Base de dados : MEDLINE
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[PMID]:29045457
[Au] Autor:Mulligan JK; Pasquini WN; Carroll WW; Williamson T; Reaves N; Patel KJ; Mappus E; Schlosser RJ; Atkinson C
[Ad] Endereço:Department of Otolaryngology-Head & Neck Surgery, Medical University of South Carolina, Charleston, South Carolina, United States of America.
[Ti] Título:Dietary vitamin D3 deficiency exacerbates sinonasal inflammation and alters local 25(OH)D3 metabolism.
[So] Source:PLoS One;12(10):e0186374, 2017.
[Is] ISSN:1932-6203
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:RATIONALE: Patients with chronic rhinosinusitis with nasal polyps (CRSwNP) have been shown to be vitamin D3 (VD3) deficient, which is associated with more severe disease and increased polyp size. To gain mechanistic insights into these observational studies, we examined the impact of VD3 deficiency on inflammation and VD3 metabolism in an Aspergillus fumigatus (Af) mouse model of chronic rhinosinusitis (Af-CRS). METHODS: Balb/c mice were fed control or VD3 deficient diet for 4 weeks. Mice were then sensitized with intraperitoneal Af, and one week later given Af intranasally every three days for four weeks while being maintained on control or VD3 deficient diet. Airway function, sinonasal immune cell infiltrate and sinonasal VD3 metabolism profiles were then examined. RESULTS: Mice with VD3 deficiency had increased Penh and sRaw values as compared to controls as well as exacerbated changes in sRaw when coupled with Af-CRS. As compared to controls, VD3 deficient and Af-CRS mice had reduced sinonasal 1α-hydroxylase and the active VD3 metabolite, 1,25(OH)2D3. Differential analysis of nasal lavage samples showed that VD3 deficiency alone and in combination with Af-CRS profoundly upregulated eosinophil, neutrophil and lymphocyte numbers. VD3 deficiency exacerbated increases in monocyte-derived dendritic cell (DC) associated with Af-CRS. Conversely, T-regulatory cells were decreased in both Af-CRS mice and VD3 deficient mice, though coupling VD3 deficiency with Af-CRS did not exacerbate CD4 or T-regulatory cells numbers. Lastly, VD3 deficiency had a modifying or exacerbating impact on nasal lavage levels of IFN-γ, IL-6, IL-10 and TNF-α, but had no impact on IL-17A. CONCLUSIONS: VD3 deficiency causes changes in sinonasal immunity, which in many ways mirrors the changes observed in Af-CRS mice, while selectively exacerbating inflammation. Furthermore, both VD3 deficiency and Af-CRS were associated with altered sinonasal VD3 metabolism causing reductions in local levels of the active VD3 metabolite, 1,25(OH)2D3, even with adequate circulating levels.
[Mh] Termos MeSH primário: Colecalciferol/metabolismo
Inflamação/metabolismo
Pólipos Nasais/metabolismo
Rinite/metabolismo
Sinusite/metabolismo
[Mh] Termos MeSH secundário: Animais
Aspergillus fumigatus/patogenicidade
Contagem de Células Sanguíneas
Dieta
Suplementos Nutricionais
Modelos Animais de Doenças
Eosinófilos/patologia
Seres Humanos
Inflamação/dietoterapia
Inflamação/patologia
Linfócitos/patologia
Camundongos
Lavagem Nasal
Pólipos Nasais/dietoterapia
Pólipos Nasais/patologia
Neutrófilos/patologia
Rinite/dietoterapia
Rinite/patologia
Sinusite/dietoterapia
Sinusite/patologia
Linfócitos T Reguladores/metabolismo
Linfócitos T Reguladores/patologia
Deficiência de Vitamina D/metabolismo
Deficiência de Vitamina D/patologia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
1C6V77QF41 (Cholecalciferol)
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171031
[Lr] Data última revisão:
171031
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171019
[St] Status:MEDLINE
[do] DOI:10.1371/journal.pone.0186374


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[PMID]:28635218
[Au] Autor:Lin L; Lu Q; Tang XY; Dai F; Wei JJ
[Ad] Endereço:Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University, Shanghai 200040, China.
[Ti] Título:[Nasal irrigation for the treatment of vasomotor rhinitis: a pilot study].
[So] Source:Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi;52(6):446-452, 2017 Jun 07.
[Is] ISSN:1673-0860
[Cp] País de publicação:China
[La] Idioma:chi
[Ab] Resumo:To observe the therapeutic effect of simple 3.0% saline nasal irrigation and combined treatment of 3.0% saline nasal irrigation and budesonide nasal spray for vasomotor rhinitis (VMR), and explore the long-term effect for VMR. Through examination of levels of substance P (SP) and mucin (MUC)5B in nasal lavage fluid, the mechanisms of nasal irrigation treatment for VMR was discussed. One hundred and one patients from Department of Otorhinolaryngology Head and Neck Surgery, Huashan Hospital of Fudan University with VMR were randomly divided into 4 groups. The number of patients was 24 in control group, 25 in budesonide nasal spray treatment group (budesonide group), 25 in nasal irrigation treatment group (nasal irrigation group) and 27 in budesonide nasal spray + nasal irrigation group (combined treatment group). Control patients were left untreated. Budesonide group was under budesonide nasal spray treatment, nasal irrigation group was treated using 3.0% saline with a temperature of 40℃ and combined treatment group was given both treatments. The duration of the intervention period was 3 months (90 days). Visual Analog Scale (VAS) was used to evaluate nasal symptoms, and the health-related quality of life was assessed using the 12-item Short Form Health Survey version 2.0 (SF-12v2). Enzyme-linked immunosorbent assay (ELISA) was used to assess the contents of SP and MUC5B in nasal lavage fluid before and after 3-month treatments in budesonide and nasal irrigation group in the study. MUC5B in nasal lavage fluid after the SP challenge and anticholinergic drug intervention in control group were also evaluated with ELISA. Nighty out of 101 patients completed the study. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 3.82±0.15, 6.18±0.17 3.92±0.15, value was 8.193, 10.060, respectively, all <0.05) and SF-12v2 score increased (146.00±1.23 152.30±0.97, 146.00±1.08 155.40±0.90, value was 3.982, 6.697, respectively, all <0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 5.72±0.15, 146.10±1.17 147.00±0.94, value was 1.038, 0.607, respectively, all >0.05) after the first month. In the budesonide and combined treatment group after relevant interventions, the total VAS score of nasal symptoms decreased (5.91±0.21 5.05±0.15, 6.18±0.17 5.10±0.12, value was 3.374, 5.351, respectively, all <0.05) and SF-12v2 score increased (146.00±1.23 150.90±0.76, 146.00±1.08 153.60±0.94, value was 3.373, 5.343, respectively, all <0.05), with both scores showed no significant differences in the nasal irrigation group (5.96±0.17 5.78±0.17, 146.10±1.17 148.10±0.80, value was 0.716, 1.438, respectively, all >0.05) after the second month. By the end of the third month, in nasal irrigation and combined treatment group, the VAS score was diminished (5.96±0.17 4.80±0.12, 6.18±0.17 4.44±0.13, value was 5.485, 8.264, respectively, all <0.05) and SF-12v2 score was elevated (146.10±1.17 150.80±0.96, 146.00±1.08 152.90±0.85, value was 3.163, 5.008, respectively, all <0.05), but there were no significant differences in budesonide group (5.91±0.21 5.68±0.18, 146.00±1.23 148.40±0.85, value was 0.819, 1.587, respectively, all >0.05). Additionally, SP in nasal lavage fluid decreased and MUC5B showed no statistical changes in budesonide group after three months, however, SP showed no any changes and MUC5B reduced significantly in nasal lavage fluid in nasal irrigation group. Furthermore, the anticholinergic drug could not decrease the concentration of MUC5B after the SP challenge in nasal cavity in control group. The therapeutic effect of simple nasal irrigation with 3.0% saline or combined treatment of 3.0% saline nasal irrigation and nasal corticosteroids is superior to simple nasal corticosteroids. Nasal corticosteroids plays a role in the inhibition of sensory nerve endings in nasal mucosa, but neurotransmitter plays a limited role in the pathogenesis of VMR.
[Mh] Termos MeSH primário: Anti-Inflamatórios/uso terapêutico
Budesonida/uso terapêutico
Lavagem Nasal/métodos
Rinite Vasomotora/terapia
[Mh] Termos MeSH secundário: Administração Intranasal
Adulto
Terapia Combinada/métodos
Ensaio de Imunoadsorção Enzimática
Feminino
Seres Humanos
Masculino
Mucina-5B/análise
Projetos Piloto
Qualidade de Vida
Cloreto de Sódio/uso terapêutico
Substância P/análise
Fatores de Tempo
Escala Visual Analógica
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Inflammatory Agents); 0 (Mucin-5B); 33507-63-0 (Substance P); 451W47IQ8X (Sodium Chloride); 51333-22-3 (Budesonide)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170906
[Lr] Data última revisão:
170906
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170622
[St] Status:MEDLINE
[do] DOI:10.3760/cma.j.issn.1673-0860.2017.06.010


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[PMID]:28602009
[Au] Autor:Snidvongs K; Thanaviratananich S
[Ad] Endereço:Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand. drkornkiat@yahoo.com.
[Ti] Título:Update on Intranasal Medications in Rhinosinusitis.
[So] Source:Curr Allergy Asthma Rep;17(7):47, 2017 Jul.
[Is] ISSN:1534-6315
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:This review describes beneficial effects and adverse events of various intranasal medications in treating rhinosinusitis. Application of intranasal steroids has been described in treating all subtypes of adult rhinosinusitis, but reports are limited in pediatrics and mostly in acute pediatric subgroups resulted in benefits While saline irrigation is effective for patients with chronic rhinosinusitis without polyps and in pediatric acute rhinosinusitis, there is no evidence yet for saline drips and sprays. Application of intranasal antifungals and nasal irrigation with surfactant brings more harm than benefits. There is no evidence supporting the use of intranasal antibiotics. We also review influence of devices, methods, and patient head position on nasal and paranasal sinus drug delivery.
[Mh] Termos MeSH primário: Antibacterianos/administração & dosagem
Antifúngicos/administração & dosagem
Rinite/tratamento farmacológico
Sinusite/tratamento farmacológico
[Mh] Termos MeSH secundário: Administração Intranasal
Animais
Antagonistas dos Receptores Histamínicos/administração & dosagem
Seres Humanos
Descongestionantes Nasais/administração & dosagem
Lavagem Nasal
Pólipos Nasais/tratamento farmacológico
Cloreto de Sódio/administração & dosagem
Esteroides/uso terapêutico
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Antifungal Agents); 0 (Histamine Antagonists); 0 (Nasal Decongestants); 0 (Steroids); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171107
[Lr] Data última revisão:
171107
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170612
[St] Status:MEDLINE
[do] DOI:10.1007/s11882-017-0720-3


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[PMID]:28583489
[Au] Autor:Gutiérrez-Cardona N; Sands P; Roberts G; Lucas JS; Walker W; Salib R; Burgess A; Ismail-Koch H
[Ad] Endereço:Faculty of Medicine, University of Southampton, Building 85, Life Sciences Building, Highfield Campus, Southampton, SO171BJ, United Kingdom. Electronic address: nag1e14@southamptonalumni.ac.uk.
[Ti] Título:The acceptability and tolerability of nasal douching in children with allergic rhinitis: A systematic review.
[So] Source:Int J Pediatr Otorhinolaryngol;98:126-135, 2017 Jul.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Allergic rhinitis (AR) is a significant issue in children. Treatment options include allergen avoidance, pharmacotherapy and immunotherapy. The use of nasal saline douching (NSD) in children has recently gained acceptability. However, there is limited data regarding the acceptability and tolerability of NSD in children with AR. METHODS: A search was conducted using Medline and Embase databases from January 1946 until June 2015 on the use of NSD in children aged 4-12 years with AR. All publications identified that assessed the beneficial effects, acceptability and tolerability were included. RESULTS: 40 studies were analyzed. Data varied considerably in terms of saline solutions used, modality of application, participant numbers, study design, follow up and outcomes. Factors that appear to influence the acceptability and tolerability of NSD include parental and health professionals' preconceptions, and characteristics of the solution. CONCLUSIONS: Nasal saline douching appears to be effective, being accepted and tolerated in the majority of children (78-100%). NSD has a significant positive impact on the quality of life in children with allergic rhinitis. When used as an adjunctive treatment having mainly a cleansing property, NSD potentiates the effects and may reduce the dose required of AR medications. Among the principal factors that influence the acceptability and tolerability of NSD are the child's age, delivery system and method, and tonicity. Nasal saline douching provides an accessible, low cost, low morbidity, easy to use treatment in children with allergic rhinitis.
[Mh] Termos MeSH primário: Lavagem Nasal/métodos
Aceitação pelo Paciente de Cuidados de Saúde/estatística & dados numéricos
Rinite Alérgica/terapia
Cloreto de Sódio/uso terapêutico
[Mh] Termos MeSH secundário: Alérgenos
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Lavagem Nasal/efeitos adversos
Qualidade de Vida
Cloreto de Sódio/efeitos adversos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Nm] Nome de substância:
0 (Allergens); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1707
[Cu] Atualização por classe:170718
[Lr] Data última revisão:
170718
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170607
[St] Status:MEDLINE


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[PMID]:28492494
[Au] Autor:Principi N; Esposito S
[Ad] Endereço:Pediatric Highly Intensive Care Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Università degli Studi di Milano, 20122 Milan, Italy. nicola.principi@unimi.it.
[Ti] Título:Nasal Irrigation: An Imprecisely Defined Medical Procedure.
[So] Source:Int J Environ Res Public Health;14(5), 2017 May 11.
[Is] ISSN:1660-4601
[Cp] País de publicação:Switzerland
[La] Idioma:eng
[Ab] Resumo:Nasal irrigation (NI) is an old practice of upper respiratory tract care that likely originated in the Ayurvedic medical tradition. It is used alone or in association with other therapies in several conditions-including chronic rhinosinusitis and allergic rhinitis-and to treat and prevent upper respiratory tract infections, especially in children. However, despite it being largely prescribed in everyday clinical practice, NI is not included or is only briefly mentioned by experts in the guidelines for treatment of upper respiratory tract diseases. In this review, present knowledge about NI and its relevance in clinical practice is discussed to assist physicians in understanding the available evidence and the potential use of this medical intervention. Analysis of the literature showed that NI seems to be effective in the treatment of several acute and chronic sinonasal conditions. However, although in recent years several new studies have been performed, most of the studies that have evaluated NI have relevant methodologic problems. Only multicenter studies enrolling a great number of subjects can solve the problem of the real relevance of NI, and these studies are urgently needed. Methods for performing NI have to be standardized to determine which solutions, devices and durations of treatment are adequate to obtain favorable results. This seems particularly important for children that suffer a great number of sinonasal problems and might benefit significantly from an inexpensive and simple preventive and therapeutic measure such as NI.
[Mh] Termos MeSH primário: Lavagem Nasal
Doenças Respiratórias/terapia
[Mh] Termos MeSH secundário: Seres Humanos
Lavagem Nasal/efeitos adversos
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171011
[Lr] Data última revisão:
171011
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170512
[St] Status:MEDLINE


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[PMID]:28403108
[Au] Autor:Cheng Y; Xue F; Wang TY; Ji JF; Chen W; Wang ZY; Xu L; Hang CH; Liu XF
[Ad] Endereço:aDepartment of Otolaryngology-Head and Neck Surgery bDepartment of Neurosurgery cDepartment of Neurology, Jinling Hospital, Nanjing, Jiangsu, China.
[Ti] Título:Analyses and treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms.
[So] Source:Medicine (Baltimore);96(15):e6614, 2017 Apr.
[Is] ISSN:1536-5964
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:In this study, we analyze and discuss the treatments of postoperative nasal complications after endonasal transsphenoidal resection of pituitary neoplasms (PNs). We performed 129 endonasal transsphenoidal resections of PNs and analyzed and treated cases with nasal complications. After endonasal transsphenoidal resection of PNs, there were 26 cases of postoperative nasal complications (20.1%), including nasal hemorrhage (4.8%), cerebrospinal fluid rhinorrhea (6.9%), sphenoid sinusitis (2.3%), atrophic rhinitis (1.6%), olfactory disorder (1.6%), perforation of nasal septum (0.8%), and nasal adhesion (2.3%). All patients clinically recovered after therapy, which included treatment of the cavity through nasal endoscopy, intranasal corticosteroids, and nasal irrigation. We propose that regular nasal endoscopic review, specific nasal medications, and regular nasal irrigation can effectively clear nasal mucosal hyperemia-induced edema and nasal/nasoantral secretions, as well as promote regeneration of nasal mucosa, prevent nasal adhesion, maintain the sinus cavity drainage, and accelerate the recovery of the physiological function of the paranasal sinus. Timely treatment of patients with nasal complications after endonasal transsphenoidal resections of PNs could greatly relieve the clinical symptoms. Nasal cleaning is very beneficial to patients after surgery recovery.
[Mh] Termos MeSH primário: Lavagem Nasal/métodos
Cirurgia Endoscópica por Orifício Natural/efeitos adversos
Doenças Nasais/terapia
Neoplasias Hipofisárias/cirurgia
Complicações Pós-Operatórias/terapia
[Mh] Termos MeSH secundário: Adolescente
Adulto
Assistência ao Convalescente/métodos
Idoso
Rinorreia de Líquido Cefalorraquidiano/etiologia
Rinorreia de Líquido Cefalorraquidiano/terapia
Criança
Epistaxe/etiologia
Epistaxe/terapia
Feminino
Seres Humanos
Masculino
Meia-Idade
Mucosa Nasal/patologia
Perfuração do Septo Nasal/etiologia
Perfuração do Septo Nasal/terapia
Procedimentos Cirúrgicos Nasais/métodos
Cirurgia Endoscópica por Orifício Natural/métodos
Nariz/lesões
Nariz/cirurgia
Doenças Nasais/etiologia
Doenças do Nervo Olfatório/etiologia
Doenças do Nervo Olfatório/terapia
Seios Paranasais/fisiopatologia
Complicações Pós-Operatórias/etiologia
Recuperação de Função Fisiológica
Estudos Retrospectivos
Rinite Atrófica/etiologia
Rinite Atrófica/terapia
Seio Esfenoidal/cirurgia
Sinusite Esfenoidal/etiologia
Sinusite Esfenoidal/terapia
Aderências Teciduais/etiologia
Aderências Teciduais/terapia
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1704
[Cu] Atualização por classe:170430
[Lr] Data última revisão:
170430
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170414
[St] Status:MEDLINE
[do] DOI:10.1097/MD.0000000000006614


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[PMID]:28224696
[Au] Autor:Ordemann AG; Stanford JK; Sullivan DC; Reed JM
[Ad] Endereço:Department of Otolaryngology and Communicative Sciences, University of Mississippi Medical Center, Jackson, Mississippi, U.S.A.
[Ti] Título:Can contaminated water be rendered safe for nasal saline irrigations?
[So] Source:Laryngoscope;127(7):1513-1519, 2017 Jul.
[Is] ISSN:1531-4995
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVES/HYPOTHESIS: To compare sterile water to three methods of sterilization (carbon filtration, boiling, and ultraviolet [UV] light) for preparation of nasal saline irrigants free of bacterial and amebic contaminants. STUDY DESIGN: Bench-top translational research and cost comparison. METHODS: Sterile water was compared to common sterilization methods. Sterile water was contaminated with known concentrations of Staphylococcus aureus, Pseudomonas aeruginosa, Moraxella catarrhalis, Acinetobacter baumannii, Klebsiella pneumonia, Legionella pneumophila, and Naegleria fowleri. Test samples were subjected to boiling, carbon filtration, or ultraviolet light (UV) and then cultivated on appropriate media. Controls included samples of sterile water (negative control) and untreated test samples (positive control). RESULTS: Carbon filtration reduced but did not eliminate the number of organisms present in test samples. Boiling test samples for 5 minutes and UV light treatment resulted in sterilization of all organisms. Negative (sham contaminated) samples produced no growth, whereas positive (untreated) samples grew numerous organisms as expected. A cost comparison between bottled water and UV water sterilization (with SteriPEN Ultra) became equal in less than 2 years of consistent use. CONCLUSIONS: Carbon filtration reduces contamination but does not sterilize water and is thus unsafe for preparation of nasal saline irrigant. Boiling and UV treatment resulted in sterilization and are equivalent to purchased sterile water. Ultraviolet treatment was found to be safe, convenient, and a cost-effective alternative to purchased sterile water. LEVEL OF EVIDENCE: NA Laryngoscope, 127:1513-1519, 2017.
[Mh] Termos MeSH primário: Carvão Vegetal
Filtros Microporos
Lavagem Nasal/métodos
Cloreto de Sódio
Esterilização/métodos
Microbiologia da Água
Poluição da Água
Purificação da Água/métodos
[Mh] Termos MeSH secundário: Carga Bacteriana
Seres Humanos
Pesquisa Médica Translacional
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
16291-96-6 (Charcoal); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170822
[Lr] Data última revisão:
170822
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170223
[St] Status:MEDLINE
[do] DOI:10.1002/lary.26538


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[PMID]:27853946
[Au] Autor:Yu MS; Kim BH; Kang SH; Lim DJ
[Ad] Endereço:Department of Otorhinolaryngology, Konkuk University Chungju Hospital, Konkuk University School of Medicine, Gugwon-daero 82, Chungju-si, Chungcheongbuk-do, 380-704, South Korea. dryums@kku.ac.kr.
[Ti] Título:Low-concentration hypochlorous acid nasal irrigation for chronic sinonasal symptoms: a prospective randomized placebo-controlled study.
[So] Source:Eur Arch Otorhinolaryngol;274(3):1527-1533, 2017 Mar.
[Is] ISSN:1434-4726
[Cp] País de publicação:Germany
[La] Idioma:eng
[Ab] Resumo:Low-concentration hypochlorous acid (HOCl) is an endogenous antibacterial and antiviral agent. The purpose of this study was to evaluate the effectiveness of HOCl irrigation in patients with chronic rhinosinusitis (CRS) refractory to medical therapy. Forty-three adult patients (mean age 45.5 years) were enrolled in this study. They were randomly chosen to receive nasal irrigation with either low-concentration HOCl generated by a Salicid device (n = 21), or a placebo (saline; n = 22) for 8 weeks. The outcome measures were scores on the 20-Item SinoNasal Outcome Test (SNOT-20), rhinosinusitis disability index (RSDI), nasal endoscopic score, and bacterial cultures. The SNOT-20 scores were significantly lower in the HOCl group than in the placebo group after 2 weeks of treatment (p < 0.05) and remained lower after 4 weeks of treatment. With respect to the RSDI scores, there was a significant improvement in the HOCl group at 1 week after treatment and in both groups at 2 weeks after treatment (p < 0.05). There were no significant differences in the endoscopic scores between the two groups after the treatment. The bacterial culture rates were lower in the HOCl group than in the placebo group after 4 weeks of treatment, but this was not significant (p > 0.05). Our results showed that low-concentration HOCl irrigation resulted in a greater improvement in CRS symptoms as compared to saline irrigation.
[Mh] Termos MeSH primário: Endoscopia/métodos
Ácido Hipocloroso
Rinite
Sinusite
Cloreto de Sódio
[Mh] Termos MeSH secundário: Adulto
Antibacterianos/administração & dosagem
Antibacterianos/farmacologia
Doença Crônica
Método Duplo-Cego
Feminino
Seres Humanos
Ácido Hipocloroso/administração & dosagem
Ácido Hipocloroso/farmacologia
Masculino
Meia-Idade
Cavidade Nasal/efeitos dos fármacos
Lavagem Nasal/instrumentação
Lavagem Nasal/métodos
Estudos Prospectivos
Rinite/diagnóstico
Rinite/terapia
Sinusite/diagnóstico
Sinusite/terapia
Cloreto de Sódio/administração & dosagem
Cloreto de Sódio/farmacologia
Resultado do Tratamento
[Pt] Tipo de publicação:JOURNAL ARTICLE; RANDOMIZED CONTROLLED TRIAL
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 451W47IQ8X (Sodium Chloride); 712K4CDC10 (Hypochlorous Acid)
[Em] Mês de entrada:1705
[Cu] Atualização por classe:170928
[Lr] Data última revisão:
170928
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161118
[St] Status:MEDLINE
[do] DOI:10.1007/s00405-016-4387-5


  9 / 215 MEDLINE  
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[PMID]:27826770
[Au] Autor:Ning Y; Huang H; Xue L; Zhao X
[Ad] Endereço:Department of Thoracic Surgery, Changzheng Hospital, Second Military Medical University, Shanghai, 200003, China.
[Ti] Título:Endobronchial Naso-bronchial Lavage: An Alternative Interventional Treatment for Post-lobectomy Bronchopleural Fistula.
[So] Source:World J Surg;41(3):785-789, 2017 Mar.
[Is] ISSN:1432-2323
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:BACKGROUND AND STUDY AIMS: Post-lobectomy bronchopleural fistula is a rare complication of lung resection surgery, and proper management is crucial for the successful resolution. Most published papers deal with surgical treatment. We report our experience with a new interventional management, endobronchial naso-bronchial lavage (ENBL). The aim of this study was to evaluate the continuing efficacy and safety of this innovative procedure. PATIENTS AND METHODS: From 2002 to 2012, 17 patients who suffered from post-lobectomy bronchopleural fistula were recruited. An ENBL tube was inserted form nostril through the trachea, bronchus and the fistula into the pleural cavity with bronchoscope. Lavage of the pleural cavity was proceeded form the ENBL tube and drained form thoracostomy drainage tube. All patients were followed up for at least 6 months. RESULT: All patients received total recovery from the post-lobectomy bronchopleural fistula. The ENBL procedure could be finished in 10-15 min. No blooding without control, pneumonia or damage of trachea associated with this procedure occurred. With an at least 6 months' follow-up of the patients, no further intervention was performed. CONCLUSIONS: It suggested that the ENBL may be an alternative interventional treatment for bronchopleural fistula treating other than surgical procedure.
[Mh] Termos MeSH primário: Fístula Brônquica/terapia
Lavagem Broncoalveolar
Fístula/terapia
Lavagem Nasal
Doenças Pleurais/terapia
Pneumonectomia/efeitos adversos
[Mh] Termos MeSH secundário: Fístula Brônquica/etiologia
Feminino
Fístula/etiologia
Seres Humanos
Masculino
Meia-Idade
Doenças Pleurais/etiologia
Complicações Pós-Operatórias/etiologia
Complicações Pós-Operatórias/terapia
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171109
[Lr] Data última revisão:
171109
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:161110
[St] Status:MEDLINE
[do] DOI:10.1007/s00268-016-3779-4


  10 / 215 MEDLINE  
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[PMID]:28078863
[Au] Autor:Gelardi M; Taliente S; Piccininni K; Silvestre G; Quaranta N; Ciprandi G
[Ad] Endereço:Department of Otolaryngology, University of Bari, Bari, Italy.
[Ti] Título:Nasal irrigation with Nasir® in children: a preliminary experience on nasal cytology.
[So] Source:J Biol Regul Homeost Agents;30(4):1125-1130, 2016 Oct-Dec.
[Is] ISSN:0393-974X
[Cp] País de publicação:Italy
[La] Idioma:eng
[Ab] Resumo:Allergic rhinitis (AR) and upper airway respiratory infections are frequent in children, and both have a relevant impact on some social aspects, including school attendance and performance, sleep, quality of life (also of the parents), and costs. Saline nasal irrigation is widely employed to reduce nasal congestion and mucopurulent secretion, to stimulate cleansing of the nasal and paranasal cavities, and to induce restoration of mucociliary clearance. The present study evaluated the effects of nasal irrigation on nasal cytology, using the new device Nasir® in 66 children (40 males, 26 females, mean age 7.31±1.7 years, age range 4-17 years) with allergic rhinitis. The patients were treated with nasal irrigation with warm (36°C) Nasir® (250 mL sacs of premixed solution): one sac twice daily for 12 days. Nasal irrigation significantly reduced the neutrophilic infiltrate (baseline median value 2.8±0.7; post treatment value 2±0.5; p less than 0.05). In addition, there was a reduction of eosinophil infiltrate (T0= 3.2±1.1; T1= 2.6±1.2; p= less than 0.05). There was no significant change with regard to bacteria (T0= 2.7±0.9; T1= 2.3±1.02; p= 0.17). In conclusion, this pilot study reports that nasal irrigation with Nasir® might be useful to attenuate upper airway inflammation.
[Mh] Termos MeSH primário: Lavagem Nasal/instrumentação
Rinite Alérgica/terapia
Cloreto de Sódio/uso terapêutico
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Soluções Isotônicas/uso terapêutico
Masculino
Projetos Piloto
[Pt] Tipo de publicação:CLINICAL TRIAL; LETTER
[Nm] Nome de substância:
0 (Isotonic Solutions); 451W47IQ8X (Sodium Chloride)
[Em] Mês de entrada:1703
[Cu] Atualização por classe:170316
[Lr] Data última revisão:
170316
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170113
[St] Status:MEDLINE



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