Trigeminal impairment in treatment-refractory chronic nasal obstruction

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
C. Migneault-Bouchard ◽  
F.J.M. Boselie ◽  
M. Hugentobler ◽  
B.N. Landis ◽  
J. Frasnelli

BACKGROUND: Patients with anatomically unexplained, chronic nasal obstruction (CNO) that is refractory to medical treatment pose a challenge for clinicians. A surgical solution, addressing mechanical obstacles, is unsuited for these patients. CNO may result from disrupted airflow perception due to activation of the intranasal trigeminal system; therefore, aim of this study is to evaluate if intranasal trigeminal function of these CNO patients is decreased. METHODS: In this retrospective cross-sectional study, we compared 143 CNO patients and 58 healthy volunteers, between 18 to 80 years old. We assessed nasal patency by means of rhinomanometry (RM) and measured susceptibility of intranasal trigeminal system by the trigeminal lateralization task (TLT). RESULTS: TLT scores were significantly lower in CNO patients compared to controls (p less than 0.001), but RM scores were not different between groups. Accordingly, TLT allowed to identify CNO patients with an accuracy of the area under the curve (AUC) of 0.78, while the value for RM was at chance (AUC=0.47). CNO patients showed normal reaction to vasoconstrictive agents with significantly lower RM values after Xylomethazoline application. CONCLUSION: Results suggest that reported nasal obstruction in CNO patients without any obvious anatomical obstacle and resistant to medical treatment may be linked to decreased perception of nasal airflow rather than physical obstruction. In this sub-set of CNO patients, trigeminal testing more adequately reflects the reported obstruction than nasal resistance assessment does. In future studies, the relation of the trigeminal status and the subjective sensation of nasal obstruction needs to be addressed with validated patient rated outcome measures (PROMs).

2017 ◽  
pp. 46-52
Author(s):  
Thanh Thai Le ◽  
Phuong Nam Tran ◽  
Thi Ngan An Nguyen

Aims: To study outcomes of septoplasty and partial inferior turbinectomy (PIT) method, expecting leastsurgical equipment, good result, price rationalization. Methods: Prospective, cross-sectional study. Including 40 patients treated by septoplasty and PIT method. Assessment had been made after 3 months post-op. Results: The common symptoms were nasal obstruction (100%), headache (40%). The deformities of nasal septalwere deviation (42.5%), crest (30%). There were 67.5% of patients with severe bilateral hypertrophic inferior turbinate, mostly over grade II, enlargement both soft and bone parts (60%). After 3 months, the nasal obstruction and headache presented good or great results in 90% of patients, 93.7% of patients had straight nasal septaland 90% hadsmall inferior turbinate.VAS: patients’s contentment was 100%. Conclusions: The study showed that septoplasty and partial inferior turbinectomy presented good results with 87.5% after surgery and 90% after 3 months. Key words: septal deformity, hypertrophy inferior turbinate, septoplasty, partial inferior turbinectomy


2018 ◽  
Vol 10 (2) ◽  
pp. 88-94
Author(s):  
Corrado Giua Marassi ◽  
Assunta Pistone ◽  
Fabio Parazzini ◽  
Silvia Vannuccini ◽  
Felice Petraglia

Introduction: Several epidemiological data on women afferent to clinics for medical treatment of pelvic pain are available, while few studies explored the general population. Thus, this study aimed to investigate women presenting with gynecological pain at the community pharmacy and to evaluate the relevance of pharmacist advice regarding medical treatment. Methods: A cross-sectional study was conducted in a sample of 10 Italian community pharmacies, by administering a structured questionnaire to fertile age women reporting pelvic pain during the last 3 months. Questions were concerning demographic information, pain characteristics, women’s behavior toward gynecological pain, and diagnosis possibly received from a physician. Results: A group of 290 women were interviewed. Severe pain was reported in 58.3%, with a mean ± SD of 4.4 ± 6.8 days of suffering, causing absenteeism from work in 45.3% of cases. Almost half of women reported that the onset of gynecological pain was before 15 years and 72.2% had consulted a physician in the past, with a mean delay of 2.5 ± 4.3 years between the onset of pain and medical consultation. However, only 28% of the overall population received a diagnosis. 51.0% received one treatment, while 39% received two or more. The first therapy was prescribed in 40.2% cases by the physician, while in the remaining it was recommended either by the pharmacist or it was a self-medication. Conclusion: Gynecological pelvic pain is a disabling problem, regardless of the underlying cause, with significant impact on social and working life and requiring a better medical management.


2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Perez-Sosa Abigail M ◽  

Background: Diabetes mellitus 2 (T2D) is the leading cause of morbidity and mortality in northern Mexico. Various treatments are used to control the disease; however, the cost of these and the difficulty of dietary management have as a consequence that the patient abandons them and looks for cheaper and easier-to-use alternatives. Aim: The purpose of this study is to determine the relationship between the use of alternative medicine and adherence to medical treatment in patients with T2D. Design and Setting: Analytic cross-sectional study. Methods: An analytical cross-sectional study was designed between March and July 2019 including 464 patients with T2D from the family medicine unit #48 Ciudad Juarez, Mexico. We used the Morisky-Green scale for adherence to treatment and the use of Alternative Medicine (CAM) was evaluated with a holistic complementary and alternative medicine questionnaire. The Chi-Square test was used for comparison of proportions and risk factors were calculated using odds ratio with 95% confidence intervals. Results: 53% of patients use CAM; biological therapy (herbs and supplements) is the most frequent (94%). The association between CAM use and adherence to medical treatment was 2.1 (95% CI 1.4-3.1, p= 0.001). The risk factors for the use of CAM were female sex, basic level education, uncontrolled disease and a time of evolution greater than 10 years. Conclusion: CAM users are 2.1 times more at risk of having a regular or bad adherence to medical treatment.


2013 ◽  
Vol 27 (2) ◽  
pp. 7-13 ◽  
Author(s):  
Kirt Areis E. Delovino ◽  
Ray U. Casile ◽  
Frederick Y. Hawson

Objective:    To describe the vocal acoustic measures of nonsmoking Filipino young adults without voice complaints at a private tertiary hospital in Quezon City; to determine if our baseline values are distributed normally and comparable to data in similar studies done abroad; and to recommend normative voice parameters which may be used as baseline data in our institution and for comparison in future studies. Methods: Design:  Cross-sectional study Setting: Private tertiary hospital Participants: A total of 70 subjects were recruited at random. Results: Values extracted for f0, Jitter %, Jitter dB, Shimmer %, Shimmer dB and NHR showed normal distribution of results. The average vocal acoustic values found in the present study for male voices producing the vowel /a/ were fo = 130.6 ± 13.65Hz, jitter = 0.0.46 % ± 0.184, jitter dB: 37.62dB ± 16.664, shimmer %= 0.23%, shimmer dB=0.23 ± 0.67 and NHR = 0.13 ± 0.010. The average values found for female voices, producing the vowel /a/ were fo = 218.38 ± 26.192Hz, jitter = 0.87% ± 0.61, jitter dB: 34.82 ± 22.5, shimmer %= 2.72 ± 1.07 shimmer dB=0.23db ± 0.67 and NHR = 0.12dB ± 0.016. Values retrieved from this study show similar trends with other papers abroad. Conclusions: Voice acoustic systems are composed of different recording criteria, recording instrumentations and algorithms which primarily cause the differences in the results obtained in various studies, thus precluding a single normalization. Following international recommendations for individual normalization per institution, we have obtained our own values. Our data was comparable to the results of other international studies. However further investigation is recommended in areas where possibilities of interdialectic variation may produce an effect on the outcome of the study. Keywords: vocal acoustic measures, computerized speech lab, normative voice parameters


2021 ◽  
Vol 31 (2) ◽  
Author(s):  
Rita de Cássia Costa da Silva ◽  
Maykon Anderson Pires de Novais ◽  
Paola Zucchi

Abstract The text addresses the representativeness in health councils in Brazil, based on guidelines proposed by the National Health Council. This study aimed to verify the adequacy of the councils to the criteria described in Resolution 453/2012, which demonstrate the representativeness of the segments that make up the collective. A descriptive cross-sectional study was conducted during May and June 2017. The study population was composed of health councils registered in the Health Councils Monitoring System, with public access and available on the Internet. The results obtained were organized considering the geographical distribution of the councils. The regions with the highest rates of non-compliance with the parity criterion were identified. It has been demonstrated that the guidelines for reformulating the councils are aligned with the notion of representativeness, but they are not a guarantee for the effectiveness of the representation. Future studies may deepen the analyses on representativeness in health councils in Brazil, and identify which mechanisms are adopted by entities to ensure the effectiveness of representation, as well as whether representation is renewed. It is recommended that the rules ordering the functioning of councils be permanently updated to promote social participation in health.


Author(s):  
Ana Cristina Lindsay ◽  
Joanna A. Pineda ◽  
Madelyne J. Valdez ◽  
Maria Idalí Torres ◽  
Phillip J. Granberry

Despite increasing interest in understanding the factors influencing awareness and acceptability of the human papillomavirus (HPV) vaccine among Latino parents, to date limited information is available specific to Central American parents living in the United States (US). Therefore, this pilot cross-sectional study was designed to explore and assess Central American immigrant parents’ awareness, acceptability, and willingness to vaccinate their children against HPV, and interest in participating in future HPV-associated cancer prevention study. Fifty-six Central American parents, majority immigrant (96.4%; n = 54) from four countries, El Salvador—50% (n = 27); Guatemala—25.9% (n = 14); Honduras—22.2% (n = 12); and Panama—1.9% (n = 1) participated in this study. Participants completed an interviewer-administered questionnaire survey in their preferred language (i.e., Spanish or English). A little over half of the participants were mothers (57.1%; n = 32) and parents’ mean age was 43.2 years (SD = 6.4). The majority was married or cohabitating (76.8%, n = 43), and 39.3% (n = 22) reported having two children. Seventy-five percent (n = 42) of parents reported they had heard of the HPV vaccine. Fewer fathers were aware of the HPV vaccine (58.3%; n = 14 vs.87.5%, n = 28; p = 0.01) than mothers. Among parents who had heard of the HPV vaccine (n = 42), 85.7% (n = 36) reported their children had received at least one dose of the HPV vaccine. Fewer fathers reported their child had been vaccinated against HPV (64.3%, n = 9 vs. 96.4%, n = 27; p = 0.06) than mothers. Moreover, 90% of parents (n = 18) whose children were unvaccinated reported willingness to vaccinate their adolescent children against HPV if recommended by their child’s physician. Findings indicate parents’ low to moderate awareness of the HPV vaccine, and high willingness to vaccinate their adolescent children if recommended by their child’s physician. Findings also demonstrate fathers’ lower awareness and acceptability of the HPV vaccine than mothers. Despite limitations and the need for more research, findings of this pilot study serve as a valuable first step toward building a knowledge foundation that is needed for developing future studies and interventions targeting Central American immigrant parents living in the US. Future studies can build on the findings of this exploratory study with other research designs and address its limitations by having a larger sample size and accounting for additional factors associated with Central American immigrant parents’ HPV awareness, knowledge, beliefs, attitudes, and vaccine acceptability from other communities across the US.


2016 ◽  
Vol 120 (9) ◽  
pp. 991-999 ◽  
Author(s):  
Ashley D. Nelson ◽  
Matthew J. Rossman ◽  
Melissa A. Witman ◽  
Zachary Barrett-O'Keefe ◽  
H. Jonathan Groot ◽  
...  

Post-cuff occlusion flow-mediated dilation (FMD) is a proposed indicator of nitric oxide (NO) bioavailability and vascular function. FMD is reduced in patients with sepsis and may be a marker of end organ damage and mortality. However, FMD likely does not solely reflect NO-mediated vasodilation, is technically challenging, and often demonstrates poor reproducibility. In contrast, passive leg movement (PLM), a novel methodology to assess vascular function, yields a hyperemic response that is predominately NO-dependent, reproducible, and easily measured. This study evaluated PLM as an approach to assess NO-mediated vascular function in patients with sepsis. We hypothesized that PLM-induced hyperemia, quantified by the increase in leg blood flow (LBF), would be attenuated in sepsis. In a cross-sectional study, 17 subjects in severe sepsis or septic shock were compared with 16 matched healthy controls. Doppler ultrasound was used to assess brachial artery FMD and the hyperemic response to PLM in the femoral artery. FMD was attenuated in septic compared with control subjects (1.1 ± 1.7% vs. 6.8 ± 1.3%; values are means ± SD). In terms of PLM, baseline LBF (196 ± 33 ml/min vs. 328 ± 20 ml/min), peak change in LBF from baseline (133 ± 28 ml/min vs. 483 ± 86 ml/min), and the LBF area under the curve (16 ± 8.3 vs. 143 ± 33) were all significantly attenuated in septic subjects. Vascular function, as assessed by both FMD and PLM, is attenuated in septic subjects compared with controls. These data support the concept that NO bioavailability is attenuated in septic subjects, and PLM appears to be a novel and feasible approach to assess NO-mediated vascular function in sepsis.


2015 ◽  
Vol 15 (1) ◽  
Author(s):  
Mariyam Suzana ◽  
Anne Mills ◽  
Viroj Tangcharoensathien ◽  
Virasakdi Chongsuvivatwong

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