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PubMed2003

Risk of asthma among Finnish patients with occupational rhinitis.

STUDY OBJECTIVES: To determine the risk of asthma among patients with occupationally induced rhinitis. DESIGN: Patients with confirmed occupational rhinitis were followed for asthma incidence through register linkage. Patients with other occupational diseases were used as a reference population. SUBJECTS: Patients entered into the Finnish Register of Occupational Diseases in from 1988 to 1999 for occupational rhinitis (n = 3,637) or other occupational disease (n = 31,457) were observed until December 31, 2000, through two national registers of individuals who were eligible for the reimbursement of asthma medication and the Population Register Center. METHODS: Incidence rates of asthma were calculated, and a log-linear model, adjusted for age, gender, and occupation, was used to estimate the relative risks (RRs) of asthma among those with occupational rhinitis compared to those with other occupational diseases. RESULTS: There were 420 and 972 incident cases of asthma, respectively, among those with occupational rhinitis and the reference population. The crude RR of asthma was 4.8 (95% confidence interval [CI], 4.3 to 5.4) for all patients with occupational rhinitis, 5.4 (95% CI, 4.8 to 6.2) for those with occupational rhinitis accepted for compensation, and 3.7 (95% CI, 3.1 to 4.5) for patients with unaccepted occupational rhinitis. The RR varied according to occupation and was the highest among farmers and wood workers, both groups having a sevenfold risk. The risk was especially high during the year following notification, but a roughly threefold risk persisted several years thereafter. CONCLUSIONS: Patients with occupationally induced rhinitis have a high risk of asthma, but further studies are needed to establish the effect of preventive interventions.

Adolescent↗
PubMed2005

Asthma-related health care resource use among asthmatic children with and without concomitant allergic rhinitis.

OBJECTIVE: To determine the incremental effect of allergic rhinitis on health care resource use in children with asthma. DESIGN: Population-based historical cohort study. SETTING: Data in a general practice database in the United Kingdom during 1998 to 2001. PATIENTS: Children 6 to 15 years old with asthma and with >or=1 asthma-related visits to a general practitioner (GP) during a 12-month follow-up period. MAIN OUTCOME MEASURES: Asthma-related hospitalizations, GP visits, and prescription drug costs during the 12-month follow-up period for patients with and without comorbid allergic rhinitis. RESULTS: Of 9522 children with asthma, 1879 (19.7%) had allergic rhinitis recorded in the GP medical records. Compared with children with asthma alone, children with comorbid allergic rhinitis experienced more GP visits (4.4 vs 3.4) and more of them were hospitalized for asthma (1.4% vs 0.5%) during the 12-month follow-up period. In multivariable regression analyses, comorbid allergic rhinitis was an independent predictor of hospitalization for asthma (odds ratio: 2.34; 95% confidence interval [CI]: 1.41-3.91) and was associated with increases in the number of asthma-related GP visits (mean increase: 0.53; 95% CI: 0.52-0.54) and asthma drug costs (mean increase pound: 6.7; 95% CI: 6.5-7.0). The association between allergic rhinitis and higher costs of prescriptions for asthma drugs was independent of asthma severity, measured indirectly by the intensity of use of asthma drugs. CONCLUSIONS: Children with comorbid allergic rhinitis incurred greater prescription drug costs and experienced more GP visits and hospitalizations for asthma than did children with asthma alone. A unified treatment strategy for asthma and allergic rhinitis, as recommended by the Allergic Rhinitis and Its Impact on Asthma initiative, might reduce the costs of treating these conditions.

Adolescent↗
PubMed1997

Quality-of-life outcomes and the use of antihistamines in a French national population-based sample of patients with perennial rhinitis.

Our primary objective in designing the first large-scale nationwide population-based survey in France was to assess the impact of perennial rhinitis on quality of life. Our secondary objective was to describe the use of drug treatment, including histamine H1 antagonists, in that population. A pollbase of 20,000 households was screened for symptoms of rhinitis. 16,786 households responded, including 35,615 patients aged over 15 years, giving an overall response rate of 84%. Using an algorithm, 1367 patients with probable perennial rhinitis were selected for a cross-sectional collection of data about the history of their condition, comorbidity, use of medical resources, sick leave and nasal symptom-related quality of life [according to the Medical Outcomes Study 36-Item Short-Form Questionnaire (SF-36)]. Finally, multivariate regression techniques were used to describe the relationship between quality-of-life scores and treatment subgroups, controlling for some other confounding factors. The point prevalence of perennial rhinitis was estimated to be 4.1% [95% confidence interval (CI): 3.9 to 4.3%]. Association of perennial rhinitis with a history of asthma was highly significant (13.4% in those with perennial rhinitis vs 3.8% in those without; odds ratio 3.26; p < 0.001). 38% of the patients with perennial rhinitis reported having taken regular medication during the last 3 months. Antihistamine use was associated with use of decongestant or topical nasal products in about one-third of patients. Four SF-36 dimensions (physical functioning, role physical, bodily pain, social functioning) showed significantly higher mean scores (indicating better quality of life) in patients receiving non-anticholinergic histamine H1 antagonist therapy, relative to those receiving other treatments, a difference that was maintained after controlling for gender, age, level of nasal symptoms, medical history of asthma and number of general practitioner visits. These results established the long term impact of perennial rhinitis on quality of life (generic and specific), and raised questions about appropriate therapy, since a positive association between current use of non-anticholinergic antihistamines with improvements on some SF-36 dimensional scores in patients with perennial rhinitis was observed.

Adult↗
PubMedDate not supplied

Prevalence of allergic rhinitis among adolescents from Distrito Federal, Brazil: comparison between ISAAC phases I and III.

OBJECTIVE: To determine the prevalence of allergic rhinitis in a random group of schoolchildren aged 13 to 14 years in Brasilia, Brazil, to evaluate tendencies over 6 years and to compare prevalence rates among different socioeconomic groups. METHODS: Two cross-sectional studies were undertaken 6 years apart, using the ISAAC (phases I and III) written questionnaire. Thirty-nine schools were chosen at random from eight administrative regions in Brasilia, and were classified into three groups according to the socioeconomic conditions of the population. RESULTS: A total of 3,009 questionnaires were collected. Of these 53.5% related to female children and 80% to students from public schools. Prevalence rates for diagnosed rhinitis, recent rhinitis and allergic rhinitis were 20, 29.3 and 12.2%, respectively. Rhinitis was more prevalent in private schools than in public ones (17.8 versus 14.1%) and sufferers were predominantly female. Prevalence rates were also higher among populations with higher socioeconomic status (23.5 versus 12.2%). Comparison with the 1996 data revealed significant increases in the prevalence of diagnosed rhinitis (12.7 versus 20%, p = 0.001). These increases were observed at all socioeconomic levels. CONCLUSIONS: A large number of 13 and 14-year-old children resident in the Distrito Federal exhibit symptoms indicative of rhinitis and the majority of them have allergic rhinitis. Over a six-year period the prevalence of allergic rhinitis increased significantly, predominantly affecting females and with greater prevalence among students at private school and from families with higher socioeconomic status.

Adolescent↗
PubMedDate not supplied

[Pathologic conditions associated with drug-induced rhinitis].

Rhinitis medicamentosa ("nose-drop-nose") is a term used for pathological condition of the nasal mucous membrane that results from long-term abuse with intranasal vasoconstrictors. The aim of this work was to examine what lead the patients with nosedropnose rhinitis to the initial usage of intranasal vasoactive drugs. In this prospective study, 92 patients with rhinitis medicamentosa were included. The evaluation of all study subjects comprised the history, ORL, microbiological and radiological examination, skin prick tests with a battery of routine respiratory and nutritive allergens and nasal cytology. The results of this study showed that the pathological conditions for initial use of intranasal vasoactive drugs were: acute upper respiratory infections in 29.3%, vasomotor rhinitis in 21.7%, allergic rhinitis in 16.3%, deviated nasal septum in 13.0%, nasal polyposis in 12%, rhinitis induced by mechanical trauma in 4.4%, and hormonal rhinitis in 3.3% of patients with rhinitis medicamentosa. In conclusion, the most common pathological conditions for developing rhinitis medicamentosa were chronic inflammatory and structural diseases manifested by permanent nasal obstruction as well as acute upper respiratory infections are.

Administration, Intranasal↗
PubMed2000

Optimizing quality of care and cost effectiveness in treating allergic rhinitis in a managed care setting.

Allergic rhinitis is a common condition in managed care populations. The direct medical cost of rhinitis exceeded $3 billion in 1996, and an additional cost of $4 billion resulted from the exacerbation of other concomitant conditions, such as asthma or otitis media. Costs continued to increase in 1999; sales of prescription antihistamines and nasal steroids exceeded $3 billion and $1 billion, respectively. The indirect costs of allergic rhinitis include lost work productivity, reduced performance and learning, and increased workplace and traffic accidents. Rhinitis treatments include allergen avoidance, over-the-counter (OTC) sedating antihistamines, nonsedating antihistamines, nasal steroids, and immunotherapy. Allergen avoidance strategies for patients with asthma and rhinitis are ineffective or are of very limited benefit. Allergists criticize the use of OTC sedating antihistamines, which are associated with reduced learning and performance even when sedation does not occur. Evidence-based literature reviews of clinical trials have shown that nasal steroids are more effective than nonsedating antihistamines in the treatment of rhinitis. The most commonly prescribed nasal steroid, fluticasone, has been shown to be effective in treating rhinitis and in improving patients' quality of life. It is also more cost effective than the most commonly prescribed antihistamine, loratadine. Clinical trials have indicated that immunotherapy is expensive and of limited benefit. As these evidence-based findings are used to develop managed care treatment guidelines, nasal steroids are likely to be recommended as the first-line treatment for rhinitis, which should result in lower treatment costs and improved outcomes for patients with rhinitis.

Cost of Illness↗
PubMed2001

Allergic rhinitis and asthma: more similarities than differences.

Clinical epidemiological and pathophysiological studies suggest a strong functional and immunological relationship between the nose and the bronchi. Nasal stimulation, can induce bronchoconstriction by a proposed rhinobronchial reflex and inflammatory mediators originating from the nose could be inhaled and trigger bronchial inflammation. Bronchial provocation in sensitised subjects results in nasal inflammation through systemic circulation. There is an increased prevalence of asthma in patients with rhinitis relatively to patients without nasal complaints and allergic rhinitis patients have an increased risk to develop asthma. Nasal and bronchial co-morbidity is high, 75% of asthmatics have rhinitis and 20% to 40% of rhinitic patient suffer from asthma. In the World Health Initiative on Allergic Rhinitis and its effect on Asthma (ARIA) it is quoted that asthma and rhinitis are common co-morbidities suggesting the concept of one airway one disease. The term allergy rhinobronchitis has been proposed to link the association between asthma and rhinitis. The treatment of rhinitis and sinusitis is important for management of asthma. Treatment of chronic rhinitis not only reduces nasal inflammation obstruction and discharge but also can reduce lower airway hyperesponsiveness and symptoms of asthma. Treating nasal inflammation is a key point in asthma control. These data strength the functional and allergologial link between nose and bronchi. Nasal inflammation induced by nasal challenge in patients with rhinitis has the ability to also induce bronchial changes in some asthmatic patients.

Anti-Allergic Agents↗
PubMed2003

[The immunological parameters and risk factors for pollen-induced allergic rhinitis and asthma].

UNLABELLED: Naturally occurring exposure to pollen allergens causes symptoms of allergic rhinitis, conjunctivitis and asthma in susceptible individuals. It is, however, unknown why some subjects develop only an allergic rhinitis while others develop asthma as well. The aim of this study was to investigate the difference of immunological parameters in patients with pollen-induced seasonal allergic rhinitis (SAR) and asthma and to determine the risk factors for pollinosis with asthma. We evaluated the demographic and clinical characteristics of the patients, sensitisation pattern to tree-, grass- and weed-pollen and perennial inhalant allergens according to skin prick tests, allergic inflammation parameters (blood and nasal eosinophil count, serum IgE, eosinophil cationic protein levels) in and out of the pollinosis season. Logistic regression analysis was used to rate the effect of covariates on risk for pollinosis and asthma. One hundred and one patients (52 men and 49 women) aged 16-63 years (median 24 yrs.) with pollinosis symptoms were investigated. All patients suffered from moderate-severe seasonal allergic rhinitis, 96% from concomitant allergic conjunctivitis, 23.8% had seasonal asthma. The significant clinical and demographic risk factors for pollinosis with asthma were smoking (OR=15.4, p=0.003) and pollinosis season lasting more than 14 weeks (OR=5.6, p=0.02). The patients with seasonal allergic rhinitis alone were significantly more frequently sensitized to orchard grass (p=0.005), ragweed (p=0.02), lamb's quarter (p=0.05) allergens. During the season the blood eosinophil count raised in all patients (p<0.01). It was shown statistically that there were no differences between groups in blood and nasal eosinophil count, serum eosinophil cationic protein level. The patients with seasonal allergic rhinitis and asthma had higher levels of serum IgE during the season (p=0.05) and out of it (p=0.01). More than two times elevated serum IgE in acute and symptom-free period of pollinosis was considered as a significant risk factor for pollinosis with asthma (OR=3.5, p=0.04 and OR=3.4, p=0.03). CONCLUSIONS: Pollinosis presented with seasonal asthma in 23.8% of cases. Our data indicate that patients with seasonal allergic rhinitis and asthma differ from the patients with seasonal allergic rhinitis alone according to higher serum IgE levels. Prolonged pollinosis season, smoking and high IgE levels increase the risk for seasonal asthma in pollen-induced allergic rhinitis subjects.

Adolescent↗
PubMed2005

[Expression and its significance of aquaporin 5 in rat nasal mucosa of experimental allergic rhinitis].

OBJECTIVE: To confirm the expression and distribution of aquaporin 5 (AQP5) in rat nasal mucosa of experimental allergic rhinitis and to investigate the relationship between AQP5 and allergic rhinitis. METHODS: Twenty-four healthy Wistar rats both male and female weighting 200-300 g were divided into two groups randomly, one was testing group (n = 12), the other was comparing group (n = 12). Generally sensitized rats in testing group were given repeated local booster sensitization into nasal cavity. Twelve normal rat nasal mucosa and twelve nasal mucosa from rat with allergic rhinitis were used. The distribution of AQP5 in normal rat nasal mucosa and nasal mucosa in rat with allergic rhinitis were observed by immunofluorescence technique. Furthermore, the expression of AQP5 in normal rat nasal mucosa and nasal mucosa from rat with allergic rhinitis were studied by immunohistochemical staining. RESULTS: Hematoxylin and eosin staining showed that there was obvious inflammation reaction, a large quantity of glands hyperplasia and acidophils soaked in nasal mucosa from rat with allergic rhinitis. (2) Both immunofluorescence technique and immunohistochemical staining showed that the distribution of AQP5 in normal rat nasal mucosa was in accordance with that in nasal mucosa from rat with allergic rhinitis on the whole. AQP5 expressed mainly in the membrane and cytoplasm of the epithelium in the glands, ducts and cilia. (3) The statistical analysis of the immunohistochemical staining showed that the quantity of AQP5 in rat nasal mucosa with allergic rhinitis (156.37 +/- 1.93) was obviously higher than that in the normal rat nasal mucosa (178.52 +/- 1.94). There was statistical significance between the two groups (t = 28.08, P < 0.01). CONCLUSIONS: The hypersecretion of glands has a close relationship with the high expression of AQP5 in allergic rhinitis.

Animals↗
PubMed2005

[The prevalence of allergic rhinitis in the adult urban population of Denizli].

OBJECTIVES: We investigated the prevalence of allergic rhinitis in the adult urban population of Denizli. STUDY DESIGN: A survey study was conducted to cover 1010 adults above 19 years of age, representing the urban population of Denizli district, Turkey. A questionnaire was designed to collect data on sociodemographic features, symptoms of allergic rhinitis, duration of symptoms, and any prior diagnosis of allergic rhinitis made by a physician. Interviews were made with randomly chosen adults from three socioeconomically different urban areas. RESULTS: Interviews were completed for 951 adults with ages ranging from 19 to 65 years (414 males, mean age 36.3+/-12 years; 537 females, mean age 35.2+/-12 years). The frequency of self-reported allergic rhinitis was 10.8%, and 5.2% had allergic rhinitis diagnosed by a physician. Two or more symptoms of allergic rhinitis were found in 7.2%. The prevalence of allergic rhinitis was higher in females. There was no relationship between the frequency of allergic rhinitis and age. CONCLUSION: The prevalence of allergic rhinitis in the adult urban population of Denizli is between 5% to 10%, with a higher frequency in females.

Adult↗
PubMed2006

[Regulation of the expression of interleukin-4 and interleukin-5 by the signal pathway of PKC-NF-kappaB in T lymphocyte of allergic rhinitis].

OBJECTIVE: To explore the role of nuclear factor-kappaB (NF-kappaB) in the signal pathway of protein kinase C (PKC) regulating the expression of interleukin-4 (IL-4) and interleukin-5 (IL-5) by T lymphocyte in allergic rhinitis. METHOD: Twenty-four allergic rhinitis patients and 24 normal control persons participated in the study. T lymphocytes were isolated and purified from blood of each person and divided into 3 groups: cells of 1st group were control group(Normal control and AR control),cells of 2nd group were stimulated with phorbol 12-myristate 13-acetate (Normal PMA and AR PMA),cells of 3rd group were stimulated with PMA and pyrrolidine dithiocarbamate (Normal PMA/PDTC and AR PMA/PDTC). The expression of NF-kappaB were observed by immunocytochemical staining, IL-4 and IL-5 protein in supernatants were measured by ELISA. RESULT: The percentage of cells of active NF-kappaB, IL-4 and IL-5 protein in supernatants of allergic rhinitis T lymphocyte stimulated with PMA were significantly higher than those of allergic rhinitis T lymphocyte stimulated without PMA ( P < 0.01) and with PMA and PDTC ( P < 0.01); than those of normal control T lymphocyte stimulated with PMA ( P < 0.01), with PMA and PDTC ( P < 0.01) and without PMA. The percentage of cells of active NF-kappaB, IL-4 and IL-5 protein in supernatants of allergic rhinitis T lymphocyte stimulated with PMA and PDTC were significantly lower than those of allergic rhinitis T lymphocyte stimulated with PMA (P < 0.01); but significantly higher than those of allergic rhinitis T lymphocyte stimulated without PMA and those of normal T lymphocyte stimulated. There were good positive correlation between the percentage of cells of active NF-kappaB and IL-4 and IL-5 protein in supernatants (r = 0.88,0.85, P < 0.01, respectively). CONCLUSION: The active PKC of allergic rhinitis T lymphocyte increasing the expression of IL-4 and IL-5 may be mediated by activating NF-kappaB, the activation of PKC-NF-kappaB signal pathway of T lymphocyte NF-kappaB may play an important role in the pathogenesis of allergic rhinitis.

Adult↗
PubMed2006

[Expression of cell adhesion molecule and nitric oxide synthase in nasal mucosa in allergic rhinitis].

OBJECTIVE: To explore the role of cell adhesion molecules (CAMs) and nitric oxide synthase (NOS) in the pathological mechanism of allergic rhinitis. METHOD: Three kinds of CAMs, which are intercellular adhesion molecule-1 (ICAM-1), vascular cellular adhesion molecule-1 (VCAM-1) and lymphocyte function antigen-1 (LFA-1), as well as three kinds of NOS, which are neuronal nitric oxide synthase (nNOS), inducible isoform of nitric oxide synthase (iNOS) and endothelial nitric oxide synthase (eNOS) were orthotopic detected by strept avidin-biotin complex (SABC) immunohistochemistry method in 40 cases of inferior nasal concha of allergic rhinitis. RESULT: There are only small number of ICAM-1, VCAM-1 and LFA-1 positive cells in the normal concha mucosa epithelial but more positive cells in allergic rhinitis. The number of positive cell of ICAM-1, LFA-1, VCAM-1 in the concha mucosa was [(14.4+/-2.2), (17.2+/-3.3), (11.5+/-2.7) per scope (x400) +/-s] respectively; in the control group the number of positive cell of ICAM-1, LFA-1, VCAM-1 in the concha mucosa was (8.7+/-1.8), (10.3+/-2.1), (6.9+/-1.8) respectively. The statistic differences were significant (t = 11.57, 10.02, 8.07 respectively; P<0.01). A certain number of nNOS positive cells were found in the concha mucosa in allergic rhinitis patients, it was mainly expressed in mucosa epithelial and submucosa glandular; a large number of iNOS positive cells were found in the concha mucosa in allergic rhinitis patients, iNOS was mainly expressed in mucosa epithelial, submucosa glandular, endothelial and submucosa inflammatory cell; the number of eNOS positive cell was few. In the normal control, few positive cells of nNOS, iNOS or eNOS could be found. Between the allergic rhinitis patients and the normal control, the number of nNOS positive cell was [(9.4+/-1.7), (4.7+/-1.3) per scope (x400)] respectively, t = 12.62 (P<0.01); the number of iNOS positive cell was (27.5+/-3.2), (4.3+/-1.7) respectively, t = 36.03 (P<0.01) the number of eNOS positive cell was (6.5+/-2.1), (6.2+/-1.9) respectively, t = 0.62 (P>0.05). CONCLUSION: These adhesion molecules might be involved in edema, exudation and infiltration of inflammatory cells of nasal mucosa in allergic rhinitis patients. The number of nNOS, iNOS positive cell in inferior concha mucosa in allergic rhinitis patients was significant higher than in normal control. It suggests that nNOS and iNOS might be involved in the pathogenesis of allergic rhinitis.

Adolescent↗
PubMed1995

Allergic rhinitis and olfactory loss.

BACKGROUND: Allergic rhinitis is associated with reports of olfactory loss, but there are few formal investigations. Patients with diminished smell function frequently have nasal polyps or sinusitis, making it difficult to separate the impact of allergic rhinitis from the effects of these other problems. OBJECTIVE: The goals of this descriptive study were to establish the prevalence of positive skin tests in patients reporting rhinitis and olfactory deficiency, and to assess olfactory function and the results of skin testing in a patient group with chronic rhinitis but without concomitant sinusitis or nasal polyps. METHODS: Sixty-two patients reporting olfactory loss and chronic rhinitis were examined by history, physical examination, olfactory testing, skin testing with perennial and seasonal allergens, endoscopic rhinoscopy, and CT scan of the paranasal sinuses. RESULTS: Seventy-one percent of all the subjects had at least one positive skin test, 69% to a perennial allergen, and 58% to mite. Eighty-two percent of the 28 subjects with chronic rhinitis but no evidence of polyps or sinusitis had positive tests. The mean olfactory score for this rhinitis group was 4.35, consistent with moderate hyposmia. The mean olfactory score of 34 subjects with polyps and/or chronic sinusitis was 0.61, consistent with anosmia, and significantly lower (P < .001). Sixty-two percent of this group had positive skin tests. CONCLUSION: These subjects who experienced olfactory loss and rhinitis appeared to have a high prevalence of allergic rhinitis as suggested by the number of positive skin tests. Olfactory loss was observed in patients without polyps or sinusitis, which suggests that allergic processes may have affected olfactory function.

Adolescent↗
PubMed1994

Epidemiology of chronic (perennial) rhinitis in Singapore: prevalence estimates, demographic variation and clinical allergic presentation.

We conducted a population-based study involving a stratified cluster disproportionate random sample of 2868 adults aged 20 to 74 years selected from five housing estates (Yishun, Toa Payoh, Jurong East, Geylang/Eunos and Bukit Merah). Chronic rhinitis was defined as the usual presence of symptoms of blocked or running nose, apart from colds or the flu, lasting for more than a year. Allergic rhinitis was considered to be present if these symptoms were associated with conjunctivitis or recognisable provocation by commonly known allergens, namely house dust, dogs, cats, birds, pollen, or medicines. The estimated general population prevalence of chronic rhinitis was 10.8% (95% confidence interval (CI) 8.8-12.7). Higher prevalences were noted in males, in younger adults, in Indians and Chinese, in those with higher socio-economic status, and in Toa Payoh, Jurong East and Geylang/Eunos. The prevalence of allergic rhinitis was 5.5% (95% CI 4.5-6.5). The most common 'allergenic' factor in allergic rhinitis was house dust (73%); provocation by birds, cats or dogs (5%), grass or tree pollens (5%), and medicine (5%) was less common but likely to have been under-recognised. Provocation by change in temperature (54%) and early in the morning (64%) was equally frequent in both 'allergic' and 'non-allergic' rhinitis; cigarette smoke, petrol and diesel fumes, food and work environment were less common (4-12%). Allergic rhinitis was highly significantly associated with asthma (13.9% in allergic rhinitis, 4.4% in non-allergic rhinitis, and 2.2% in non-rhinitic subjects).

Adult↗
PubMed1997

Prevalence of asthma and rhinitis in Perugia, Italy.

This cross-sectional study evaluated the prevalence of, and risk factors for, asthma and rhinitis in a randomized sample of males and females, aged 0-69 yrs, in Perugia, Italy. To determine the prevalence of asthma and rhinitis, 824 subjects were interviewed by trained physicians using a modified American Thoracic Society and National Heart and Lung Institute-Division of Lung Disease questionnaire proposed in 1978 (ATS-DLD-78). Skin-prick tests were carried out in 667 subjects > or = 3 yrs of age. Age, sex, atopy, smoking, and household pets were considered potential risk factors for the development of asthma and rhinitis. Cumulative prevalences of: asthma was 8.1%; current asthma 5.0%; and rhinitis 15.2%. Positive skin tests were observed in 21.3% of subjects: in 63.4% of the cases of current asthma and in 68.7% of rhinitis cases. The prevalence of asthma and rhinitis was similar in both sexes. Prevalence of current asthma was almost three times higher in childhood than after the age of 10 yrs. Positive skin tests for pollens and house dust mite were the most prevalent risk factors for asthma. Current smoking was inversely associated with prevalence of current asthma possibly because of a self-selecting effect. Household pets were found not to be major risk factors for asthma or rhinitis. In conclusion, prevalence of asthma and rhinitis is a common health problem in the Perugia area, and atopy, particularly pollen sensitivity, is the most important risk factor for the development of asthma and rhinitis.

Adult↗
PubMedDate not supplied

[Diagnostic use of enzymatic RAST skin tests and determination of eosinophils in nasal mucosa in allergic rhinitis].

AIMS: Allergic rhinitis is the most frequent disease mediated by immunoglobulin E (IgE). Nasal challenge is the gold standard for the diagnosis of allergic rhinitis. Skin tests (ST) are the most used diagnostic method to detect the presence of specific IgE bind to skin mast cells. The exposition of the nasal mucous membrane to the allergen is followed by an increase of the local eosinophils; the count of eosinophils in nasal mucous (ENM) is a diagnostic test for allergic rhinitis. Enzymatic RAST or enzymatic allergo-sorbent test (ESA) measures the level of serum allergen-specific IgE. OBJECTIVE: To measure the sensitivity, specificity, and diagnostic precision of ST, EAST and ENM in allergic rhinitis. METHOD: We studied 241 individuals, 162 of them had allergic rhinitis, and 79 were healthy controls. They underwent nasal challenge and intradermic ST for Dermatophagoies spp (acarus). Fraxinus americana (Ash-tree), Amaranthus palmieri (quelite), Cynodon Dactylon (capriola) and Felis catus (cat), EAST for Dermatophagoides pteronyssinus (acarus), and ENIVI. Results of ST, EAST and ENIVI were compared with their corresponding nasal challenge, and the prevalence of allergic rhinitis for each allergen was calculated. The best cut point was assessed by means of receiver-operator curves (ROC), and sensitivity, specificity, positive predictive value, negative predictive value, inter-observer concordance coefficient, area under ROC (0), standard error of 0 (SEO), and 95% confidence interval of 0 of each test were calculated using the best cut point. RESULTS: ST and EAST had the best sensitivity and specificity. ENM had the lowest sensitivity and specificity. CONCLUSION: For the diagnosis of Dermatophagoides spp allergic rhinitis ST for Dermatophagoides spp and EAST for Dermatophagoides pteronyssinus have the same diagnostic precision. According to the indexes for diagnostic precision, and inter-observer concordance coefficient, ST and EAST are useful to diagnose allergic rhinitis induced by the evaluated allergens. ENIVI is a test that is not very useful for the diagnosis of allergic rhinitis.

Eosinophils↗
PubMed2001

Update on nonallergic rhinitis.

BACKGROUND: Although nonallergic rhinitis is a well recognized entity, its incidence and therapy have not been definitively studied. Recent epidemiologic studies and treatment trials have furthered our knowledge regarding the frequency of occurrence of this disorder and effective treatment modalities. OBJECTIVE: To review and put into perspective recent advances in our knowledge regarding the incidence and significance as well as therapy of chronic nonallergic rhinitis. In addition, based upon these data, to propose a classification of this disorder. DATA SOURCES: The MEDLINE database and the results of a national survey of allergists (National Rhinitis Task Force) conducted in 15 allergy practices involving 975 patients. CONCLUSIONS: Nonallergic rhinitis is a common disease that probably affects as many as 17 million Americans. Of equal importance is that, based on available data, approximately 22 million people suffer with a combination of nonallergic rhinitis and allergic diseases (mixed rhinitis). Both nonallergic and mixed rhinitis occur more frequently in adults than in children, may be more common in female patients than in male patients, and are more likely to be perennial than seasonal. Agents demonstrating efficacy (based on controlled trials or having approval by the FDA) for the therapy of nonallergic rhinitis are azelastine and topical nasal steroids.

Adrenal Cortex Hormones↗
PubMed1998

Sense of smell in allergic and nonallergic rhinitis.

Hyposmia is a fairly common complaint in patients with long-continuing allergic or nonallergic rhinitis. Other factors such as aging, smoking, or nasal surgery may affect olfaction, but these have been little studied in rhinitis-related hyposmia. The purpose of this study was to measure and compare olfactory thresholds in 105 rhinitis patients and 104 healthy controls and to analyze possible relationships between the sense of smell and rhinitis, age, sex, smoking, prick-test results, nasal resistance, and history of nasal or paranasal surgery. The olfactory threshold was assessed with a commercially available kit of squeeze-bottle pairs. The most important variables associated with the sense of smell were determined with stepwise multiple regression analysis, and intergroup differences were assessed with analysis of variance. The reference interval of olfactory thresholds by age was estimated with regression analysis. Nasal resistance was measured by active anterior rhinomanometry. Age and rhinitis were the only variables with significant effect on the olfactory threshold in the whole series. Both the proportion of hyposmic persons and the degree of the impairment of the sense of smell were significantly higher in the rhinitis group than in the control group. The nonallergic patients' sense of smell was poorer than that of seasonal or perennial allergic rhinitis patients. A history of operations for nasal polyposis was associated with hyposmia, but operations for chronic maxillary sinusitis were not. Neither smoking habits nor sex were related to olfactory thresholds. In conclusion, hyposmia in rhinitis patients is partly attributable to age-related changes, but our results indicate that the disease itself impairs the sense of smell.

Adult↗