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PubMed2006

Prevalence of serum neutralising antibody to equine rhinitis A virus (ERAV), equine rhinitis B virus 1 (ERBV1) and ERBV2.

The objective of this study was to determine the incidence of serum neutralising (SN) antibody to ERAV, ERBV1 and ERBV2 in a population of horses from birth to 22 years of age. The prevalences of ERAV, ERBV1 and ERBV2 SN antibodies in 381 sera obtained from 291 horses were 37%, 83% and 66%, respectively. ERAV, ERBV1 and ERBV2 maternal antibody was present in foals 12 h postsuckling but by 10-12 months, ERAV SN antibody was not detected in any of the horses, while ERBV1 and ERBV2 SN antibodies were common (83% and 100%, respectively). Sera were obtained from 44 Thoroughbred horses when they were newly introduced into a training centre when their average age was 23 months and a second sample was obtained approximately 7 months later. ERAV SN antibody was present in 8 (18%) when first bled and in 27 (61%) when tested 7 months later. Accordingly 19 of the 44 horses (43%) seroconverted to ERAV within 7 months of entering the training stable. Among all the horses the average ERAV SN antibody titre was relatively high (3796) and in contrast, ERBV1 and ERBV2 titres were relatively low (average 84 and 45, respectively) and often fell to below detectable levels over time and at a rate comparable to new seroconversions in the same group of horses.

Age Factors↗
PubMedDate not supplied

The course of asthma parallels that of allergic rhinitis: a 23-year follow-up study of college students.

The purpose of this study is to examine the relationship between the course of asthma and allergic rhinitis among former Brown University students who were diagnosed with these diseases either before or after their freshman year of 1962 or 1963. A total of 738 former students, who were evaluated and underwent skin testing during their freshman year, completed a 23-year follow-up questionnaire inquiring of their history of allergies and asthma and are the focus of this study. The activity of asthma as related to the course of allergic rhinitis (hay fever and/or nonseasonal allergic rhinitis) was examined. Among 44 asthmatic subjects with purely seasonal allergic rhinitis (hay fever and no history of nonseasonal allergic rhinitis), asthma was active in 75% of those with worse hay fever, 70% of those with unchanged hay fever, 50% of those with better (but not symptom-free) hay fever, and 10% of those with symptom-free hay fever. The resolution of asthma symptoms correlated significantly with improvement in hay fever (p = 0.0053). Among 70 asthmatics with any form of allergic rhinitis (hay fever and/or nonseasonal allergic rhinitis), asthma was active in 75.0% of those with worse allergic rhinitis, 66.7% of those with unchanged allergic rhinitis, 53.3% of those with better (but not symptom-free) allergic rhinitis, and 20.0% of those with symptom-free allergic rhinitis. The resolution of asthma symptoms correlated significantly with improvement in allergic rhinitis (p = 0.0052). The activity of allergic rhinitis as related to the course of asthma was also examined. Among 44 asthmatic subjects with purely seasonal allergic rhinitis (hay fever and no history of nonseasonal allergic rhinitis), hay fever was active in 100% of those with worse asthma, 100% of those with unchanged asthma, 90.9% of those with better (but not symptom-free) asthma, and 60.9% of those with symptom-free asthma. The resolution of hay fever symptoms correlated significantly with improvement in asthma (p = 0.0109). Among 71 asthmatic subjects with any form of allergic rhinitis (hay fever and/or nonseasonal allergic rhinitis), allergic rhinitis was active in 91.9% of those with active asthma and 64.7% of those with symptom-free asthma. The resolution of allergic rhinitis symptoms correlated significantly with improvement in asthma (p = 0.0078). In summary, among individuals with asthma and allergic rhinitis, improvement of allergic rhinitis was associated with a resolution of asthma symptoms, whereas a worsening of allergic rhinitis was associated with the persistence of asthma symptoms. Likewise, among asthmatic subjects with allergic rhinitis, improvement of asthma was associated with a resolution of allergic rhinitis symptoms, whereas a worsening of asthma was associated with the persistence of allergic rhinitis symptoms.

Adolescent↗
PubMedDate not supplied

[Chronic rhinitis--effect of topical administration of corticosteroids on eosinophilic leukocytes].

Clinical manifestation of chronic rhinitis is due to local release of mediators from inflammatory cells. Eosinophil leukocytes are important in pathogenesis of nasal hypersensitivity as well as nasal hyperreactivity [1, 2]. The aim of the study was to follow-up the effect of local corticosteroid treatment on a number of eosinophils in nasal secretion of patients with chronic rhinitis. The study was prospective and controlled. A total number of 88 subjects was included in the study. Patients with chronic rhinitis who were treated with local corticosteroids (63) constituted the experimental group (37 with isolated allergic rhinitis, 10 with isolated nonallergic noninfective hyperreactive rhinitis, 10 with allergic rhinitis associated with nasal polyposis and 6 with nonallergic noninfective hyperreactive rhinitis associated with nasal polyposis). There were 25 patients with chronic rhinitis in the control group (18 with isolated allergic rhinitis, 2 with isolated nonallergic noninfective hyperreactive rhinitis, 3 with allergic rhinitis associated with nasal polyposis, and 2 with nonallergic noninfective, hyperreactive rhinitis associated with nasal polyposis). During the treatment with beclomethasone dipropionate aqueous nasal spray (daily dose was 400 micrograms during 6 weeks for isolated rhinitis and 6 months for associated forms of rhinitis), control examinations were regulary performed. The first control was after one week, the second after six weeks, the third after three months and the fourth after six months. The same control was carried out in the control group of patients who were without therapy. Cytological examination of nasal secretions included brush method of collecting secretions, staining smears with Leishman's stain and light microscopic scrutinising of nasal smear magnified up to 1000 times. The results of the study demonstrated the highly significant decrease in the number of eosinophils after the therapy in patients with isolated allergic rhinitis (x2(FR) = 71,121, DF = 2, p < 0.01), in patients with isolated hyperreactive rhinitis (x2(FR) = 19,050, DF = 2, p < 0.01), in patients with allergic rhinitis associated with nasal polyposis (x2(FR) = 26,730, DF = 3, p < 0.01), as well as in patients with hyperreactive rhinitis associated with nasal polyposis (x2(FR) = 17,000, DF = 3, p < 0.01). There were no significant differences in control group of patients, neither in subgroup with allergic rhinitis (x2(FR) = 2,528, DF = 2, p > 0.05) nor in subgroup with hyperreactive rhinitis associated with nasal polyposis (x2(FR) = 0.250, DF = 2, p > 0.05) (Table 2). Local corticosteroids have the potential to influence the regulation of eosinophil apoptosis. The induction of apoptosis by beclomethasone dipropionate treatment is an efficient way to remove eosinophil leukocytes from inflammatory sites [8]. The locally used corticosteroids in chronic rhinitis reduced significantly the number of eosinophils in nasal secretion. This result proves immunomodulatory effects of these medicaments in the pathogenesis of chronic rhinitis.

Administration, Intranasal↗
PubMedDate not supplied

Rhinitis: a dose of epidemiological reality.

In the wide spectrum of medical practice, rhinitis is often incorrectly assumed to be solely allergic in etiology. Consequently, other rhinitis subtypes (nonallergic and mixed) remain under-diagnosed. This is of concern because inaccurate diagnosis may lead to unsatisfactory treatment outcome. Contributing to this under-diagnosis is the fact that primary care practitioners do not often have at their disposal the same diagnostic tools as the allergist. Tools that the allergist is more likely to use include nasal cytology, skin testing and in vitro assays for specific immunoglobulin E. Patients with pure nonallergic rhinitis have negative skin tests or clinically irrelevant positive results. Mixed rhinitis refers to the presence of both allergic and nonallergic rhinitis components within the same individual. Allergic rhinitis more commonly develops before the age of 20, whereas nonallergic rhinitis affects an older population and disproportionately more females. The type of nasal symptoms manifested by the patient usually does not differentiate allergic from nonallergic rhinitis. Vasomotor rhinitis is the most common form of nonallergic rhinitis, followed by nonallergic rhinitis with eosinophilia and others. In terms of estimated prevalence, allergic rhinitis affects approximately 58 million Americans, 19 million have pure nonallergic rhinitis and 26 million have mixed rhinitis. Thus a wide spectrum of relevant epidemiologic information can be used to assist in determining the differential diagnosis of rhinitis. Physicians are reminded to look further and consider whether a rhinitis patient truly has pure allergic rhinitis or whether a diagnosis of mixed rhinitis or nonallergic rhinitis is more appropriate.

Diagnosis, Differential↗
PubMed2005

Characteristics of intermittent and persistent allergic rhinitis: DREAMS study group.

BACKGROUND: In the Allergic Rhinitis and its Impact on Asthma (ARIA) classification, intermittent and persistent rhinitis were proposed to replace seasonal and perennial allergic rhinitis (AR). AIM: To better understand the ARIA classification of rhinitis. METHODS: A cross-sectional study was carried out in 591 patients consulting ENT or allergy specialists for AR and 502 control subjects. The diagnosis of AR was based on a score for allergic rhinitis (SFAR) > or =7. Patients were classified according to the four ARIA classes (mild intermittent, mild persistent, moderate/severe intermittent and moderate/severe persistent). Allergen sensitization (skin prick tests (SPTs) or specific IgE) and co-morbidities were examined according to the ARIA classes. RESULTS: Ten percent of patients had mild intermittent rhinitis, 14% mild persistent rhinitis, 17% moderate/severe intermittent rhinitis and 59% moderate/severe persistent rhinitis. Most patients with intermittent rhinitis had a pollen sensitivity, but 5% had a single house dust mite (HDM) sensitization. Over 50% of patients with persistent rhinitis were allergic to pollens or HDM. Asthma was present in 24% of rhinitis patients and in only 2% of the control population (P<0.0001). Patients with moderate/severe persistent rhinitis had the highest asthma prevalence (33%). DISCUSSION: Intermittent and persistent rhinitis are not synonymous of seasonal and perennial rhinitis. Most patients consulting specialists have severe rhinitis. Asthma prevalence increases with duration and severity of rhinitis supporting the ARIA major recommendation that patients with persistent rhinitis should be evaluated for asthma.

Adolescent↗
PubMed2007

Epidemiology of rhinitis: allergic and nonallergic.

In summary, the epidemiological data and characterization of allergic and nonallergic rhinitis has been reviewed. Chronic rhinitis symptoms are among the most common problems presenting to physicians. When approaching this problem the diagnostic challenge is to determine the etiology, specifically whether it is allergic, nonallergic, or perhaps an overlap of both conditions. Estimates of the prevalence of allergic rhinitis range from as low as 9% to as high as 42%. Although the prevalence of nonallergic rhinitis has not been studied definitively, it appears to be very common with an estimated prevalence in the United States of approximately 19 million. In comparison, the prevalence of mixed rhinitis is approximately 26 million, and allergic rhinitis ("pure" and "mixed" combined) 58 million. Challenges in the differential diagnosis of rhinitis result from two major factors. Not only are presenting symptoms of allergic, nonallergic, and mixed rhinitis often indistinguishable from one another, but also the differential diagnosis of nonallergic rhinitis is extensive. Nonallergic rhinitis is often characterized by onset after age 20, female predominance, nasal hyperactivity, perennial symptoms, and nasal eosinophilia in approximately one-third of the population. Positive tests for relevant specific IgE sensitivity in the setting of rhinitis do not rule out "mixed rhinitis" and may not rule out nonallergic rhinitis. The significance of symptom exacerbation by nonallergic triggers in the setting of allergic rhinitis remains to be determined. Goals for the future include reaching a consensus on the definitions of rhinitis and rhinitis subtypes including the establishment of mixed rhinitis, updating guidelines for the interpretation of nonrelevant positive tests for specific IgE sensitivity, and reaching agreement on the nonallergic triggers that best define VMR or VMR subtypes. Only then can the most applicable research results be obtained. The desired result is the delivery of the most appropriate treatment, specifically tailored to the accurate diagnosis of patients with rhinitis.

Humans↗
PubMed2004

Persistent rhinitis - allergic or nonallergic?

Although rhinitis has been classified as being either allergic, noninfectious, or "other forms" (nonallergic noninfectious), these categories lack strict classification criteria and often overlap. The term "nonallergic noninfectious rhinitis" is commonly applied to a diagnosis of any nasal condition, in which the symptoms are similar to those seen in allergic rhinitis but an allergic aetiology has been excluded. This group comprises several subgroups with ill-defined pathomechanisms, and includes idiopathic rhinitis, irritative-toxic (occupational) rhinitis, hormonal rhinitis, drug-induced rhinitis, and other forms (non-allergic rhinitis with eosinophilia syndrome [NARES], rhinitis due to physical and chemical factors, food-induced rhinitis, emotion-induced rhinitis, atrophic rhinitis). Unlike allergic rhinitis, there are no specific diagnostic tests and diagnosis is primarily based on a history of reaction to specific irritant-toxic triggering agents (either general or occupational), drugs, infections, and hormonal status, coupled with exclusion of allergic rhinitis and other forms of non-allergic rhinitis by skin prick testing. Accordingly, from a clinical standpoint NARES, irritative-toxic, hormonal, drug-induced and idiopathic rhinitis are possibly the least difficult forms of nonallergic rhinitis to diagnose.

Diagnosis, Differential↗
PubMedDate not supplied

Allergic rhinitis update: Epidemiology and natural history.

Allergic rhinitis is the most common chronic condition, with an estimated prevalence in the United States of 5-22%, which increases from infancy, peaks in childhood and adolescence, and decreases in the elderly. As a major cause of morbidity, absenteeism, and restricted activity in both children and adults, allergic rhinitis, similar to asthma, appears to be increasing with time. Allergic rhinitis is commonly defined as seasonal or perennial, depending upon whether symptoms are manifested at defined yearly intervals or throughout the year, respectively. While trees, grasses, weeds, and molds are the most frequent causes of seasonal allergic rhinitis, dust mites and molds are the major contributors to perennial allergic rhinitis. The pathogenesis of allergic rhinitis is based upon interactions of allergen with membrane-bound allergen-specific IgE on the surface of mediator cells, i.e., basophils and mast cells, leading to the release of allergic mediators (both performed and newly synthesized) including histamine, leukotrienes, and eosinophil cationic protein (ECP). These are responsible for both immediate allergic responses characteristic of acute allergic rhinitis and the late inflammatory reactions responsible for chronic allergic rhinitis. The evaluation of rhinitis should include a detailed patient history, a careful physical examination, and appropriate diagnostic tests including skin prick tests or serum assays for allergen-specific IgE. Seasonal allergic rhinitis is readily distinguished from perennial allergic rhinitis by history and confirmed by positive skin tests to causative aeroallergens. It is important to differentiate seasonal rhinitis from non-allergic disorders including infectious rhinitis, structural or anatomic problems such as nasal polyps or septal deviation, rhinitis medicamentosa (due to the overuse of topical vasoconstrictors), hormonal rhinopathy (e.g., pregnancy, hypothyroidism), non-allergic vasomotor rhinopathy, non-allergic inflammatory rhinitis with eosinophils (NARES), or rarely, a neoplasm. A knowledge of the epidemiologic and clinical presentation of allergic rhinitis together with these pathophysiologic mechanisms is essential for a modern-day diagnostic and therapeutic approach to the patient who suffers from allergic rhinitis.

Adolescent↗
PubMedDate not supplied

Co-existence of asthma and allergic rhinitis: a 23-year follow-up study of college students.

The purpose of this study is to examine the co-existence of asthma and allergic rhinitis among former college students who were diagnosed with these diseases either before or after their freshman year. A total of 738 former Brown University students (69% males and 31% females) who were evaluated and underwent skin testing during their freshman year completed a 23-year follow-up questionnaire inquiring of their history of allergies and asthma. The mean age of the participants at the time of the follow-up study was 40 years. In this group, the cumulative incidence of asthma was 11.3% (84/738), hay fever was 41.5% (306/738), and nonseasonal allergic rhinitis was 14.0% (103/738). The cumulative incidence of allergic rhinitis (hay fever) and/or nonseasonal allergic rhinitis (was 45.8% (338/738). Among the 84 individuals with a cumulative incidence of asthma, 63 (75.0%) had a history of hay fever, 27 (32.1%) had a history of nonseasonal allergic rhinitis, and 72 (85.7%) had a history of allergic rhinitis. Among the 306 participants with a cumulative incidence of hay fever, 63 (20.6%) had a history of asthma. Twenty-seven (26.2%) of the 103 individuals with a history of nonseasonal allergic rhinitis had a cumulative incidence of asthma. Among the 338 individuals with a cumulative incidence of allergic rhinitis 72 (21.3%) had a history of asthma. Among the participants with a history of both asthma and hay fever, 44.8% developed hay fever first, 34.5% developed asthma first, and 20.7% developed both diseases at the same time. Among the individuals with a history of asthma and nonseasonal allergic rhinitis, 38.5% developed nonseasonal allergic rhinitis first, 30.8% developed asthma first, and 30.8% developed both diseases at the same time. This study further demonstrates the frequent co-existence of asthma and allergic rhinitis. Among asthmatics, allergic rhinitis occurred in 85.7%. Only 14.3% of asthmatics did not have allergic rhinitis. Among individuals with allergic rhinitis, asthma occurred in 21.3%. Also, allergic rhinitis often precedes or occurs at the same time as asthma.

Adult↗
PubMedDate not supplied

Demographics and epidemiology of allergic and nonallergic rhinitis.

Chronic rhinitis symptoms are among the most common problems presenting to physicians. When approaching this problem the diagnostic challenge is to determine the etiology, whether it is allergic, nonallergic, or perhaps an overlap of both conditions. Estimates of the prevalence of allergic rhinitis range from as low as 9% to as high as 42%. Although nonallergic rhinitis is a well-recognized diagnosis, its prevalence has not been studied definitively. If the assumption is made that approximately 20% of the U.S. population has allergic rhinitis, then 58 million people in the United States suffer from this diagnosis. Population survey results have estimated that 19 million Americans suffer from nonallergic rhinitis. Frequently, nonallergic rhinitis occurs in tandem with allergic disease and presents as mixed rhinitis. Because 44% of patients with allergic rhinitis may have concomitant nonallergic rhinitis, it is estimated that an additional 26 million people have a nonallergic component to their rhinitis (mixed rhinitis). Therefore, a total estimated 45 million people have either pure nonallergic rhinitis or mixed rhinitis. Because nonallergic rhinitis is common, it is important to differentiate this condition from rhinitis of allergic etiology. Once the diagnosis is established, an appropriate treatment plan tailored to a specific diagnosis can be optimally designed.

Demography↗
PubMed2000

Epidemiologic evidence for asthma and rhinitis comorbidity.

Asthma and rhinitis are often comorbid conditions, and the overall characteristics of the diseases and the treatment options for the disorders are similar. Several recent epidemiologic studies in the general population have provided evidence to strongly associate the development of asthma with a previous history of either allergic or perennial rhinitis. Additional links between asthma and rhinitis include a description of increased aspirin intolerance in both disorders and the observation that most subjects with occupational asthma experience rhinitis. Further, the likelihood of the development of asthma is much higher in individuals with both perennial and seasonal rhinitis than for individuals with either condition alone. Asthma and rhinitis were found to be comorbidities regardless of atopic state, and perennial rhinitis has been associated with an increase in nonspecific bronchial hyperresponsiveness. Several studies have identified rhinitis as a risk factor for asthma, with the prevalence of allergic rhinitis in asthmatic patients being 80% to 90%. These studies and others demonstrate that the coexistence of asthma and allergic rhinitis is frequent, that allergic rhinitis usually precedes asthma, and that allergic rhinitis is a risk factor for asthma. Finally, studies that have examined the age of onset of atopy as a confounding factor for the development of asthma and allergic rhinitis have suggested that early age atopy may be an important predictive factor for respiratory symptoms that continue into late childhood. In conclusion, rhinitis and asthma are strongly associated, and rhinitis has been identified as a risk factor for asthma.

Asthma↗
PubMedDate not supplied

Clinicocytological correlation in establishing the aetiology of chronic rhinitis.

Two hundred patients clinically diagnosed as having chronic rhinitis were provisionally grouped into allergic and non-allergic types of rhinitis on the basis of history, clinical examination, X-ray of the paranasal sinuses using the occipitomental view and other relevant investigations like differential and total leucocyte count. Whereas 158 cases were categorized into allergic rhinitis, 13 were diagnosed as suffering from vasomotor rhinitis, 25 from infective rhinitis and 4 patients from atrophic rhinitis. A nasal cytogram performed in all these cases showed allergic rhinitis in 107 cases, vasomotor rhinitis in 30 cases, infective on top of allergic rhinitis in 32 cases, common cold over allergic rhinitis in 3 cases, infective rhinitis in 20 cases, a non-infective non-allergic type in 4 cases and atrophic rhinitis in 4 cases. There was a good clinicocytological correlation; however, 30 patients clinically suspected to be having allergic rhinitis had an infective episode alone or on top of allergic rhinitis. Nasal cytology was thus found useful in modifying the treatment. It is a simple, easy and reliable investigation that can be done routinely in the out-patient department.

Adolescent↗
PubMed2005

Severity and impairment of allergic rhinitis in patients consulting in primary care.

BACKGROUND: Allergic rhinitis is a disease impairing quality of life, sleep, and work. A new classification for allergic rhinitis, Allergic Rhinitis and its Impact on Asthma (ARIA), has recently been proposed. OBJECTIVE: To study the effect of allergic rhinitis using ARIA definitions to determine severity and duration. METHODS: A total of 3052 patients consulting general practitioners for allergic rhinitis were studied. Patients were classified according to the 4 classes of ARIA. In all patients, quality of life (Rhinoconjunctivitis Quality-of-Life Questionnaire), sleep (Jenkins questionnaire), and work performance (Allergy-Specific Work Productivity and Activity Impairment questionnaire) were assessed. RESULTS: Mild intermittent rhinitis was diagnosed in 11% of the patients, mild persistent rhinitis in 8%, moderate/severe intermittent rhinitis in 35%, and moderate/severe persistent rhinitis in 46%. The severity of rhinitis has more of an effect on quality of life, sleep, daily activities, and work performance than the duration of rhinitis. In moderate/severe rhinitis, more than 80% of patients report impaired activities, as opposed to only 40% with mild rhinitis. CONCLUSION: It seems that the term moderate/severe should be replaced by severe. A study in the general population is necessary, however, to assess the prevalence of the 4 ARIA classes of allergic rhinitis, especially in patients who are not consulting physicians for their symptoms.

Adult↗
PubMedDate not supplied

[Intradermal tests using vasomotor agents in allergic rhinitis].

INTRODUCTION: Allergic rhinitis is characterised by nasal hyperactivity to specific and non-specific agents. For research purposes, non-specific nasal hyperactivity can be estimated by histamine and metacholine nasal challenge tests. At present, nasal challenge tests are not used for routine diagnosis of rhinitis. Wayoff and colleagues proposed the examination of the skin reactivity to papaverine, acetylcholine, histamine and compound 48/80 in rhinitis patients. Our previous study of skin reactivity to vasomotor agents, using modified skin tests of Wayoff and colleagues showed their clinical validation and usefulness for subclassification of patients with non-allergic rhinitis. To the present, there are only a few studies of skin reactivity to vasomotor agents in patients with allergic rhinitis. The aim of this study was to examine the skin reactivity to vasomotor agents of allergic rhinitis patients and determine whether the patients with allergic rhinitis differ from healthy subjects. METHODS: A prospective, controlled, in vivo study was carried out in 86 subjects: 44 patients with allergic rhinitis and 42 healthy subjects. Skin reactivity was examined by intradermal tests with different concentrations of papaverine, metacholine, histamine and compound 48/48. The non-specific skin reactivity to saline was also measured. Skin reactivity to intradermal test with different concentrations of papaverine, metacholine, histamine and compound 48/48 was measured, as well as specific skin reactivity to control saline solution. Pathological skin reactivity to vasomotor agents was defined as follows: hyporeactivity to papaverine (5 mg/mL), when wheal-and-flare skin reaction diameter was less than 15 mm; hyper-reactivity to metacholine (0.02, 0.2 and 2.0 mg/mL), when two of three wheal-and-flare skin reaction diameters were greater than 15, 25 and 31 mm, respectively; hyper-reactivity to histamine (0.01, 0.1, 1.0 and 10.0 mg/mL), when three of four wheal-and-flare skin reaction diameters were greater than 7, 13, 25 and 40 mm, respectively; and hyper-reactivity to compound 48/80 (0.01, 0.1, 1.0 and 10.0 mg/mL), when three of four wheal-and-flare skin reaction diameters were greater than 9, 16, 26 and 38 mm, respectively. RESULTS: The study included 86 subjects: 44 patients with allergic rhinitis and 42 healthy subjects. The control group of healthy subjects consisted of 22 females, aged from 18 to 35 yrs (mean 28 yrs), and 20 males, aged from 18 to 40 yrs (mean 28 yrs). The difference between the number [p(= 0.758) > 0.05] and age [p(= 0.990) > 0.05] of females and males was not significant. In the allergic rhinitis patients group, there were 23 females, aged from 18 to 54 yrs (mean 33 yrs) and 21 males, aged from 18 to 50 yrs (mean 36 yrs). The difference between the number [p(= 0.763) > 0.05] and age [p(= 0.558) > 0.05] of females and males was not significant. Frequencies of pathological skin reactivity to single vasomotor agents and saline in the control group of healthy subjects and in the allergic rhinitis patients group are shown in Table 1. In the control group, frequencies of normal skin reactivity to papaverine [p(= 1.8 x 10(-7)) < 0.01], metacholine [p(= 4.3 x 10(-6)) < 0.01], histamine [p(= 4.3 x 10(-6)) < 0.01], compound 48/80 [p(= 1.8 x 10(-7) < 0.01] and saline [p(= 6.9 x 10(-4)) < 0.01] were significantly greater than frequencies of pathological skin reactivity. In the patients group, frequencies of normal skin reactivity to papaverine [p(= 6.0 x 10(-8)) < 0.01] and saline [p(= 2.6 x 10(-3) < 0.01] were significantly greater, and to metacholine [p(= 0.016) < 0.05] were significantly greater than frequencies of pathological skin reactivity. In this group, the difference between frequencies of pathological skin reactivity to histamine [p(= 0.366) > 0.05] and compound 48/80 [p(= 0.070) > 0.05] were not significant. There was no significant intergroup difference for pathological skin reactivity to papaverine, metacholine and saline (Table 1). In the patients group frequencies of pathological skin reactivity to histamine and compound 48/80 were significantly higher than in the control group of healthy subjects. Frequencies of pathological skin reactivity to single vasomotor agents and in combinations in the control group of healthy subjects and in the allergic rhinitis patients group are shown in Table 2. The difference of pathological skin reactivity to single vasomotor agents and in combinations between the control group (14/42) and the allergic rhinitis patients group (27/44) was significant [p(= 0.017) < 0.05]. CONCLUSION: In routine evaluation of the rhinitis patients, skin tests with vasomotor agents have some advantages: these tests do not require special equipment, they are not time-consuming, they are easy to perform and simple for the interpretation of results. (ABSTRACT TRUNCATED)

Adolescent↗
PubMed2007

Viral and bacterial rhinitis.

In contradistinction to the poetically inspired disjunction between the name and quality of a rose recited by Juliet in the famous quote from Shakespeare's play, disease labels used in the medical sciences need to have exact meaning to ensure that they communicate an accurate diagnosis and a valid treatment approach. Above, we presented a consistent nosology for rhinitis consequent to infection. There, we argued that the term "rhinitis" should be used to describe the condition of nasal mucosal pathology and that the rSSC be used to describe the appreciated expression of that pathology. In discussing viral and bacterial rhinitis, we conclude that former is consistent with a strict application of our nosology where the accompanying rSSC is usually referred to as cold or flu, but that the latter is not. Lacking direct evidence for bacterial infection of the nasal mucosa, bacterial rhinitis is better referred to as an acute bacterial infection of an adjacent compartment complicated by rhinitis (e.g., sinusitis complicated by rhinitis) or as "toxic rhinitis" complicated by bacterial infection. Interestingly, bacterial infection of the adjacent compartments is a frequent complication of viral rhinitis making "bacterial" rhinitis a complication of a complication of viral rhinitis. The antiviral and antibacterial host-defense mechanisms available to the nasal mucosa are multilayered and formidable. For this reason, nasal mucosal infection with extracellular bacterial pathogens is rarely established and infection with a broad range of upper respiratory viruses is self-limited with short duration morbidity and no mortality. However, in select subpopulations, those infections predispose to more serious complications associated with secondary bacterial, and perhaps viral, infection of the sinuses, middle ears, and lungs. The morbidity and mortality of these complications remains a concern, and strategies to decrease their frequency need to be formulated and tested in clinical trials. Because the viruses causing rhinitis are spread by interpersonal contact, the most appropriate and least expensive prophylactic measures are good hygiene and contact avoidance. Prophylactic efficacy for vaccination and passive immunoglobulin therapy was demonstrated for influenza and RSV infections, respectively. However, these approaches hold little promise for other viruses and are associated with some risks, making them less acceptable for populations "at low risk" for the more serious complications of viral rhinitis. Existing pharmacological treatments for viral rhinitis target the effector chemicals of the rSSC and therefore are largely palliative, whereas antiviral treatment has limited theoretical and realized efficacy, and no treatment has been shown to decrease the risk of complications. Indeed, given the small treatment window available (time between rSSC onset and typical resolution) and the poor understanding of the immune/inflammatory pathways of host defense, it is doubtful that the general population's demand for a cure will be satisfied in the near future, but then, viral rhinitis by any other name is still just a cold.

Bacterial Infections↗
PubMed1999

National guidelines needed to manage rhinitis and prevent complications.

OBJECTIVES: Rhinitis is an extremely common disease worldwide and nasal allergies are one of the major causes of the condition. Allergic rhinitis not only produces a range of nasal and non-nasal symptoms, but it has been closely associated with other chronic airways diseases, such as asthma and sinusitis. This review was undertaken to evaluate the relationship of allergic rhinitis to these diseases and to provide support for proposing national guidelines for managing rhinitis. DATA SOURCES: Relevant studies in English were searched for using MEDLINE, bibliographies from obtained articles, and consultation with experts. STUDY SELECTION: All major studies related to the epidemiology and effects of allergic rhinitis and the relationship between allergic rhinitis and asthma, sinusitis, and other airways diseases were reviewed. DATA SYNTHESIS: There is substantial scientific and clinical evidence that allergic rhinitis frequently coexists with asthma, and sinusitis and may be a predisposing factor for both. In addition, a number of studies have demonstrated that nasal inflammation and obstruction directly affect pulmonary function and clinical symptoms of asthma. Finally, it has been clearly demonstrated that treating allergic rhinitis with antihistamines, nasal corticosteroids, immunotherapy, and allergen avoidance have a significant, positive effect on lung function and asthma symptomology. CONCLUSIONS: The prevalence of allergic rhinitis, asthma, and sinusitis are increasing. Asthma and sinusitis can be debilitating conditions. Asthma alone can be life threatening and costly to treat. The timely and optimal treatment of allergic rhinitis may help prevent these conditions or, at least, prevent them from worsening. Consequently, there is an immediate need to establish national, evidence-based, practice guidelines to assist primary care physicians in diagnosing and managing rhinitis and in evaluating and managing rhinitis and in evaluating and managing allergic rhinitis coexisting with other airways diseases.

Adult↗
PubMed2005

Sibship characteristics and risk of allergic rhinitis and asthma.

Studying associations between sibship characteristics and allergic diseases in detail may contribute clues to their etiology. The authors studied associations between sibship characteristics and risk of self-reported allergic rhinitis and asthma among 31,145 pregnant women participating in a nationwide study in Denmark during 1997-2000. Increasing sibship size was associated with a decreased risk of allergic rhinitis and asthma with allergic rhinitis but not with asthma without allergic rhinitis. The protective effect of having older siblings was stronger than the protective effect of having younger siblings for both allergic rhinitis and asthma with allergic rhinitis. There was no association between interval to closest older or younger sibling and risk of allergic rhinitis or asthma with allergic rhinitis, while the risk of asthma without allergic rhinitis increased with intervals of 2 or more years compared with less than 2 years to the nearest older sibling. The protective effect of having siblings on the risk of asthma with allergic rhinitis could be explained by a protective effect of siblings on the risk of allergic rhinitis alone. In conclusion, our findings suggest that different etiologic mechanisms are involved for allergic rhinitis and asthma with respect to the effect of sibship characteristics. Furthermore, the findings that allergic rhinitis was associated with the number of younger siblings but not with the age interval to younger siblings support the hypothesis of an influence of postnatal mechanisms and suggest that these mechanisms may not necessarily be operating only in early life.

Adolescent↗
PubMedDate not supplied

[Value of eosinophilia in blood and nasal exudate in the diagnosis of different types of rhinitis].

162 patients with different patterns of rhinitis were studied. In 94 a diagnosis of allergic rhinitis was made. The remaining 68 were considered as nonallergic rhinitis. In the allergic group, 64 had seasonal allergic rhinitis. 24 of them were studied during the hay fever season and 40 out of the hay fever season. Positive nasal smear eosinophilia (up to 10%) was found in 56 of 96 patients from the allergic group (59.5%), 21 of them had perenneal allergic rhinitis and 35 had seasonal allergic, of those 20 were studied during the hay fever season. In the non allergic group, 35 were diagnosed as intrinsic rhinitis and 33 as cholinergic rhinitis. Positive nasal smear eosinophilia could be demonstrated in 15 out of 35 cases of intrinsic rhinitis (42.8%), but could not be shown in patients suffering from cholinergic rhinitis. Peripheral blood eosinophilic cells were found in normal values in all patients in spite of the character of the rhinitis. These results suggest that nasal smear eosinophilic cells count is a useful orientative datum in the diagnosis of allergic and intrinsic rhinitis (59.5% and 42.8% respectively in our cases) but is not useful in the diagnosis of cholinergic rhinitis (not one out of 33 cases). Blood eosinophil cells count had no value in nasal allergy diagnosis.

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