (13.9%), transparency (12.1%), medical ethics (2.3%). There was inaccurate information in 24.3% of the analyzed sites. CONCLUSIONS The majority of the websites regarding allergic rhinitis are not in accordance with the ethical principles of CREMESP. In general, the quality of a great part of the Brazilian web sites that address "allergic rhinitis", and the quality of the information disseminated by them, are insufficient to satisfy doctors and patients.
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Abstract
UNLABELLED Children with enlarged tonsils and adenoids usually present breathing abnormalities such as snoring, mouth breathing and sleep apnea. It is known that upper airway obstruction and consequent mouth breathing may result in pulmonary diseases. AIM The goal of this preliminary study was to evaluate the inspiratory pressure in children with upper airway obstruction due to enlarged tonsils. STUDY DESIGN Clinical with transversal cohort. MATERIAL AND METHOD We evaluated 37 children (4-3 years old, female/male) with enlarged tonsils who would be submitted to a T&A surgery in the Department of Otolaryngology, Medical School, University of Sao Paulo, from October 2002 to March 2003. The control group comprised 28 children without tonsillar disease submitted to the same tests. Inspiratory pressure was obtained using a manometer and vacuum meter. RESULTS We could observe lower inspiratory pressures in children with upper airway obstruction. The mean of inspiratory pressure in the upper airway obstruction group was 14.607 cm/H2O and in the control group was of 27.580 cm/H2O. CONCLUSIONS Enlarged tonsils and adenoids were associated with poor inspiratory pressure, resulting in increased breathing effort and work of the involved muscles.
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Affiliation(s)
- Melissa Guerato Pires
- Division of Otorhinolaryngology, Hospital das Clínicas/Medical School, University of Sao Paulo.
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Abstract
OBJECTIVE We investigated the role of allergic rhinitis in chronic otitis media (otitis media with effusion [OME] and chronic perforation of the tympanic membrane) in São Paulo, Brazil and whether there is any association between these diseases. STUDY DESIGN AND SETTING We studied 51 patients followed in the otologic group of the Otorhinolaryngology Division of the University of São Paulo Hospital. The patients were divided into 3 groups: allergic rhinitis, nonallergic rhinitis with eosinophils syndrome (NARES), and patients with types of rhinitis or without rhinitis. We analyzed the age, gender, intensity of the nasal disease, surgical procedure, and surgical results in each group. RESULTS We found about 50% of patients presenting with nasal disease and nasal eosinophilia (33.33% of allergic and 15.69% of NARES). CONCLUSION Nasal disease has an impact on otologic middle ear disease, considering that the normal nasal mucosa do not have eosinophils.
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Affiliation(s)
- Olavo Mion
- Otorhinolaryngology Division, University of São Paulo Hospital, Brazil
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