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Biomedical subjects

H Malmberg

Publications and source records attributed to H Malmberg.

At least 37 records · Page 2Linked to original sources

Detection of rhinovirus in sinus brushings of patients with acute community-acquired sinusitis by reverse transcription-PCR.

Of 20 adults with acute community-acquired sinusitis (ACAS), rhinovirus was detected in specimens from 10 (50%) patients, including maxillary aspirates from 8 (40%) patients and nasal swabs from 9 (45%) patients, by reverse transcription-PCR (RT-PCR). Human coronavirus was detected by RT-PCR in nasal swabs from 3 of 20 patients but in no sinus secretions. These findings suggest that rhinovirus is an important cause of ACAS and that viral invasion of the sinus cavity itself may be a common event during the disease.

Adult↗

Nasal provocation test in the diagnostics of hairdressers' occupational rhinitis.

Hairdressers are exposed daily at their work to many different hair chemicals and dandruff. The work-related nasal symptoms are common, especially with hair bleaching and striping. There are some reports on hairdressers asthma, but publications concerning occupational rhinitis among hairdressers are very few. The purpose of this study is to investigate the work-related rhinitis symptoms of hairdressers, and to study whether nasal provocation tests (NPTs) can be applied in diagnostics. The study subjects were 40 hairdressers having work-related rhinitis symptoms. Detailed work and exposure histories and work-related symptoms were inquired of using a questionnaire. Prick tests were done. Altogether 142 NPTs were done: 40 placebo, 36 dandruff, 35 ammonium persulphate (APS), and 31 ammonium thioglycolate (ATG). To register the nasal response rhinorrhea and nasal blockage were scored. In 3 allergen NPTs there was an essential change in the nasal status: in 2 APS and in 1 dandruff tests. Three patients were diagnosed as having an occupational rhinitis. The low number of positive reactions in NPTs and few positive reactions in skin prick tests verified that immediate allergy caused by hairdressers' work substances is uncommon. However, in cases of clear work-related rhinitis, there is a need to perform examinations to find the probable allergy.

Adult↗

The effect of nasal obstruction on outcomes of uvulopalatopharyngoplasty.

Nasal obstruction is considered an aggravating factor in some patients with obstructive sleep disorders. There are no previous reports about the effect of nasal obstruction on outcomes of uvulopalatopharyngoplasty (UPPP). The symptoms of 100 patients treated by UPPP in our hospital were analysed. Forty-nine of them were diagnosed as having obstructive sleep apnea syndrome (OSAS), as ODI 4 was > 5. Nasal obstruction was measured using preoperative anterior active rhinomanometry. The degree of snoring and daytime sleepiness was evaluated using a questionnaire preoperatively and again 6-12 months after the operation. Snoring was relieved in 96% of all patients. Excessive daytime sleepiness improved in 87%, which is also consistent with earlier good results. There was no significant difference in improvement of these symptoms in nonapneic snorers and in patients with OSAS. In the group of 10 patients with highest nasal airway resistance snoring was relieved in only 78% as compared with 98% in the others (p < 0.05). Also excessive daytime sleepiness was better relieved in the group of patent nasal airway, but this difference was not statistically significant. Nasal obstruction can effect the outcome of UPPP. Treatment of nasal obstruction should be considered in chronic snoring if snoring and excessive daytime sleepiness persist after UPPP.

Airway Resistance↗

Astemizole in combination with pseudoephedrine in the treatment of seasonal allergic rhinitis.

The efficacy and side effects of once-daily astemizole-D, a combination of 10 mg astemizole and 240 mg pseudoephedrine, were compared with those of twice-daily brompheniramine-D, a combination of 12 mg brompheniramine and 50 mg phenylpropanolamine (Lunerin), in 64 patients with seasonal allergic rhinitis caused by birch pollen. Efficacy was monitored by patient's diary scores, investigator assessments of nasal and eye symptoms and need of rescue medication during the 4-week study period. Both astemizole-D and brompheniramine-D reduced nasal and eye symptoms of allergy. There were no significant differences between the treatment groups regarding obstruction, but brompheniramine-D alleviated symptoms of rhinorrhoea and itchy eyes significantly more than astemizole-D. On the other hand, the patients in the brompheniramine-D group reported dry mouth, tiredness and drowsiness more often than those in the astemizole-D group. The results indicate that the two drugs are effective in the treatment of seasonal allergic rhinitis, but astemizole-D is better tolerated than brompheniramine-D.

Adolescent↗

Neurofilament profile in olfactory mucosa of patients with a clinical diagnosis of Alzheimer's disease.

In an attempt to find a reliable peripheral marker of Alzheimer's disease (AD), pieces of olfactory mucosa were removed by biopsy from 11 patients with probable AD and from eight control patients. The samples were analysed immunocytochemically using monoclonal and polyclonal antibodies. The olfactory and peripheral neurons of the olfactory mucosa in both AD and control patients typically exhibited immunoreactivity to neurofilament (NF) triplet proteins, including both phosphorylated and non-phosphorylated epitopes, as well as to synaptophysin, but lacked reactivity to other intermediate filament proteins, microtubule-associated protein 2 and tau. Our results do not support the recent findings suggesting the lack of NF proteins in olfactory neurons or the preferential phosphorylated status of NF proteins in olfactory neurons solely in AD.

Adolescent↗

Long-term clinical course of hypersensitive rhinitis.

Information on the long-term clinical course of hypersensitive rhinitis was collected among 180 patients who had previously participated in an allergological study. The time period between the initial study and the follow-up questionnaire study was about 18.2 years. Of the patients, 72 were men and 108 women, aged 3.6-69.3 years (mean age 28.5 years) at the time of the initial study. Initially, atopic rhinitis had been verified by allergological investigations in 61.7% while 38.3% of the cases had been designated as intrinsic. During the 18-year period symptoms decreased in severity in 37.2% and ceased completely in 27.2%. Total disappearance of symptoms was more frequent in the intrinsic than in the atopic group.

Follow-Up Studies↗

A comparison between intranasal budesonide aerosol and budesonide dry powder in the treatment of hay fever symptoms.

Sixty patients with seasonal allergic rhinitis due to birch pollen were enrolled in an open, randomized parallel group study. Efficacy and side effects were studied after intranasal administration of budesonide given as a freon propellant aerosol or as dry powder with a sniff actuated inhalation device. Medication started a few days before the actual peak pollen season and lasted for three weeks. The dose was 400 micrograms once daily. Efficacy was assessed daily by patient-rated symptoms scores and by nasal peak inspiratory flow measurements at the visits to the clinic. Safety was assessed by monitoring clinical adverse events. No clear changes in nasal symptom scores or nasal peak flow occurred during the pollen season in either treatment group as compared to the pretreatment period, although the pollen season was very difficult in Finland during the study, ad 12000 grains per m3. Substantial or total control of symptoms was achieved in 93% of the patients in the aerosol group and in 79% in the powder group. Side effects were minimal in both groups. We conclude that dry powder administration of budesonide is as effective and well tolerated as the aerosol in the treatment of seasonal allergic rhinitis.

Administration, Inhalation↗

Terfenadine with or without phenylpropanolamine in the treatment of seasonal allergic rhinitis.

The efficacy of terfenadine in combination with phenylpropanolamine was assessed by comparison with terfenadine alone in a double-blind, parallel group study of 66 patients with nasal birch pollen allergy. The patients were allocated randomly into two groups; 34 patients received terfenadine (60 mg) twice daily and 32 patients a combination tablet containing terfenadine (60 mg) and phenylpropanolamine (50 mg) twice daily for 17 days during the birch pollen season. Nasal symptoms (sneezing, discharge, itching and blockage) were relieved significantly by both drugs, but control of symptoms was more rapid and better with the terfenadine-phenylpropanolamine combination. Rhinoscopic evaluation of nasal secretion and mucosal swelling showed no differences between the treatment groups. Compared with pre-season values, nasal peak expiratory flow (PEF)-values worsened significantly during the season in the terfenadine, but not in the terfenadine-phenylpropanolamine, group. The general condition of the patients was significantly better in the terfenadine-phenylpropanolamine group. There were no marked side-effects in either group. At the end of the trial some of the patients in both treatment groups still had symptoms; this is apparently due to the long-lasting and severe pollen season. It is concluded that terfenadine combined with phenylpropanolamine gives better control of seasonal allergic rhinitis than terfenadine alone.

Benzhydryl Compounds↗

Recurrence of nasal polyps after surgical treatment.

Recurrence of nasal polyposis after polypectomy or ethmoidectomy was studied in 85 patients four years after surgery. The patients were classified into one of three groups according to clinical findings: an atopy group (history confirmed by skin test or nasal provocation), an acetylsalicylic acid intolerance (ASA) group (confirmed by provocation), or an "intrinsic" group (no specific diagnosis). The risk of recurrence was significantly greater in patients with ASA intolerance than in the other two patient groups; the frequency of reoperations during the follow-up period was significantly higher in the ASA group and the need for topical corticosteroid treatment had also been more frequent. Bronchial asthma was diagnosed in 40% of all patients. Asthma was significantly more often associated with ASA group (91%) vs 46% at AT and in only 16% at INTR group.

Adrenal Cortex Hormones↗

Ordinary and high-dose ipratropium in perennial nonallergic rhinitis.

The aim of the present study was to test the efficacy of the topically active cholinoceptor antagonist, ipratropium, in the treatment of rhinorrhea in perennial nonallergic rhinitis, with special reference to identification of subgroups of responders and increased efficacy from high-dose therapy. Thirty-six adult patients with watery rhinorrhea as a dominant symptom completed the study, which consisted of a 2-week run-in period followed by two 3-week treatment periods with placebo and ipratropium in an ordinary dosage (80 micrograms four times a day) in a double-blind, crossover design, and, finally, an open 2-week period with high-dose therapy (400 micrograms four times a day). The number of nose blowings was 47% lower during treatment with ipratropium in the ordinary dosage than during the placebo period (p less than 0.001). There was an additional reduction during high-dose therapy that was slight but statistically significant (p less than 0.05). Ipratropium had no effect on the number of sneezes or on nasal blockage index. During ordinary-dose therapy, side effects were slight and confined to the nose, whereas the high-dose therapy caused unpleasant nasal dryness and, in a few cases, systemic side effects. It was not possible to separate responders from nonresponders by case history, physical examination, or nasal methacholine testing. It is concluded that intranasal ipratropium is effective in the treatment of watery rhinorrhea in perennial nonallergic rhinitis and that 320 micrograms a day is sufficient in most patients.

Adult↗

Clinical findings in patients with allergic rhinitis.

Clinical observations, X-ray findings and results of laboratory tests were evaluated in 770 patients with allergic rhinitis. Anamnestic data and results of the allergological examination of these patients have been presented elsewhere (Holopainen et al., 1979b; Binder et al., 1982). Allergic symptoms were seasonal in 54.5% and perennial in 45.5% of the patients. Mucosal changes as seen on rhinoscopy were significantly more common among patients with perennial than among patients with seasonal rhinitis. Watery discharge was the most common nasal finding, observed in 90% of all patients. Nasal smears showed increased numbers of eosinophilic leucocytes in 70% of the cases. Relationships between the cellular population of the nasal secretion, other laboratory test results and clinical findings are described. X-ray examination revealed pathological changes in the paranasal sinuses in 53.4% of the patients.

Adolescent↗

Ipratropium (Atrovent) in the treatment of vasomotor rhinitis of elderly patients.

Ipratropium is a parasympatholytic agent with high topical activity. The effect of intranasal ipratropium was studied in 34 patients who were over 60 years of age and who suffered from chronic watery vasomotor rhinorrhoea. The study was a double-blind cross-over placebo controlled trial. Trial parameters were: daily nasal symptom and side effect scores, nasal methacholine testing before and after treatment, and clinical evaluation. The active drug clearly reduced nasal discharge. Nasal methacholine testing showed reduction of nasal secretion after the active treatment period. The majority of the patients preferred the active drug to the placebo. Excessive drying of the nasal mucosa was the most common side effect. Ipratropium seems to have a beneficial effect on vasomotor rhinitis, which often is an irritating condition in elderly patients.

Administration, Intranasal↗

Astemizole in the treatment of hay fever.

A double-blind parallel trial of astemizole, pheniramine and placebo was carried out in 51 patients with hay fever. Astemizole is a new potent H1-antihistamine with long duration of action but devoid of central activity. Evaluation criteria were daily symptom- and side effect score cards, daily nasal peak flow measurements, clinical examination and blood tests. Control of nasal symptoms was significantly better with both antihistamines than with placebo. Tiredness and anticholinergic side effects were less common in the astemizole group than in the pheniramine group. No significant changes in the "safety evaluation" blood tests were observed.

Adolescent↗