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Biomedical subjects

F Filiaci

Publications and source records attributed to F Filiaci.

At least 19 recordsLinked to original sources
PubMed2005

Intraoral distraction of a patient with premaxilla agenesis.

The complex disharmonies which affect the maxillofacial region, in the sagittal and vertical dimensions, can find further complications due to the deficit of maxillary osseous tissue in transversal direction. Surgery can be indispensable to correct the malocclusion. Various methodologies have been developed for the correction of transversal maxillary hypoplasia. Among these, the Authors mention the intraoral distraction for the treatment of a male patient with pre-maxilla agenesis and serious contraction of the upper maxillary. A particularity of this case is represented by the occurred transversal skeletal expansion, starting from a past scar, outcome of a previous surgery.

Adult↗
PubMed2005

Assessment of Cottle's areas through the application of a mathematical model deriving from acoustic rhinometry and rhinomanometric data.

OBJECTIVES: Each nasal area, as defined by Cottle, has a different influence on the nasal airflow. The longitudinal distribution of resistances in nasal cavities was calculated by the anterior rhinomanometry and acoustic rhinometry data. DESIGN: Dynamic study of Cottle's areas in normal subjects was carried out by rhinomanometry and acoustic rhinometry. SETTING: Study by the Department of Otolaryngology of the University of Rome-La Sapienza. PARTICIPANTS: Twenty-seven Caucasian adults in local and general healthy conditions took part and completed this study, with a total of 54 nasal cavities included because of negativity at ENT-examination and clinical history, with normal respiratory parameters at the rhinomanometry and acoustic rhinometry. MAIN OUTCOME MEASURES: We determined nasal and acoustic resistances, nasal volumes and cross-sectional surface areas, as defined by Cottle, using nasal endoscopy. The longitudinal distribution of nasal resistances was obtained by integrating experimental surface areas using a novel mathematical model. The estimation of the longitudinal nasal resistance variations as a result of a theoretical reduction of the surface areas. RESULTS: The reduction of the 2-3-1 areas (in this order of importance) showed the greatest influence on the nasal resistances with coefficients of determinations greater than 0.98, this being quite different from that of the areas 4 and 5 for quite smaller area reduction percentages. CONCLUSIONS: The areas 2-3-1 control the overall nasal resistance so the surgical procedures on these areas greatly influence the dynamics of nasal airflow. The mathematical model developed here gives useful information to nasal functional surgery and may be applied to other schemes of nasal cavity.

Acoustics↗
PubMed2001

Study and application of a mathematical model for the provisional assessment of areas and nasal resistance, obtained using acoustic rhinometry and active anterior rhinomanometry.

Nasal resistance (NR) depends on the geometrical features and tortuosity of the nasal airway and on the air flow. Knowing the longitudinal distribution of cross-sectional areas (CSAs) in the nasal cavity (which can be obtained using acoustic rhinometry) and the laminar nasal resistance (obtainable by processing the rhinomanometric results), it is possible to calculate, utilizing a mathematical model elaborated on the basis of fluid dynamics, the differential nasal resistance (NRdiff) and the cumulative nasal resistance (NRcum), thus localizing the position at which the highest resistance is concentrated and the related longitudinal distribution. Using a mathematical model, we integrated the sigmoid curves DeltaP/Q of rhinomanometry with the cross-sectional areas obtained using acoustic rhinometry, thus obtaining the normal distribution of differential and cumulative nasal resistances. Afterwards, we empirically reduced the cross-sectional areas corresponding to the head, body, tail and the whole inferior turbinate, recalculating the differential and cumulative nasal resistance distribution curves. The results show that reduction of up to 50% of cross-sectional areas does not substantially affect the resistivity role of the nasal valve, while greater reductions move the highest resistivity point to an area at the junction of the body and the head of the inferior turbinate. The study of the differential nasal resistance trend curves as a function of the reduction of cross-sectional areas shows that the resistance variation of the body and the whole inferior turbinate prevail with reductions of up to 40%, while the variation of cross-sectional areas of the body bordering the inferior turbinate head is predominant with higher reductions. The cross-sectional areas of the nasal airway cavity with highest resistivity are mainly located in an anterior position, where the differential nasal resistances are higher, but there are substantial variations produced by reducing the cross-sectional area of the posterior nasal airway. A similar model can produce provisional values for the results obtainable with functional nasal surgery.

Acoustics↗
PubMed2000

A randomized controlled trial showing efficacy of once daily intranasal budesonide in nasal polyposis.

A randomized, double-blind, placebo-controlled trial was performed to assess the efficacy of once daily budesonide in patients with nasal polyps. After a 2-week run-in period, 157 patients with symptomatic bilateral nasal polyposis were randomized to receive budesonide, 140 micrograms once or twice daily or 280 micrograms once daily (delivered doses) via Turbuhaler, or placebo for 8 weeks. Polyp size was assessed endoscopically and, in two centres, by magnetic resonance imaging (MRI). Nasal symptoms (blocked nose, runny nose, sneezing) were recorded daily, and patients provided an overall assessment of efficacy at the end of the study. Budesonide, 280 micrograms/day (280 micrograms o.d. and 140 micrograms twice daily), significantly reduced polyp size, compared with placebo, whereas budesonide, 140 micrograms once daily, had no significant effect. Nasal polyp mass score, measured by MRI, was also significantly reduced in patients receiving 280 micrograms/day. All three doses of budesonide significantly reduced symptom scores, and there were no significant differences between the groups. Overall, approximately 70% of patients receiving budesonide, 280 micrograms/day, reported substantial or total control of symptoms, compared with 45% of placebo-treated patients. It is concluded that budesonide, 280 micrograms once daily, reduces polyp size and relieves symptoms in patients with nasal polyposis.

Administration, Intranasal↗
PubMed1999

Non-specific nasal provocation test with histamine. Analysis of the dose-response curve.

Non-Specific Nasal Hyper-reactivity (NSNH) is described as a clinical condition characterized by the presence of rhinitic symptoms that are a consequence of non-specific stimulations. Because of its effects on vascular, epithelial, and glandular receptors, NSNP Test (NSNPT) with histamine allows the study of NSNH. The aims of this study are 1. to analyze the behavior of NSNH both in non-allergic chronic vasomotory patients and in healthy control subjects 2. to correlate total nasal resistance(TNR) to each dosage of histamine to derive the dose/response curves and 3. to study these curves to analyze and possibly define different stages according to the intensities of response of NSNH. We have studied 26 subjects affected by non-allergic vasomotor rhinitis and 10 healthy control subjects. We sprayed a NSNPT with histamine-phosphate (0.2-0.3-0.4-0.5-0.6-0.8 mg) in different sessions to avoid accumulation phenomena. Five minutes before and five minutes after each challenge, TNR was determined by active anterior rhinomanometry. TNR was correlated to the doses of histamine by an empirical equation. The most important results of this study are as follows: a) the variation of TNR follows a model of exponential curve, b) it is possible to classify NSNH, as a function of the regression b coefficient belonging to the empirical equation used, in reactivity classes, c) from one reactivity class to another, post-stimulation TNRs double; 0.5 mg of histamine of the NSNPT is the optimal dose, d) there is an overlap between the responses of some normal subjects and rhinopathic patients that will be the subject of a further study. Finally, our data suggest that, in a future perspective, it is possible to use the NSNPT with histamine for diagnostic, prognostic and therapeutic control purposes.

Adult↗
PubMed1997

Screening patients affected by common variable immunodeficiency.

Chronic immunoglobulin administration decreases the incidence of bronchial and pulmonary infections in patients affected by chronic variable immunodeficiency (CVI). In this study, an ENT screening was carried out in 22 patients affected by chronic variable immunodeficiency and treated with chronic immunoglobulin administration. All the patients underwent ENT physical examination, nasal endoscopy by fiberoptics, mucociliary transport test (MTT), anterior rhinorheomanometry (RRM), nasal provocation test with cold water (ANPT), audiometry and impedentiometry, olfactory evaluation, and paranasal sinus X rays. Dysphagia was present in 91% of the patients, nasal secretion and obstruction in 77%, and hypoacusia, tinnitus, and otodinia in 57%. Rhinitis and pharyngitis were observed in 86% of the patients, and serous middle ear effusion in 50%. Confirmed maxillary sinusitis was observed in five patients. Hyposmia was observed in 50% of the patients. MTT was significantly longer in the patients than in the controls (18.0 +/- 10.5 vs. 11.2 +/- 2.4 min; p < .05). Nasal resistance was lower in patients than in controls (0.46 +/- 0.32 vs. 1.11 +/- 0.22 Pa/L.s-1; p < .001). ANPT was positive in 9 patients out of 25 versus 1 control out of 15 (p < .05). Finally, seven patients were affected by transmissive hypoacusia, and one patient by neurosensorial hypoacusia. Our results suggest that chronic immunoglobulin administration in CVI patients is not effective against ENT disorders, probably because of the important role played by nasal hyperreactivity. Frequent ENT examination and early treatment of ENT disorders are therefore suggested in order to prevent chronic disease.

Adolescent↗
PubMed1996

Comparison of mizolastine with loratadine in the treatment of perennial allergic rhinitis.

Mizolastine is a new, non-sedating antihistamine providing satisfactory symptomatic relief in seasonal allergic rhinitis. The purpose of this study has been to compare mizolastine to loratadine in perennial allergic rhinitis. This multicentre, double-blind study has involved 68 patients, randomly allocated, after a one-week placebo run-in, to 10 mg mizolastine or 10 mg loratadine, both given on a once-daily basis, for four weeks. Comparable symptom relief occurs in both groups resulting, respectively for mizolastine and loratadine, in a 66.6% and a 61.3% decrease in total nasal score, to a 74.8% and a 76.4% decrease in total ocular score, and to a 69.0% and a 64.8% decrease in global total score. Safety is satisfactory in both groups. Mizolastine is at least as effective as loratadine in relieving perennial allergic rhinitis symptoms and its safety profile allows its use in the treatment of this disease.

Adult↗
PubMed1995

Intranasal immunotherapy with Dermatophagoides extract: in vivo and in vitro results of a double-blind placebo-controlled trial.

Intranasal immunotherapy (IT) has been proposed as a means to induce an effective immunity of the nasal mucosa in patients with allergic rhinitis, avoiding systemic side effects. In the present study 20 individuals with chronic allergic rhinitis, and skin prick test reactive to Dermatophagoides pteronyssinus (DP) only, were randomized and subjected to a three months' double-blind placebo-controlled trial of intranasal IT with DP extract. All patients received also sodium cromoglycate as pre-medication. Before and at the end of the treatment the patients performed specific nasal provocation tests, and samples of serum and nasal secretions were collected to measure total and specific IgE, levels of eosinophil cationic protein (ECP), and mast-cell-derived tryptase. A clinical score was computed by the symptoms indicated by the patients. The clinical score did not change in the two groups after the treatment, whereas a decrease in nasal reactivity was observed. Total IgE increased only in secretions from placebo-treated patients, but were not modified in sera. IgE to DP in sera and nasal secretions did not change significantly. Tryptase levels in nasal secretions decreased in both groups, while ECP was unchanged after IT. Serum ECP levels decreased more in actively treated patients than in the placebo group. The data suggest that changes of IgE and inflammatory mediators may be affected by the use of sodium cromoglycate in both groups, but some parameters change early in different directions in IT- and placebo-treated groups.

Administration, Intranasal↗
PubMed1984

Specific local immunotherapy in the treatment of hay fever.

The authors refer results of a 3-year study carried out on ten patients suffering from hay fever, diagnosed by means of skin tests, specific nasal provocation and serum RAST who underwent specific local immunotherapy consisting of application of an aqueous allergenic extract, the initial level of which was based on threshold values resulting from the nasal provocation test. The two-monthly check ups were based on the evaluation of mucociliary clearance, anterior rhinorheomanometry, specific nasal provocation and the test of Maunsell for blocking antibodies, as well as on the drawing up of a daily symptomatological diary for each single patient. The results were extremely interesting: subsidence of symptoms during the pollinating season, an increase in the number of blocking serum antibodies and of threshold values relative to specific nasal provocation. Conductance and mucociliary clearance, which were both decidedly pathological before beginning the local immunotherapy, slowly returned to the norm. The authors, furthermore, refer that the use of disodium cromoglycate during the first months of specific local immunotherapy which allows them to reach doses 5-7 times greater than those obtainable with the above mentioned form of treatment, offers uncertain advantages as far as local and above all general immunity is concerned and this alone does not justify the use of nasal applications in the treatment of bronchial asthma of allergic origin.

Adolescent↗
PubMed1983

Aspecific nasal reactivity in allergic and non-allergic rhinopathy.

The Allergo-Immunology Department of the 2nd ENT Division of Rome University studied the behaviour of aspecific nasal provocation with methacholine bromide and with H2O at 2-4 degrees C in five groups of patients thus divided: normal subjects, subjects affected by allergic rhinitis, subjects with positive reaction to Graminacee in and out of season, subjects affected by perennial rhinitis due to D.Pt., and those affected by perennial rhinitis of non-allergic origin. All subjects underwent complete E.N.T. check-ups, anterior rhinorheomanometry (RRM), mucociliary clearance test (MCT) and evaluation of amount of nasal secretion. We were able to observe that nasal provocation with methacholine bromide, though on the one hand it was not able to provoke a significant reaction in the mucociliary transport function even though it caused a substantial reaction in the conductance in all five groups, on the other hand it caused a significant modification of nasal secretion with varying levels in the different groups. Furthermore, it was to be observed that nasal provocation with a cold water solution set at 2-4 degrees C caused a more significant reduction of the nasal conductance in subjects affected by perennial rhinitis of non-allergic origin in comparison to the other groups taken into consideration, even though it did not cause particular variations in the parameters relative to mucociliary transport and nasal secretion.

Adolescent↗
PubMed1983

Incidence of allergic rhinitis in children.

The authors give an account of the outcome of research done in the Allergo-Immunological Centre of the IInd ENT Division of Rome University, carried out among 210 children who were affected by nasal atopy. Particular stress was placed on the involvement of the nasopharyngo-tubal system. The age of the children ranged from 2-12 years and they underwent: 1) ENT visit; 2) allergy tests; 3) anterior rhinorheomanometry; 4) tubal function tests; 5) mucociliary clearance time; 6) X-ray examination of paranasal sinuses. The results revealed that the most frequent symptom in these children is rhinitis, whatever the allergic sensitization was. The forms of atopy which manifested themselves by chronical allergic patients (D.Pt. and P.O.) were the cause of: 1. asthmatic-type syndromes; 2. early onset of atopic symptoms around 4-7 years of age (9-10 years in the seasonal forms); 3. greater degree of extrinsic rhinitis with edema of the turbinates - the first step towards a polypoid degeneration of such subjects; 4. tubal functional deficit (60% of subjects allergic to P.O. and 50% allergic to D.Pt whereas only 27% are found in the seasonal forms); 5. mucociliary clearance linked directly with the length of disease; involvement of the paranasal sinuses (53/61 patients allergic to D.Pt., 9/28 allergic to P.O., 9/56 allergic to Graminacee). Furthermore the nasal patency was more insufficient in patients affected by the chronical forms of the atopy. In the light of these results the authors advocate focus attention on the significance of an early diagnosis of nasal atopy in children and the need for interdisciplinary collaboration among specialists.

Age Factors↗
PubMed1981

Behaviour on the nasal provocation test in patients affected by conjunctivitis and/or asthma of allergic origin.

In the Allergo-Immunological Centre of Rome University we selected 120 patients of both sexes, ranging from 5-65 years of age, affected by asthma and/or conjunctivitis without past or present history of nasal impairment (itching, sneezing, hydrorrhea). As a result of the allergometric tests carried out, the authors divided the samples into three groups: 1) positive reaction to Dermatophagoides Pteronissimus (66.6%); 2) positive reaction to the Graminacee (28.3%); 3) positive reaction to Parietaria officinalis (5.1%). After having undergone the rhinoreomanometric test of nasal provocation, 50% of the patients revealed a positive reaction to the specific allergen, more specifically at 50 PNU/ml 40% of the case were positive, and at 100 PNU/ml 50% were positive. These results are discussed in the light of modern biological knowledge on the mastocytes in normal subjects and in those suffering from allergy.

Adolescent↗
PubMed1980

Secretory immune response after nasal vaccination with live attenuated influenza viruses.

Immunoglobulins and virus-specific antibody in nasal secretions were measured in 18 volunteers before and after intra-nasal vaccination with two live-attenuated type A influenza virus strains. Specific serum antibody rises occurred in 14 out of 18 vaccinees; of those, 11 and 10, respectively, showed significant increase of IgA concentration and of virus-specific antibody in nasal secretions collected 2-4 weeks after vaccination. In one case, a volunteer showed appreciable increase of virus neutralizing antibody in nasal secretions without increase of local IgA concentration and of serum HI antibody. This data indicate that administration of live virus vaccines by upper respiratory route confers effective immunity associated with local antibody synthesis.

Adult↗