Allergy & Rhinology最新文献

{"title":"Autonomic nervous system dysfunction and sinonasal symptoms.","authors":"Alexander Yao,&nbsp;Janet A Wilson,&nbsp;Stephen L Ball","doi":"10.1177/2152656718764233","DOIUrl":"https://doi.org/10.1177/2152656718764233","url":null,"abstract":"<p><strong>Background: </strong>The autonomic nervous system (ANS) richly innervates the nose and paranasal sinuses, and has a significant role in lower airway diseases, e.g., asthma. Nonetheless, its contribution to sinonasal symptoms is poorly understood. This review aimed to explore the complex relationship between the ANS and sinonasal symptoms, with reference to systemic diseases and triggers of ANS dysfunction.</p><p><strong>Methods: </strong>A review of articles published in English was conducted by searching medical literature databases with the key words \"autonomic nervous system\" and (\"sinusitis\" or \"nose\" or \"otolaryngology\"). All identified abstracts were reviewed, and, from these, relevant published whole articles were selected.</p><p><strong>Results: </strong>The ANS has a significant role in the pathophysiologic mechanisms that produce sinonasal symptoms. There was limited evidence that describes the relationship of the ANS in sinonasal disease with systemic conditions, e.g. hypertension. There was some evidence to support mechanisms related to physical and psychological stressors in this relationship.</p><p><strong>Conclusion: </strong>The role of ANS dysfunction in sinonasal disease is highly complex. The ANS sits within a web of multiple factors, including personality and psychological distress, that contribute to sinonasal symptoms. Further research will help to clarify the etiology of ANS dysfunction and its contribution to common systemic conditions.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764233"},"PeriodicalIF":2.2,"publicationDate":"2018-04-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764233","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36286323","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic dilemmas of mechanical restriction of the medial rectus: A case report.","authors":"James A Gallogly,&nbsp;Farhoud Faraji,&nbsp;Mejd H Jumaily,&nbsp;John S Schneider,&nbsp;Joseph D Brunworth","doi":"10.1177/2152656718764231","DOIUrl":"https://doi.org/10.1177/2152656718764231","url":null,"abstract":"<p><strong>Background: </strong>Due to the proximity of the maxillary sinus and ethmoid sinuses to the orbit, inflammatory processes that originate in the sinonasal region have the potential to extend into the orbit.</p><p><strong>Objective: </strong>We presented a case of ptosis and restrictive strabismus of the medial rectus muscle.</p><p><strong>Methods: </strong>A case report with a literature review of possible diagnoses.</p><p><strong>Results: </strong>Biopsy, imaging, and laboratory evaluation by otolaryngology, ophthalmology, and rheumatology services were unable to identify the cause of the fibrosis after 22 months of follow-up. A response to oral steroids indicated an inflammatory process.</p><p><strong>Conclusion: </strong>Unilateral mechanical restriction of the medial rectus muscle is a rare complication of nasal disease. Inflammatory processes and iatrogenic injury are known to cause fibrosis of surrounding tissue. We presented a unique case of medial rectus fibrosis that did not meet the diagnostic criteria of recognized etiologies.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764231"},"PeriodicalIF":2.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764231","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288328","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Fenugreek Anaphylaxis in a Pediatric Patient.","authors":"Nancy I Joseph,&nbsp;Eileen Slavin,&nbsp;Brian P Peppers,&nbsp;Robert W Hostoffer","doi":"10.1177/2152656718764134","DOIUrl":"https://doi.org/10.1177/2152656718764134","url":null,"abstract":"<p><p>Fenugreek (<i>Trigonella foenum-graecum)</i> is a food product that belongs to the <i>Leguminosae</i> family along with other legumes. It has been used in India, Greece, and Egypt for culinary and medical purposes since ancient times, and today, fenugreek is used for flavoring foods, dyes, and drugs throughout the world. Many members of the <i>Leguminosae</i> family have been associated with allergies including soybean, green pea, and peanut. Fenugreek is also included in this family and may result in allergic reactions. Two cases of anaphylaxis have been described in children after ingestion of curry and pastes that contain fenugreek, although the true nature of the causative agent was unclear. We report the first case of fenugreek anaphylaxis in a pediatric patient defined by skin testing, immunoglobulin E ImmunoCAP assays, and clear ingestion.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764134"},"PeriodicalIF":2.2,"publicationDate":"2018-04-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764134","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288590","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of differential expression of protease-activated receptors in patients with allergic fungal rhinosinusitis.","authors":"Shikhar Sawhney,&nbsp;Sandeep Bansal,&nbsp;Madhur Kalyan,&nbsp;Indu Verma,&nbsp;Ramandeep Singh Virk,&nbsp;Ashok Kumar Gupta","doi":"10.1177/2152656718764199","DOIUrl":"https://doi.org/10.1177/2152656718764199","url":null,"abstract":"<p><strong>Background: </strong>Ever since its characterization in the 1970s, allergic fungal rhinosinusitis (AFRS) has been the subject of much controversy, especially regarding its pathogenesis. In this study, we analyzed the differential expression of genes that encode protease-activated receptors (PAR) in patients with AFRS and patients with chronic rhinosinusitis, and tried to understand the pathogenic basis of this disease.</p><p><strong>Objective: </strong>To analyze the differential expression of PAR genes in patients with AFRS and in patients with chronic rhinosinusitis.</p><p><strong>Methods: </strong>Mucosa from ethmoid sinuses of 51 patients (tests and controls) was biopsied and evaluated for messenger RNA expression of PAR genes by using reverse transcriptase-polymerase chain reaction. Each of the four PAR genes, i.e., par1, par2, par3 and par4 was amplified, the final gene products were run on 1.8% agarose gel and analyzed by densitometry to calculate differential expression. The significance level was determined as p ≤ 0.05.</p><p><strong>Results: </strong>It was observed that the expressions of all four par genes were higher in the test samples compared with the controls, but statistical significance was achieved only for par1 (p=0.004) and par2 (p=0.05). Comparative expression of the four PAR genes was also performed within the test and control groups, and a statistically significant difference was seen between par1 and par2 (p=0.007), par1 and par3 (p=0.029), par1 and par4 (p=0.0001), par2 and par4 (p=0.002), and par3 and par4 (p=0.009) in the test group. In the control group as well, par1, par2, and par3 exhibited a higher expression compared with par4 but the difference was significant between par3 and par4 genes only.</p><p><strong>Conclusion: </strong>Patients with AFRS expressed increased levels of PAR genes in their nasal mucosa, and, of the four PAR genes, a higher expression of par1, par2, and par3 was observed in both the groups compared with par4. This information contributes toward our understanding of pathogenesis and possibly treatment of AFRS.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764199"},"PeriodicalIF":2.2,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764199","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36286318","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-inflammatory effect of wogonin on allergic responses in ovalbumin-induced allergic rhinitis in the mouse.","authors":"Kyeong Ah Kim,&nbsp;Joo Hyun Jung,&nbsp;Yun Sook Choi,&nbsp;Gyu Kang,&nbsp;Seon Tae Kim","doi":"10.1177/2152656718764145","DOIUrl":"https://doi.org/10.1177/2152656718764145","url":null,"abstract":"<p><strong>Background: </strong>Wogonin is commonly used for the treatment of allergic diseases. However, neither its precise effect in preventing allergic rhinitis (AR) nor its mechanism of action are known.</p><p><strong>Objectives: </strong>In this study, the effect of wogonin on allergic responses in ovalbumin (OVA) induced AR was investigated in mice.</p><p><strong>Methods: </strong>BALB/c mice were sensitized with intraperitoneal (i.p.) OVA and then challenged intranasally with OVA. Wogonin (10 and 30 mg/kg) was given to the treatment groups, and the effect of wogonin on the release of allergic inflammatory mediators, specifically OVA-specific immunoglobulin E (IgE) and inflammatory cytokines, was explored. Eosinophil infiltration and the levels of interleukin (IL) 5 and IL-13 were measured by immunohistochemistry.</p><p><strong>Results: </strong>In mice with AR, wogonin decreased OVA-specific IgE levels in serum, and the levels of the cytokines IL-4, IL-5, IL-13, eotaxin, and RANTES in nasal lavage fluid. Serum levels of IL-4, IL-5, and IL-13 were lower in both groups of wogonin-pretreated mice than in the OVA group. A reduction in eosinophil infiltration of the nasal mucosa and inhibition of the expression of IL-5 and IL-13 were also noted in the treated groups.</p><p><strong>Conclusion: </strong>Wogonin induced antiallergic effects in a murine model of AR by decreasing the infiltration of eosinophils and levels of T-helper type 2 cytokines. Thus, wogonin merits consideration as a therapeutic agent for treating AR.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764145"},"PeriodicalIF":2.2,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764145","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36286317","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Description of Baseline Characteristics of Pediatric Allergic Asthma Patients Including those Initiated on Omalizumab.","authors":"Abhishek Kavati, Dominic Pilon, Benjamin Ortiz, Brandee Paknis, Ashok Vegesna, Bradd Schiffman, Maryia Zhdanava, Patrick Lefebvre, Brian Stone","doi":"10.1177/2152656718763387","DOIUrl":"10.1177/2152656718763387","url":null,"abstract":"<p><strong>Background: </strong>Indication of omalizumab in the United States was recently extended to include pediatric (6-11 years) uncontrolled moderate-to-severe allergic asthma patients.</p><p><strong>Objective: </strong>The purpose of this study was to describe baseline characteristics of this population from a real-world dataset.</p><p><strong>Methods: </strong>Allergic asthma patients and uncontrolled moderate-to-severe allergic asthma patients, aged 6-11 years, were identified in the Allergy Partners Network Electronic Medical Records (2007-2016). The index date for allergic asthma patients was the latest between the second asthma-related visit and the allergic status confirmation. Uncontrolled moderate-to-severe allergic asthma patients were stratified into omalizumab-exposed (index date) or omalizumab-unexposed (index date randomly generated) groups. Characteristics were evaluated during the 12-month preindex period.</p><p><strong>Results: </strong>A total of 5806 allergic asthma, 37 omalizumab-exposed, and 2620 omalizumab-unexposed patients were selected (mean age approximately 9 years). Allergic asthma and omalizumab-unexposed patients were predominantly white (70.2% and 61.2%) whereas the majority of omalizumab-exposed were African Americans (62.2%). Mean immunoglobulin E was 782.0 IU/ml in allergic asthma patients (available in 2.2%), 1134.4 IU/ml in omalizumab-exposed (available in 100.0%), and 746.1 IU/ml in omalizumab-unexposed (available in 3.1%). Allergic asthma patients were less severe than omalizumab-exposed and omalizumab-unexposed based on the forced expiratory volume in 1 s as a percentage of predicted value (FEV₁% predicted) and the Childhood Asthma Control Test (C-ACT). FEV₁% predicted was below normal (<80%) in 42.4% of omalizumab-exposed and 39.1% of omalizumab-unexposed patients, also 63.6% of omalizumab-exposed and 46.7% of omalizumab-unexposed had uncontrolled asthma (C-ACT score <20). In African American omalizumab-exposed patients, FEV₁% predicted was below normal in 47.6% and 55.0% had uncontrolled asthma.</p><p><strong>Conclusions: </strong>In a real-world setting, pediatric patients with uncontrolled moderate-to-severe allergic asthma have a significant disease burden as shown by high rates of poor lung function, disease control, and symptoms. Currently available treatments could help improve disease management in this population.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718763387"},"PeriodicalIF":2.2,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/7d/7c/10.1177_2152656718763387.PMC6028162.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288589","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Sinonasal epithelial-myoepithelial carcinoma: Report of a novel subsite and review of the literature.","authors":"Theodore A Schuman, Adam J Kimple, Claire H Edgerly, Charles S Ebert, Adam M Zanation, Brian D Thorp","doi":"10.1177/2152656718764229","DOIUrl":"10.1177/2152656718764229","url":null,"abstract":"<p><strong>Background: </strong>Epithelial-myoepithelial carcinoma (EMC) is a rare tumor of the major and minor salivary glands. Sinonasal EMC is extremely uncommon and hitherto not described within the frontal or ethmoid sinuses.</p><p><strong>Objective: </strong>To present a novel sinonasal subsite and review the literature regarding sinonasal EMC.</p><p><strong>Methods: </strong>A case of frontoethmoidal EMC was presented. A medical literature data base was queried from January 1, 1950, to August 8, 2017, for all reports of sinonasal EMC.</p><p><strong>Results: </strong>A 69-year-old man underwent combined open and endoscopic craniofacial resection of a right frontoethmoidal EMC, a previously undescribed primary location for this tumor. A comprehensive review of the literature revealed 13 additional cases of sinonasal EMC.</p><p><strong>Conclusion: </strong>EMC is an uncommon neoplasm typically found in the major salivary glands; occurrence in the nose or paranasal sinuses is extremely rare. EMC often follows an indolent clinical course, although, in a minority of cases, particularly in large tumors with nuclear atypia, more aggressive behavior may be observed.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764229"},"PeriodicalIF":2.2,"publicationDate":"2018-04-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/f1/09/10.1177_2152656718764229.PMC6028158.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36286321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Amlodipine-induced angioedema: An unusual complication of a common medication.","authors":"Merin E Kuruvilla,&nbsp;Neha Sanan","doi":"10.1177/2152656718764139","DOIUrl":"https://doi.org/10.1177/2152656718764139","url":null,"abstract":"<p><p>Hypersensitivity reactions to dihydropyridine calcium channel blockers (CCB) are exceedingly rare, although sporadic reports of isolated angioedema seem to be gradually increasing in frequency. We present a case of angioedema likely triggered by amlodipine.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764139"},"PeriodicalIF":2.2,"publicationDate":"2018-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764139","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288591","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A needle in a haystack: Endoscopic removal of a foreign body from the infratemporal fossa.","authors":"Khrystyna Ioanidis,&nbsp;Brian Rotenberg","doi":"10.1177/2152656718764142","DOIUrl":"https://doi.org/10.1177/2152656718764142","url":null,"abstract":"<p><strong>Background: </strong>This report presented the case of a difficult-to-remove needle foreign body. The patient had a dental procedure in which a 30-gauge needle was lost in the gingival buccal sulcus. Several attempts at removal were unsuccessful. The patient presented to the otolaryngology clinic with trismus, pain with mastication, intermittent right otalgia, and numbness of the right cheek.</p><p><strong>Methods: </strong>The needle was finally localized in the infratemporal fossa and removed by using image guidance technology.</p><p><strong>Results: </strong>This case demonstrated an approach to a difficult-to-locate foreign body removal and the importance of intraoperative imaging in foreign body localization.</p><p><strong>Conclusion: </strong>Foreign bodies of the infratemporal fossa and posterior orbit are better removed via endoscopic than open technique.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"9 ","pages":"2152656718764142"},"PeriodicalIF":2.2,"publicationDate":"2018-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1177/2152656718764142","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"36288592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Long-term omalizumab use in the treatment of exercise-induced anaphylaxis.","authors":"Mark R Peterson,&nbsp;Christopher A Coop","doi":"10.2500/ar.2017.8.0204","DOIUrl":"https://doi.org/10.2500/ar.2017.8.0204","url":null,"abstract":"<p><p>Reported is a case of a 39-year-old male who was diagnosed with exercise-induced anaphylaxis (EIA). He was initially treated prophylactically with fexofenadine, montelukast, and ranitidine. He also used an epinephrine autoinjector as needed. He was refractory to these medications and continued to have episodes of EIA. He was then started on a trial of omalizumab, an immunoglobulin E monoclonal antibody, and had resolution of the EIA episodes. After discontinuation of the omalizumab, the EIA episodes returned. He was restarted on omalizumab and since that time, has had 5 years free of EIA episodes and can now exercise without any symptoms. To our knowledge, this is only the third case in the literature of successful treatment of EIA by using omalizumab. This case was unique because it provided successful long-term use of omalizumab for EIA. Further studies are recommended for the use of omalizumab in the treatment of EIA.</p>","PeriodicalId":45192,"journal":{"name":"Allergy & Rhinology","volume":"8 3","pages":"170-172"},"PeriodicalIF":2.2,"publicationDate":"2017-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.2500/ar.2017.8.0204","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"35546355","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}