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Biomedical subjects

G Senna

Publications and source records attributed to G Senna.

At least 37 records · Page 2Linked to original sources
PubMed2001

The role of patient training in the management of seasonal rhinitis and asthma: clinical implications.

BACKGROUND: Allergic rhinitis is an inflammatory disease often associated with bronchial asthma. Intranasal corticosteroids and oral antihistamines are the first-choice drugs. Patient training is relevant to asthma management, but little is known about its impact on rhinitis. We evaluated the role of patient training in the treatment of allergic rhinitis and its effects on nasal and bronchial symptoms. METHODS: One hundred and one patients (M/F = 62/39, age range 12-62 years) with pollen-induced rhinitis (32 with concomitant mild asthma) were enrolled. They were randomized into three groups: A (n = 30) with drug therapy alone, B (n = 35) with drug therapy plus training on the use of nasal spray, and C (n = 36) the same as B plus a lesson on rhinitis and asthma. All patients received mometasone furoate nasal spray for 8 weeks as regular therapy, plus rescue medications on demand. Symptoms and drug consumption were evaluated during the pollen season. RESULTS: The rate of noncompliance/dropout was highest in the untrained patients (P = 0.001). No difference in nasal symptoms was seen among the three groups. On the other hand, group C had significantly fewer asthma symptoms (P = 0.02) and less albuterol use (P = 0.005) than group A. Moreover, the trained group globally used less rescue medication than the other groups (P = 0.02). CONCLUSIONS: Detailed training of patients seems to improve compliance with treatment, reduce concomitant asthma symptoms, and reduce the use of symptomatic drugs.

Administration, Intranasal↗
PubMed2001

The natural history of respiratory allergy: a follow-up study of 99 patients up to 10 years.

A strict relationship between allergic rhinitis and allergic asthma has been seen recently, and in many ways respiratory allergy could be seen as a single disorder of the airways. The link between rhinitis and asthma can be elucidated only by studying the natural history of the disease over long periods. We describe the follow-up of 99 allergic patients up to 10 years and the evolution of their disease. Ninety-nine patients (50 male, 49 female, mean age 31 years) out of 142, suffering from allergic rhinitis or allergic asthma, could be monitored up to 10 years after the initial diagnosis. Demographics, sensitizations and smoke habit were assumed as evaluation parameters. At baseline, 44 patients suffered from AR alone, 12 from AA alone and 43 from AR+AA. After 10 years, 31.8% of the AR patients developed developed AA and 50% of the patients with AA developed AR. Only the familial history for atopy significantly influenced the disease's evolution, whereas gender, age, smoking habit and skin sensitization did not. Sixty-five percent of patients with a single sensitization at the beginning developed new sensitizations. In conclusion, this long-term survey confirms that a relevant percentage of patients with AR alone or AA alone have a progression of the disease.

Adolescent↗
PubMed2001

[Anisakiasis: a borderline disorder].

Anisakis simplex is a nematode which can parasitize many different kinds of fish or cephalopods (codfish, salmon, tuna, mackerel, hake, etc). Anisakis simplex can cause different diseases in humans. The human being acquires the larvae by eating raw or undercooked seafood. Acute anisakiasis is probably caused by an inflammatory and/or allergic response in the digestive tract mucosa with abdominal pain. It can also induce IgE-mediated reactions with several clinical manifestations ranging from urticaria/angioedema to anaphylaxis. Chronic anisakiasis results from abscesses or eosinophilic granulomas caused by parasite invasion. This later form can mimic appendicitis, duodenal ulcer, inflammatory bowel diseases and intestinal obstruction. An early gastroduodenoscopy can confirm the diagnosis and prevent the complications. Serodiagnosis of anisakiasis is difficult since many Anisakis antigens show cross-reativity complications. In fact many people have high IgE titles in the absence of obvious allergic reactions to seafoods. As preventive measures heating for 10 min over 65 degrees C or freezing (minus 20 degrees for 24 h) destroys the infectivity of the larval stage but not always prevent allergic reactions.

Animals↗
PubMed2001

Restoration of enamel and dentin erosion due to gastroesophageal reflux disease: a case report.

Gastroesophageal reflux disease (GERD) is a condition where acid contents of the stomach are regurgitated into the oral cavity, which results in continual exposure of the teeth to these acids. Knowledge of the relationship between GERD and dental erosion enables the appropriate diagnosis and treatment of the underlying medical condition as well as the affected teeth. This article details a case report where severe dental erosion was present due to GERD. After management of the disease, treatment (i.e., diagnosis, treatment planning, and restoration) of the eroded dentition is described.

Adult↗
PubMed2000

[Rhino-bronchial syndrome].

A close anatomical and functional relationship between superior and inferior airways is well documented. A typical example is offered by the close relationship between allergic rhinitis and asthma whose close connection is documented by epidemiological and pathological data. The mechanisms which can explain this phenomenon are not fully known but naso-bronchial reflexes, mouth-breathing due to nasal obstruction and aspiration of nasal secretions seem all to be important. Moreover it has been recently proved that the treatment of rhinitis can improve the concomitant asthma thus confirming their relationship. Another less frequent association is between sinusitis and asthma. Such a connection seems to be frequent in patients suffering of atopic rhinitis but also in patients presenting a nasal obstruction of different nature such as deviations of the nasal septum, adenoid hypertrophy etc. Also in this case a correct medical or surgical treatment of sinusitis can improve asthma symptomathology. Finally a classic example of involvement of superior and inferior airways is represented by the syndrome of ASA intolerance. These patients in fact initially complain of rhinitis which afterwards is complicated by the onset of nasal polyposis and asthma which can prove clinically very severe. Nowadays, anyway, there is no evidence that the treatment of rhinitis or polypectomy can improve the clinical course of asthma. In conclusion, diseases of superior and inferior airways must be considered in strict connection and need the same global treatment.

Asthma↗
PubMed1999

Likelihood ratios and Fagan's nomogram: valuable but underrated tools for in vitro latex sensitization assessment.

The relevance of latex allergy has greatly increased in the last decade especially in health workers and in children with spina bifida. Serological testing has been proposed in the diagnosis since history can be inconclusive and skin and provocative testing can induce severe adverse reactions. We evaluated positive likelihood ratios (LRpos) and the Fagan's nomogram in the diagnosis of latex allergy. Thirty patients with positive clinical history, who showed positive results in the skin prick test and in glove-exposure test were compared to 36 blood donors with negative clinical history, who showed negative results in the skin prick test and in glove-exposure test. LRpos was calculated at four different cutoff concentrations of IgE specific to latex measured with a totally automated analyzer. LRs appear better compared to the traditional classes in the reporting of IgE and, coupled with the Fagan's nomogram which allows the calculation of post-test probability, could improve laboratory testing in latex allergy.

Adult↗
PubMed1998

[Cytokines and asthma].

Asthma is a chronic inflammatory lung disease in which eosinophils are one of the most important involved cells. These cells accumulate in the lung because of cytokines, which are able to regulate cellular responses. The role of cytokines is well known in allergic asthma: IL4, IL5, IL3, GMCSF are the principally cytokine involved. IL4 regulate IgE synthesis while IL5, (and IL3) cause the activation and accumulation of eosinophils. In non allergic asthma, whilst only IL5 seemed to be important recent data, shows that also IL4 plays an important role. Therefore nowadays no relevant difference seems to exist between allergic and non allergic asthma; instead the primer is different: the allergen in allergic asthma and often an unknown factor in the non allergic asthma. Recently other cytokines have been proved to play a role in the pathogenesis of asthma. IL8 is chemotactic not only for neutrophils but also for eosinophils and might cause chronic inflammation in severe asthma. IL13 works like IL4, while RANTES seems to be a more important chemotactic agent than IL5. Finally IL10, which immunoregulates T lymphocyte responses, may reduce asthma inflammation. In conclusion cytokine made us to learn more about the pathogenesis of asthma even if we do not yet know when and how asthma inflammation develops.

Asthma↗
PubMed1998

[The natural history of asthma].

Asthma is a chronic inflammatory disease of airways with a multifactorial pathogenesis. Both genetic and environmental factors contribute to the development of the disease which can vary in the same patient through time. Due to its complexity, natural history of asthma is poorly well-known. Generally, in the history of asthma three periods of life are taken into consideration: early childhood, adolescence and adult life. It has been demonstrated that less than one third of children who are affected by wheezing in early childhood develop a true asthma afterwards. Usually in these subjects who are male and atopic, viruses and subsequently allergens represent the most important factors responsible for the development of asthma. During adolescence airborne allergens represent the main cause of the disease: mites in infancy and pollens in late childhood. The incidence of asthma during adolescence is growing according to recent studies, and even if the symptomatology of asthma improves through time, about two thirds of patients remain asthmatic in their adult life. As regards adults etiology, it is less known, women are more frequently affected than men and the prognosis is generally poorer. Several factors negatively influence the course of asthma such as age, smoking, the severity of the disease during infancy, the persistence of functional obstructive alterations and the increased aspecific bronchial reactivity. Adequate therapy is crucially important to cope with these factors and can change the course of the disease.

Adolescent↗
PubMed1996

Local nasal immunotherapy with extract in powder form is effective and safe in grass pollen rhinitis: a double-blind study.

BACKGROUND: Local nasal immunotherapy has been studied, by means of an extract in powder form, in patients with allergic rhinitis caused by grass pollen. METHODS: Thirty-two patients allergic to grass were studied for 37 weeks in a double-blind controlled trial. Subjects were selected on the basis of a positive history, skin test result, RAST finding, and result of intranasal challenge to grass pollen. Two 16-patient groups were randomly assigned to active or placebo treatment. The treatment lasted 26 weeks (14 for the build-up phase, 12 for the maintenance period). RESULTS: No significant differences were observed in nasal symptoms during the treatment. During the pollen season the mean weekly symptom and medication scores were significantly lower in the treated group, compared with the control group, even considering each allergic symptom separately. Moreover, only in the treated group was a significant increase of specific nasal threshold to grass pollen observed after treatment. CONCLUSIONS: This study indicates that local nasal immunotherapy with allergen in powder form can be a suitable alternative to the traditional subcutaneous immunotherapy in terms of clinical efficacy and safety in grass-allergic rhinitis.

Administration, Intranasal↗
PubMed1995

Local nasal immunotherapy for birch allergic rhinitis with extract in powder form.

BACKGROUND: Traditional subcutaneous immunotherapy has been proved effective in birch pollenosis. It has, however, some drawbacks as systemic reactions, which are rare but important. Local nasal immunotherapy (LNIT) represents a potential safer route of allergen administration. OBJECTIVE: To study the clinical efficacy and safety of local nasal immunotherapy by means of an extract in powder form as treatment of birch allergic rhinitis. METHODS: Thirty birch allergic patients have been selected on the basis of a positive history, skin test, radioallergosorbent test assay (RAST) and specific nasal challenge. Two 15 patient groups were randomly assigned to the active treatment or to the placebo one. Treatment lasted 22 weeks (14 for the build-up phase and eight for maintenance period) and symptoms were recorded during the treatment and the birch pollen season. RESULTS: The clinical efficacy of LNIT is suggested by a significant reduction of medication score only in the treated group during the pollen season, although the symptom score was significantly lower in the treated group for 1 week only. Moreover, a significant increase of specific nasal threshold dose was observed after treatment only in the active treated group. Mild adverse reaction to LNIT, limited to the upper respiratory tract, were reported during the treatment in the active group, but they did not interfere with LNIT schedule. No asthmatic or systemic reaction were observed. CONCLUSIONS: This study indicates that LNIT with allergen in powder form has proven clinically effective in the treatment of birch allergic rhinitis. Further studies are needed to establish whether this treatment can be considered a real alternative to the traditional subcutaneous immunotherapy in birch allergic rhinitis.

Administration, Intranasal↗
PubMed1994

Tolerability of nimesulide in aspirin-sensitive patients.

In most patients with aspirin and nonsteroidal antiinflammatory drug (NSAID) intolerance, antiinflammatory treatment is a clinical problem. In this study we evaluated the tolerance to a new nonsteroidal antiinflammatory drug, nimesulide (Aulin, Boehringer Mannheim, Italia), in 429 patients presenting with clear histories of intolerance to NSAIDs. Nimesulide has been chosen due to its weak inhibitory action on cyclooxygenase and its peculiar mechanism of action. We carried out a single-blind challenge with cumulative doses of nimesulide administered on three different days, until the therapeutic dose of 200 mg or intolerance symptoms were reached. Nimesulide has been well tolerated in 418 subjects and only 11 patients (3.3%) showed a positive test. Our study demonstrates that nimesulide seems to be a suitable drug in aspirin hypersensitivity.

Adolescent↗
PubMed1993

Local nasal immunotherapy for Dermatophagoides-induced rhinitis: efficacy of a powder extract.

BACKGROUND: Local nasal immunotherapy by means of an extract in "macronized" powder from was studied in allergic rhinitis to Dermatophagoides species. METHODS: Twenty-four Dermatophagoides-sensitive patients were studied for 12 months in a double-blind controlled trial. Subjects were selected on the basis of a positive history, skin test, radioallergosorbent test, and intranasal challenge to Dermatophagoides antigen. Two 12-patient groups were selected at random; the first group was given active treatment, and the second received placebo. RESULTS: After 6 months, the mean weekly symptom and medication scores were significantly lower in the treated group than in the control group. The treated group had a significant increase of specific nasal threshold to Dermatophagoides antigen after treatment. Adverse reactions to local nasal immunotherapy, which were limited to the upper respiratory tract, occurred very rarely and did not interfere with dose schedule. CONCLUSION: Local nasal immunotherapy in powder form may be a suitable alternative to the traditional subcutaneous immunotherapy in terms of clinical efficacy and safety.

Adult↗