Search Results (40)

Nasal irrigation (NI) is an effective, safe, low-cost strategy for treating and preventing upper respiratory tract diseases. High-volume, low-pressure saline irrigations are the most efficient method for removing infectious agents, allergens, and inflammatory mediators. This article reviews clinical evidence supporting NI use in various conditions: nasal congestion in infants, recurrent respiratory infections, acute and chronic rhinosinusitis, allergic and gestational rhinitis, empty nose syndrome, and post-endoscopic sinus surgery care. NI improves symptoms, reduces recurrence, enhances the efficacy of topical drugs, and decreases the need for antibiotics and decongestants. During the COVID-19 pandemic, NI has also been explored as a complementary measure to reduce viral load. Due to the safe profile and mechanical cleansing action on inflammatory mucus, nasal irrigations represent a valuable adjunctive treatment across a wide range of sinonasal conditions. Full article

For the self-medication of nasal congestion following a common cold, decongestant nasal sprays can be recommended according to the medicine guidelines. In Germany, these are only available in community pharmacies (CPs) with free pricing. The aim was to analyze the medication recommendation, counseling, and pricing. A covert simulated patient study, internationally recognized as the “gold standard”, was conducted in all CPs of two medium-sized cities in north-eastern Germany. Each CP was visited twice (86 visits) with the identical scenario by one female and one male simulated patient. At the beginning, they asked for a nasal spray and, when asked, stated that they had had nasal congestion for three days. Slightly more than half (54.7%, 47/86) of the recommended nasal sprays were free of preservatives. The median counseling score was 2.0 out of 8 points, with a significantly higher score observed for the female SP (p = 0.004). Information on the maximum intake duration of five days recommended in the German pharmacy guideline was not provided during any visits. The prices varied in total from EUR 1.95 to EUR 6.22. Therefore, measures by the legislator and the chambers of pharmacists are necessary to sustainably improve the medication recommendation, the counseling, and the price transparency. Full article

Background and aim. Acute rhinitis (AR) is a common condition in children, primarily of viral origin, causing nasal congestion, rhinorrhea, and discomfort, with a significant impact on quality of life and economic burden. Current treatments are limited to symptomatic relief, with nasal irrigation being the primary non-pharmacological intervention. This study aimed at evaluating the efficacy and safety of Elysium Naso-gola—an isotonic saline solution enriched with mullein (Verbascum thapsus), thyme (Thymus vulgaris), propolis, and long-chain polyphosphates—in reducing symptom severity and duration in pediatric AR. Methods. A randomized, double-blind, placebo-controlled pilot trial was conducted on 60 children (aged 4–14 years) with AR. Participants were randomized into two groups: the active group received Elysium Naso-gola, while the placebo group received a sterile isotonic saline solution, both administered as nasal sprays four times daily for seven days. Symptom severity was assessed at baseline (T0), day 5 (T1), and day 10 (T2) using the I-NOSE questionnaire and Visual Analog Scale (VAS). The primary outcome was symptom reduction at T1, while secondary outcomes included nasal obstruction improvement and complete symptom resolution at T2. Results. At baseline, both groups exhibited comparable symptoms severity. At T1, the active group showed a significant reduction in I-NOSE scores compared to placebo group (p < 0.05), with a marked decrease in nasal obstruction severity. VAS scores also indicated a greater improvement in nasal breathing in the active group. At T2, complete symptom resolution was achieved in 60% of patients treated with Elysium Naso-gola, compared to only 5.3% in the placebo group (p < 0.01). No adverse events were reported, and treatment adherence was high in both groups. Conclusions. The findings suggest that Elysium Naso-gola is a safe and effective non-pharmacological treatment for pediatric AR, providing faster symptom relief and higher resolution rates. Larger multicenter trials are warranted to confirm these preliminary results and further explore its role in pediatric respiratory care. Full article

Background and Objectives: Acute Otitis Media (AOM) is a leading cause of morbidity in children, characterized by fever, otalgia, and hearing loss. If untreated, AOM may progress to chronic complications requiring surgical management. Globally, factors such as allergies, environmental tobacco smoke, and nutritional deficiencies are well-established risk factors, but in Indonesia, particularly rural areas like Bandung Regency, limited awareness and data exacerbate the burden of disease. Smoking prevalence and low immunization rates further increase risks for AOM. Materials and Methods: This case-control study, conducted between September 2019 and February 2020 in Bandung Regency, evaluated risk factors for AOM in children aged 24–59 months. Data were collected through structured questionnaires, anthropometric assessments, and ENT examinations. A total of 168 AOM-positive and 367 AOM-negative children were recruited from primary healthcare facilities. Results: Multivariable analysis identified significant associations with AOM: allergic rhinitis (AOR 1.92), cigarette smoke exposure (AOR 1.79), stunted growth (AOR 1.48), and incomplete basic immunizations (AOR 1.77). These findings highlight the importance of addressing modifiable factors such as nutrition and immunization to reduce AOM incidence. Conclusions: The rhinitis allergy and exposure to cigarette smoke are among the well-established risk factors that our results validate. Additional research is necessary to validate if our findings involving two modifiable risk factors, stunted children and insufficient basic vaccination, may increase the risk of AOM. Full article

Asthmatic children who tested positive for COVID-19 experienced changes in lung function and persistent symptoms following SARS-CoV-2 infection, even for several months after diagnosis, and with the same features as in an acute phase. This study aimed to analyze a pediatric age group (between 0 and 17 years old) diagnosed with asthma, and SARS-CoV-2 infection attending regular monitoring visits in a Pediatric Department of a Regional Tertiary Hospital (Filantropia Clinical Municipal Hospital Craiova, Romania) during the COVID-19 pandemic and post-pandemic time interval (i.e., March 2020–July 2024), and identify how the infection influenced their long-term symptoms and treatment. Materials and Methods. The following variables were recorded: demographic data (gender, age group, residence), data related to allergies (allergic rhinitis, atopic dermatitis, and food allergies), the presence of exacerbations, the fraction of exhaled nitric oxide, the ventilatory function, the asthma phenotype (allergic or non-allergic), as well as the GINA assessment of asthma control at clinical visits were analyzed. SARS-CoV-2 infections were evaluated in terms of year of infection, symptoms, cough presence and persistence, and modifications of the asthma treatment during and after COVID-19 disease. The data were statistically analyzed with SPSS, using the Mann–Whitney U, Kruskal–Wallis H, and Chi-Square tests. Results. A lower incidence of COVID-19 cases was recorded in the first pandemic of asthmatic patients (2020 and 2021), but an increase in the rate of cases was observed at the beginning of the second pandemic, in 2022. The nitric oxide values in asthmatic children who were infected with SARS-CoV-2 were statistically significantly increased (p < 0.0005), especially for children with persistent cough for more than 4 weeks. A significant increase in the number of exacerbations was also observed in patients who tested positive for SARS-CoV-2 infection (p < 0.0005). Ventilatory function values were statistically significantly different in asthmatic children with and without SARS-CoV-2 infection (p < 0.05). Conclusions. The persistence of cough after the acute phase of SARS-CoV-2 infection as well as the changes in ventilatory tests emphasize the need of periodic medical check-ups, as well as the implementation of a therapeutic regimen appropriate for each pediatric patient. Full article

Background: This systematic review aimed to synthesize the existing evidence on the use of Streptococcus salivarius (S. salivarius) probiotics as prophylactic or therapeutic tools for pediatric oral, dental, and respiratory diseases. Methods: A comprehensive search was carried out across multiple databases using the following terms: S. salivarius, probiotic, children, pediatric. Results: The systematic literature search identified 613 publications, which were meticulously screened, and, ultimately, 15 suitable citations were included in this systematic review. Three strains of S. salivarius (M18, K-12, 24SMB) were used, and they all demonstrated positive benefits in pediatric pathology. Conclusions: Administration of S. salivarius has benefits, is effective, and is convenient (cost-effective) in pediatric prophylaxis. Oral administration as a chewable tablet or powder of S. salivarius M18 for 3 months is able to reduce the incidence of black stains, plaque, and tooth decay in children. S. salivarius K-12 treatment decreased the occurrence of pharyngeal, recurrent, and streptococcal disease, and the benefits also extend to a reduction of nonstreptococcal diseases, including tracheitis, viral pharyngitis, rhinitis, flu, laryngitis, acute otitis media, and enteritis. Administration of S. salivarius 24SMB as an intranasal spray was able to reduce the risk of acute otitis media in children prone to this condition. Full article

Background: Identifying predictive factors of long COVID syndrome (LCS) is essential to preventing and managing this condition. We investigated the prevalence, symptoms, and risk factors of LCS in a cohort of Italian children and adolescents. Methods: We carried out a cross-sectional survey on demographic characteristics and clinical data related to COVID-19 phase and LCS in a cohort of children and adolescents, sending a questionnaire by using the PEDIATOTEM platform. Results: The prevalence of LCS was 25% (99/396). The most frequent symptoms of LCS included nasal congestion, diarrhea, headache, and fatigue. We found no association between demographic data (gender, age, and ethnicity) and LCS. Additionally, we showed that patients with concurrent allergic rhinitis, atopic dermatitis, respiratory disease, gastrointestinal disease, and rheumatologic disease had a higher risk of LCS than patients without those comorbidities. Patients experiencing fatigue, muscle, and abdominal pain in COVID-19 showed a higher risk of LCS than patients complaining of other symptoms. We found no association between vaccination and LCS. Conclusions: Specific comorbidities or symptoms during acute illness were identified as being risk factors for LCS. Understanding which are the risk factors for LCS could yield a clearer picture of its pathogenesis. Full article

Capsaicin, the organic compound which attributes the spicy flavor and taste of red peppers and chili peppers, has been extensively studied for centuries as a potential natural remedy for the treatment of several illnesses. Indeed, this compound exerts well-known systemic pleiotropic effects and may thus bring important benefits against various pathological conditions like neuropathic pain, rhinitis, itching, or chronic inflammation. Yet, little is known about the possible biological activity of capsaicin at the kidney level, as this aspect has only been addressed by sparse experimental investigations. In this paper, we aimed to review the available evidence focusing specifically on the effects of capsaicin on renal physiology, as well as its potential benefits for the treatment of various kidney disorders. Capsaicin may indeed modulate various aspects of renal function and renal nervous activity. On the other hand, the observed experimental benefits in preventing acute kidney injury, slowing down the progression of diabetic and chronic kidney disease, ameliorating hypertension, and even delaying renal cancer growth may set the stage for future human trials of capsaicin administration as an adjuvant or preventive therapy for different, difficult-to-treat renal diseases. Full article

Equine rhinitis B virus is a lesser-known equine respiratory pathogen that is being detected with increasing frequency via a voluntary upper respiratory biosurveillance program in the United States. This program received 8684 nasal swab submissions during the years 2012–2023. The nasal swabs were submitted for qPCR testing for six common upper respiratory pathogens: Streptococcus equi subspecies equi (S. equi), equine influenza virus (EIV), equine herpesvirus type 1 (EHV-1), equine herpesvirus type 4 (EHV-4), equine rhinitis A virus (ERAV), and equine rhinitis B virus (ERBV). The overall ERBV qPCR-positivity rate was 5.08% (441/8684). ERBV was detected as a single pathogen in 291 cases (65.99% of positives, 291/441) and was detected as a coinfection with at least one other respiratory pathogen in 150 cases (34.01%, 150/441). Young horses, less than a year of age, with acute onset of fever and respiratory signs and horses used for competition are more likely to test qPCR-positive for ERBV. Horses with ERBV may present with fever, nasal discharge, ocular discharge, and/or cough. Coinfection is a common feature of ERBV infection and S. equi, EHV-4 and EIV were the most common pathogens coinfected with ERBV. This report provides important information regarding the clinical relevance of ERBV in the horse and begins investigating the impact of coinfection on clinical disease. Full article

Nasal nitric oxide (nNO) is a gas synthesized by the inducible and constitutive NO synthase (NOS) enzyme in the airway cells of the nasal mucosa. Like lung nitric oxide, it is thought to be associated with airway inflammation in various respiratory diseases in children. The aim of our review was to investigate the current state of use of nNO measurement in children. A comprehensive search was conducted using the Web of Science and PubMed databases specifically targeting publications in the English language, with the following keywords: nasal NO, children, allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, primary ciliary dyskinesia (PCD), and cystic fibrosis (CF). We describe the use of nNO in pediatric allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, PCD, and CF based on the latest literature. nNO is a noninvasive, clinically applicable test for use in pediatric allergic rhinitis, chronic rhinosinusitis, acute rhinosinusitis, PCD, and CF. It can be used as a complementary method in the diagnosis of these respiratory diseases and as a monitoring method for the treatment of allergic rhinitis and acute and chronic rhinosinusitis. Full article

Background: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has outpaced vaccine availability and delivery from vaccine manufacturers, and thus, a scarcity of vaccines happened to many countries around the world. In Thailand, the mixing of different types of vaccines was approved and clinically implemented partially due to concerns about the availability and efficacy of one vaccine. Objective: This study aimed to investigate the effectiveness and safety of heterologous CoronaVac–ChAdOx1 nCoV-19 vaccines compared with the usual regimen of homologous CoronaVac–CoronaVac. A retrospective cohort study was conducted by dividing patients into the CoronaVac–CoronaVac group and the CoronaVac–ChAdOx1 group. Results: A total of 875 patients received vaccinations at Srisangwan Hospital between April to October 2021 and were included for analysis. The patients in both homologous and heterologous groups had low rates of COVID-19 infection. In addition, the hospitalization rates in the 40 days after the second vaccination were low in both regimens. Minimal adverse events (AE) were reported in both groups, including local AE (e.g., discomfort at the injection site, rash, soreness, swelling, and redness) and systemic AE (e.g., fever, headache, weariness, nausea, vomiting, diarrhoea, and myalgia). Moreover, several factors were associated with lower adverse events following immunization (AEFIs), including age ≥ 50 years, male, and body weight ≥ 50 kg. In contrast, thyroid disease, diabetes mellitus, allergic rhinitis, and psychiatric disorders were independent risk factors associated with an increase in AEFIs. Conclusions: The heterologous CoronaVac–ChAdOx1 and homologous CoronaVac–CoronaVac regimens were promising vaccination strategies for the prevention of SARS-CoV-2 infection. However, the heterologous CoronaVac–ChAdOx1 potentially caused fewer AEFIs compared with the homologous CoronaVac–CoronaVac regimen. Full article

Respirable particulate matter (RSP) is currently very harmful to the human body, potentially causing pulmonary silicosis, allergic rhinitis, acute bronchitis, and pulmonary heart disease. Therefore, the study of the deposition pattern of RSP in the human respiratory system is key in the prevention, treatment, and research of related diseases, whereby the main methods are computer simulation, in vitro solid models, and theoretical analysis. This paper summarizes and analyzes past deposition of RSP in the respiratory tract and also describes them in specific case studies such as COPD and COVID-19 patients, based on the review of the evidence, direction, and focus of future research focusing on simulation, experimentation, and related applications of RSP deposition in the respiratory tract. Full article

This study evaluated the risks of childhood acute bronchitis and bronchiolitis (CABs) for children with asthma or allergic rhinitis (AR). Using insurance claims data of Taiwan, we identified, from children of ≤12 years old in 2000–2016, cohorts with and without asthma (N = 192,126, each) and cohorts with and without AR (N = 1,062,903, each) matched by sex and age. By the end of 2016, the asthma cohort had the highest bronchitis incidence, AR and non-asthma cohorts followed, and the lowest in the non-AR cohort (525.1, 322.4, 236.0 and 169.9 per 1000 person-years, respectively). The Cox method estimated adjusted hazard ratios (aHRs) of bronchitis were 1.82 (95% confidence interval (CI), 1.80–1.83) for the asthma cohort and 1.68 (95% CI, 1.68–1.69) for the AR cohort, relative to the respective comparisons. The bronchiolitis incidence rates for these cohorts were 42.7, 29.5, 28.5 and 20.1 per 1000 person-years, respectively. The aHRs of bronchiolitis were 1.50 (95% CI, 1.48–1.52) for the asthma cohort and 1.46 (95% CI, 1.45–1.47) for the AR cohort relative to their comparisons. The CABs incidence rates decreased substantially with increasing age, but were relatively similar for boys and girls. In conclusion, children with asthma are more likely to develop CABs than are children with AR. Full article

Accurate assessments of exposure to urban air pollution with higher traffic emissions and its health risks still face several challenges, such as intensive computation of air pollution modeling and the limited availability of personal activity data. The macroscopic health effects can be transmitted to the whole population for personal prevention via air quality health index (AQHI), but the possibility risk index of the specific allergic diseases is still lacking. This interdisciplinary study aims at evaluating the forecasted results of high-resolution air quality with updated traffic emissions and accessing the potential impacts of outdoor pollution on morbidity of rhinitis for urban residents. A high-resolution modelling system (1 km × 1 km) containing the online traffic emission model (VEIN), meteorological and air quality model (WRF-CHIMERE) and the health impact module was developed. A new health index of Potential Morbidity Risk Index (PMRI) was further established using higher resolution health risk coefficients of major air pollutants on allergic rhinitis, and different methods (with/without considering population distributions) targeting different user groups (residents, hospitals and health administrations) were calculated and analyzed. Operational forecasted results of hourly PMRI can be further combined with online map services to serve as an effective tool for patients with allergic rhinitis to arrange their daily activities so as to avoid acute exacerbation. The forecasted PMRIs accessible to the public will also be beneficial for the public health administrations in planning the medical resource and improving the outpatient efficiency. Full article

Mesoporous Silica Nanoparticles (MSN) are porous inorganic materials that have been extensively used for drug delivery due to their special qualities, such as biocompatibility, biodegradability, and non-toxicity. MSN is a promising drug delivery system to enhance the efficacy and safety of drug administration in nasal diseases like chronic rhinitis (CR). In this study, we used the sol-gel technique for MSN synthesis and incorporate fluticasone propionate (FP) for intranasal drug administration for the treatment of chronic rhinitis (CR). In order to confirm the particle size, shape, drug release, and compatibility, various instruments were used. MSN was effectively prepared with average sizes ranging between 400 $\pm 34\mathrm{nm}$ (mean $\pm \mathrm{SD}$) as measured by dynamic light scattering (DLS), while zeta potential verified in all cases their positive charged surface. To investigate MSN features, the Fourier transform infrared spectrometer (FTIR), scanning electron microscopy (SEM), transmission electron microscope (TEM), thermal analysis, X-ray diffraction (XRD), and nitrogen adsorption/desorption measurement were used. The loaded compound was submitted to in vitro dissolution tests, and a remarkable dissolution rate improvement was observed compared to the crystalline drug in both pH conditions (1.2 and 7.4 pH). By using an MTT assay cell viability was assessed. The expression levels of the anti-inflammatory cytokines IL-4 and IL-5 were also measured using mRNA extraction from rat blood. Other characterizations like acute toxicity and hemolytic activity were also performed to confirm loaded MSN safety. Loaded MSN was incorporated in nasal spray prepared by using innovator excipients including poloxamer. After this, its nasal spray’s physical characteristics were also determined and compared with a commercial product (Ticovate). Full article