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PubMed1979

Not to be sneezed at.

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Clinical Trials as Topic↗
PubMed2003

Methods of testing urethral resistance in the female rat.

Development of an animal model of stress urinary incontinence is dependent on a measure of urethral resistance, such as leak point pressure (LPP). However, animals will not cough or perform Valsalva maneuvers upon request. The aim of this study was to use urodynamics to compare bladder pressures during spontaneous voids (SV), anesthetized LPP measurement, and induced sneezing in female rats. A suprapubic catheter was implanted in the bladder dome of 10 female rats. Two days later, the rats were tested urodynamically under urethane anesthesia. The bladder was emptied and filled with saline. The abdomen was then depressed manually to increase abdominal pressure while bladder pressure was measured. The bladder pressure when leakage occurred was taken as LPP. In addition, the rats were stimulated to sneeze by cutting off a whisker and using it to tickle the nostril. Both peak pressure and increase in pressure during LPP (43.4 +/- 3.6 and 33.1 +/- 3.8 cm H2O, respectively) were significantly higher than pressures during both SV (30.4 +/- 3.8 and 19.3 +/- 3.4 cm H2O, respectively) and sneeze (9.5 +/- 0.7 and 2.6 +/- 0.5 cm H2O, respectively). The time course of a sneeze (0.6 +/- 0.2 sec) was significantly shorter than the time course of both LPP (4.4 +/- 0.5 sec) and SV (6.9 +/- 1.3 sec). No rat leaked from a sneeze unless the sneeze triggered an SV. LPP triggered a SV in 5 rats and sneeze triggered a SV in 6 rats. With urodynamic measurement, it is possible to easily distinguish between LPPs, SVs, and sneezes. LPP can provide a quantifiable measure of decreased urethral resistance, whereas induced sneezes can provide a diagnostic test for severe incontinence.

Animals↗
PubMed2003

Acquired nasal hyperresponsiveness aggravates antigen-induced rhinitis in the guinea pig.

Whether a state of nasal hyperresponsiveness influences antigen-induced biphasic nasal blockage and sneezing were examined using a guinea pig model of allergic rhinitis. Sensitized animals were challenged with an antigen, Japanese cedar pollen, once every week. Before the 13th challenge, the animals were randomly divided into 2 groups, and then the 13th challenge was performed (Groups A-0 and B-0). The 14th challenge was done on day 2 (Group A-2) and on day 7 (Group B-7) after the 13th challenge, on which nasal hyperresponsiveness was present and absent, respectively. Biphasic nasal blockage and sneezing after the challenge in Group A-2 were more severe than those in Group A-0, while those of Group B-7 were almost the same as those of Group B-0. An anti-histaminic, mepyramine, inhibited sneezing but not the biphasic nasal blockage in Group B-7. A cysteinyl leukotriene (CysLT) antagonist, pranlukast, suppressed the late nasal blockage but not the early blockage and sneezing in Group B-7. In contrast, in Group A-2, mepyramine significantly attenuated not only sneezing but also the early nasal blockage. Pranlukast significantly inhibited both nasal blockage and sneezing in Group A-2. In conclusion, nasal hyperresponsiveness aggravated the antigen-induced nasal responses, to which histamine and CysLTs considerably contributed.

Animals↗
PubMed1999

Comparison of ipratropium bromide 0.03% with beclomethasone dipropionate in the treatment of perennial rhinitis in children.

OBJECTIVE: To compare the safety and efficacy of ipratropium bromide 0.03% (IB) with beclomethasone dipropionate 0.042% (BDP) in the treatment of perennial rhinitis in children. METHODS: Thirty-three children with nonallergic perennial rhinitis (NAPR) and 113 with allergic perennial rhinitis (APR) were randomly assigned to either IB or BDP for 6 months in a single-blind, multicenter protocol in which the physician was blinded to treatment. At each visit, patients and physicians rated symptom control of rhinorrhea, nasal congestion, and sneezing. Patients also completed quality of life questionnaires at baseline and after 6 months of therapy. RESULTS: Both treatments showed a significant improvement in control of rhinorrhea, congestion, and sneezing compared with baseline over the 6 months of treatment (P < .05). Only for the control of sneezing was BDP consistently better than IB (P < .05). Among the patients given IB, 61% to 73% assessed the control of rhinorrhea as good or excellent on different study visit days, 43% to 60% similarly rated the control of nasal congestion, and 39% to 43% the control of sneezing. The results for BDP were 68% to 78% for the control of rhinorrhea, 55% to 72% for the control of nasal congestion, and 54% to 68% for the control of sneezing. Quality of life assessment documented that both drugs significantly reduced interference with daily activities and disturbance of mood due to rhinorrhea compared with baseline (P < .05). Both treatments were well tolerated with IB causing less nasal bleeding and irritation than BDP. CONCLUSIONS: Ipratropium bromide was safe and effective in controlling rhinorrhea and diminishing the interference by rhinorrhea in school attendance, concentration on school work, and sleep. Ipratropium bromide was as effective as BDP in the control of rhinorrhea and showed a relatively good effect on congestion. Patient and physician assessment favored BDP in the control of sneezing.

Adolescent↗
PubMed2003

Auditory response to a photic stimulus.

BACKGROUND: The photic sneeze response is a well-established clinical phenomenon in which patients respond by sneezing in an uncontrolled manner. This paroxysm of sneezing is evoked by a sudden exposure to an intense or bright light source. The pathogenesis of this response is apparently quite complex. Sudden exposure to bright light involves the optic, oculomotor, and trigeminal nerves, the autonomic nervous system and central brainstem functions. Anecdotal reports have suggested the photic sneezing response may occur as an autosomal dominantly inherited condition. However, such a familial pattern is not always present. METHODS: This article presents a descriptive report of a case in which a patient sought comprehensive eye care and, during the course of the examination, reported a relationship between light and a predictable auditory response. The mechanism for this involuntary auditory response to a bright light may be similar to that involved with photic sneeze response. RESULTS: This patient's history, specific features of the auditory response, and ophthalmic findings as a result of the comprehensive eye examination are reported. CONCLUSION: The photic sneeze response is not an uncommon phenomenon. A similar mechanism may explain the auditory response to a photic stimulus reported in this article.

Auditory Perception↗
PubMed2005

Comparison of leak point pressure methods in an animal model of stress urinary incontinence.

We compared three different methods of testing leak point pressure (LPP) in rats with or without the pudendal nerves and nerves to the iliococcygeus/pubococcygeus muscles transected: (1) sneeze induced with a whisker in the nostril (sneeze LPP), (2) manually increased abdominal pressure (Crede LPP), and (3) increased intravesical pressure using the vertical tilt table method (vertical tilt table LPP). In sham rats, passive intravesical pressure rises in Crede and vertical tilt table methods induced active urethral closure mechanisms that contributed to high LPPs (41.4 and 35.5 cm H2O, respectively), which were significantly reduced by nerve transection. During sneezing, leakage was observed in nerve-transected rats, but not in sham rats, indicating that sneezing can activate an additional urethral closure mechanism. Measuring LPP during sneezing or passive intravesical pressure rises in the vertical tilt table and Crede method seems to be useful for assessing the continence mechanisms under different stress conditions in rats.

Abdomen↗
PubMed1991

Abdominal muscle length during respiratory defensive reflexes.

The purpose of the present study was to assess the mechanical behavior of an expiratory muscle during defensive reflexes. Transversus abdominis muscle length changes were measured using sonomicrometry in anesthetized dogs. The abdominal muscle lengthened during the inspiratory phase and shortened at a rapid velocity during the expiratory portion of coughs and sneezes. The mean extent of muscle shortening was not different during coughing compared to breathing (P greater than 0.20) but was approximately double in magnitude during sneezing compared to breathing (P less than 0.005). On the other hand, the peak velocity of muscle shortening was approximately 5-fold greater during coughing (P less than 0.002) and 10-fold greater during sneezing (P less than 0.05) than during breathing. During the largest coughs and sneezes in each animal, peak velocity of muscle shortening averaged 77 +/- 9 and 179 +/- 65% of end-inspiratory length per sec, respectively. Muscle end-inspiratory length during coughs and sneezes differed from values during breathing (range +/- 8%), although for the group of animals the mean changes were small (+/- 1%). Despite these changes in end-inspiratory length, the abdominal muscle continued to operate at lengths both above and below its resting length. These results suggest that during defensive reflexes, greater increases occur in the velocity than in the extent of transversus abdominis muscle shortening relative to during breathing. In addition the transversus abdominis muscle appears to play an active respiratory role during defensive reflexes.

Abdomen↗
PubMed2000

Nose blowing propels nasal fluid into the paranasal sinuses.

Intranasal pressures were measured in adults during nose blowing, sneezing, and coughing and were used for fluid dynamic modeling. Sinus CT scans were performed after instillation of radiopaque contrast medium into the nasopharynx followed by nose blowing, sneezing, and coughing. The mean (+/-SD) maximal intranasal pressure was 66 (+/-14) mm Hg during 35 nose blows, 4.6 (+/-3.8) mm Hg during 13 sneezes, and 6.6 (+/-3.8) mm Hg during 18 coughing bouts. A single nose blow can propel up to 1 mL of viscous fluid in the middle meatus into the maxillary sinus. Sneezing and coughing do not generate sufficient pressure to propel viscous fluid into the sinus. Contrast medium from the nasopharynx appeared in >/=1 sinuses in 4 of 4 subjects after a nose blow but not after sneezing or coughing.

Adult↗
PubMed1996

Randomized controlled trial of clemastine fumarate for treatment of experimental rhinovirus colds.

We used a rhinovirus challenge model to test the therapeutic efficacy of clemastine fumarate for reducing sneezing and nasal secretion in a double-blind, randomized clinical trial. Clemastine fumarate (1.34 mg) or placebo was administered at 8 A.M. and 8 P.M. for 4 days, beginning 24 hours, 36 hours, 48 hours, and 60 hours after viral challenge. Infected evaluable subjects who received clemastine (n = 75) had reduced sneeze-severity scores compared with those who received placebo (n = 75) on illness days 2 (0.3 vs. 0.5; P = .003), 3 (0.4 vs. 0.8; P = .0003), 4 (0.3 vs. 0.5; P = .025), and 5 (0.1 vs. 0.3; P = .03); sneeze counts for infected evaluable subjects (vs. counts for those who received placebo) were reduced on illness days 2 (1.5 vs. 3.1; P = .01), 3 (1.7 vs. 5.6; P = .0001), and 5 (0.7 vs. 1.9; P = .03). Infected evaluable subjects who received treatment had reduced rhinorrhea scores (compared with those who received placebo) on illness days 2 (0.7 vs. 1.0; P = .04) and 3 (0.6 vs. 0.9; P = .04) and had reduced nasal secretion weights on day 3 (3.6 g vs. 6.3 g; P = .03). Over 4 days of treatment, mean sneeze scores for infected evaluable subjects (vs. scores for those who received placebo) were reduced by 50%, mean sneeze counts by 57%, mean rhinorrhea scores by 27%, and mean nasal secretion weights by 35%. Other cold symptoms were unaffected by treatment. Treatment with clemastine was associated with an excess incidence of dry mouth (6%), dry nose (19%), and dry throat (17%).

Administration, Intranasal↗
PubMed2005

Electroencephalogram and behavioral changes induced by histamine application into the nasal cavity and the effects of some H(1)-receptor antagonists.

The present study was performed to measure the olfactory bulb with an electroencephalogram (EEG) to investigate the relationship between the EEG and behavioral changes of rats induced by the topical application of histamine into the nasal cavity. The effects of some H(1)-receptor antagonists on the EEG and behavioral changes induced by histamine were also studied. The topical application of histamine into the nasal cavity resulted in a significant and dose-dependent increase in the incidence of sneezing and nasal rubbing. The EEG spike at the olfactory bulb was also observed to be in parallel with the sneezing. In addition, there was an intimate relationship between the EEG spike and sneezing; however, no correlation was observed between the EEG spike and nasal rubbing. All the H(1)-receptor antagonists used in the present study caused an inhibition not only of sneezing but also of the EEG spike at the same dose level. These results suggested that the EEG spike observed in the olfactory bulb is an objective and reliable indication of sneezing induced by allergic rhinitis.

Action Potentials↗
PubMed1993

Early and late nasal symptom response to allergen challenge. The effect of pretreatment with a glucocorticosteroid spray.

We challenged 30 pollen-sensitive volunteers with allergen, recorded symptoms and signs over a 10-h period, and rechallenged them after 24 h, in order to characterize the early and late allergic symptom response in the nose. The challenge was performed after topical pretreatment with the glucocorticosteroid budesonide (200 micrograms twice daily) for 14 d and with placebo in a double-blind, cross-over trial. The early response, consisting of sneezing, discharge, and blockage, was followed by a weak late response, consisting of a few sneezes and nose-blowings, and of a sustained nasal blockage. These symptoms did not have a well-defined peak in time, and a biphasic symptom curve could not be identified. The rechallenge response showed increased nasal responsiveness. The degree of budesonide effect on the early response varied, depending on the symptom; there was a marked effect on sneezing (72% reduction; P < 0.01), a moderate effect on discharge (37% reduction; P < 0.01), and a slight effect on blockage (17% reduction of nasal inspiratory peak flow rate; P < 0.02). The degree of inhibition of the rechallenge response was similar to the effect on the initial early response. The effect on the late response was very pronounced for all symptoms and signs (97% reduction of sneezes, 76% reduction of nose-blowings, 96% reduction of blockage; P < 0.01). In conclusion, we found it difficult in the individual subject to identify a well-defined late symptom response by criteria similar to those employed to characterize the late response in the bronchi. The effect of budesonide was more marked on sneezing than on blockage, and the drug was considerably more effective on the late response than on the early response.

Administration, Topical↗