Biến đổi khí hậu, nhiệt độ thay đổi thất thường làm ảnh hưởng nghiêm trọng đến đường hô hấp, đặc biệt là các triệu chứng về bệnh viêm mũi dị ứng thời tiết. Thời tiết là một tác nhân khách quan mà chúng ta không thể nào tránh được, nên cách tốt nhất là hãy tự bảo vệ bản thân mình. Vậy thực chất bệnh viêm mũi dị ứng thời tiết là gì? Làm cách nào để thoát khỏi loại bệnh này? Hãy tìm hiểu cùng chúng tôi cách điều trị viêm mũi dị ứng do thời tiết ngay tại nhà cực kỳ an toàn và hiệu quả.
Nguồn: Trích https://venusglobal.com.vn/viem-mui-di-ung-thoi-tiet/
#viêm_mũi_dị_ứng_thời_tiết
#cách_chữa_viêm_mũi_dị_ứng_thời_tiết
#cách_trị_viêm_mũi_dị_ứng_thời_tiết
#cách_chữa_bệnh_viêm_mũi_dị_ứng_thời_tiết
#viêm_xoang_sàng_hàm_mạn_tính
#chữa_viêm_mũi_dị_ứng_thời_tiết
This document provides an overview of allergic rhinitis, including its definition, symptoms, epidemiology, etiology, pathophysiology, diagnosis, and treatment approaches. Some key points:
- Allergic rhinitis is an IgE-mediated inflammatory disease of the nose induced by exposure to allergens, characterized by symptoms like sneezing, nasal discharge, and congestion.
- Genetic and environmental factors like pollution, infections, and diet influence one's risk. Common allergens include dust mites, animal dander, and pollen.
- Upon allergen exposure, IgE antibodies are produced, and subsequent exposures lead to degranulation of mast cells and basophils
The document discusses immunotherapy for allergic rhinitis. It provides evidence that sublingual immunotherapy (SLIT) is effective for treating allergic rhinitis based on multiple meta-analyses and clinical studies. SLIT significantly reduces rhinitis symptoms and medication use compared to placebo. While local reactions are common, systemic reactions are rare with SLIT. The efficacy of SLIT is comparable to subcutaneous immunotherapy and certain pharmacotherapies but SLIT has a better safety profile. SLIT may also be more cost-effective long-term due to the reduced need for symptomatic drugs.
This document provides an overview of allergic rhinitis. It defines allergic rhinitis as an IgE-mediated hypersensitivity disease characterized by sneezing, nasal discharge and obstruction. The document notes that allergic rhinitis prevalence is 15-20% globally, with higher rates in children. It affects quality of life by impacting school/work performance. Risk factors include genetics, family history of atopy, environmental irritants and allergens. Diagnosis involves history, exam, skin prick tests and blood tests. Management includes environmental control, nasal irrigation, medications like antihistamines, decongestants, steroids and immunotherapy.
This document discusses occupational disorders such as occupational asthma. Some key points are: occupational asthma accounts for about 15% of new asthma cases in adults and results in over 1 million disability cases annually. Diagnosis involves a work history and objective tests like spirometry. Treatment involves avoiding the causal agent, though symptoms may persist, as well as medications like inhaled corticosteroids. The prognosis is generally poor, with only 1/3 achieving long-term recovery even after avoiding exposure.
The document discusses work-related asthma and occupational lung diseases. It notes that 9-15% of adult asthma cases are work-related, caused by allergic responses to sensitizing agents. Up to 20% of adult asthma may be work-exacerbated or work-induced. Occupational asthma can be caused by sensitizers or irritants and includes conditions like reactive airways dysfunction syndrome. A diagnostic approach involves spirometry, tests of non-specific bronchial hyperreactivity, and specific inhalation challenges.
This document discusses occupational asthma, beginning with a definition of asthma as a chronic inflammatory airway disorder causing wheezing, breathlessness and coughing. It describes the different types of occupational asthma including extrinsic, intrinsic, work-related and work-aggravated. Extrinsic asthma is mediated by an IgE response while intrinsic is not antigen specific. Common occupational agents that can cause asthma are discussed including metal working fluids, isocyanates, cleaning agents, carpets and flour. Signs and symptoms, diagnosis and management of occupational asthma are also summarized.
Occupational asthma (OA) is a form of asthma caused by inhalation of allergens or irritants in the workplace. There are two main mechanisms for OA - immunologic sensitization which occurs after prolonged exposure to workplace allergens, and exposure to high levels of irritants with little latency period. Diagnosis is based on a history of asthma symptoms in the workplace and pulmonary function tests showing obstruction. Prevention focuses on educating workers and managers about risks to allow early identification of affected individuals.
A description of Work related asthma, Occupational Asthma and Work exacerbated asthma
References: Murray and Nadel's Textbook of Respiratory Medicine
American College of Chest Physicians 2008 Consensus Statement
Hope you find it useful.
This document provides an overview of allergic rhinitis, including its definition, symptoms, epidemiology, etiology, pathophysiology, diagnosis, and treatment approaches. Some key points:
- Allergic rhinitis is an IgE-mediated inflammatory disease of the nose induced by exposure to allergens, characterized by symptoms like sneezing, nasal discharge, and congestion.
- Genetic and environmental factors like pollution, infections, and diet influence one's risk. Common allergens include dust mites, animal dander, and pollen.
- Upon allergen exposure, IgE antibodies are produced, and subsequent exposures lead to degranulation of mast cells and basophils
The document discusses immunotherapy for allergic rhinitis. It provides evidence that sublingual immunotherapy (SLIT) is effective for treating allergic rhinitis based on multiple meta-analyses and clinical studies. SLIT significantly reduces rhinitis symptoms and medication use compared to placebo. While local reactions are common, systemic reactions are rare with SLIT. The efficacy of SLIT is comparable to subcutaneous immunotherapy and certain pharmacotherapies but SLIT has a better safety profile. SLIT may also be more cost-effective long-term due to the reduced need for symptomatic drugs.
This document provides an overview of allergic rhinitis. It defines allergic rhinitis as an IgE-mediated hypersensitivity disease characterized by sneezing, nasal discharge and obstruction. The document notes that allergic rhinitis prevalence is 15-20% globally, with higher rates in children. It affects quality of life by impacting school/work performance. Risk factors include genetics, family history of atopy, environmental irritants and allergens. Diagnosis involves history, exam, skin prick tests and blood tests. Management includes environmental control, nasal irrigation, medications like antihistamines, decongestants, steroids and immunotherapy.
This document discusses occupational disorders such as occupational asthma. Some key points are: occupational asthma accounts for about 15% of new asthma cases in adults and results in over 1 million disability cases annually. Diagnosis involves a work history and objective tests like spirometry. Treatment involves avoiding the causal agent, though symptoms may persist, as well as medications like inhaled corticosteroids. The prognosis is generally poor, with only 1/3 achieving long-term recovery even after avoiding exposure.
The document discusses work-related asthma and occupational lung diseases. It notes that 9-15% of adult asthma cases are work-related, caused by allergic responses to sensitizing agents. Up to 20% of adult asthma may be work-exacerbated or work-induced. Occupational asthma can be caused by sensitizers or irritants and includes conditions like reactive airways dysfunction syndrome. A diagnostic approach involves spirometry, tests of non-specific bronchial hyperreactivity, and specific inhalation challenges.
This document discusses occupational asthma, beginning with a definition of asthma as a chronic inflammatory airway disorder causing wheezing, breathlessness and coughing. It describes the different types of occupational asthma including extrinsic, intrinsic, work-related and work-aggravated. Extrinsic asthma is mediated by an IgE response while intrinsic is not antigen specific. Common occupational agents that can cause asthma are discussed including metal working fluids, isocyanates, cleaning agents, carpets and flour. Signs and symptoms, diagnosis and management of occupational asthma are also summarized.
Occupational asthma (OA) is a form of asthma caused by inhalation of allergens or irritants in the workplace. There are two main mechanisms for OA - immunologic sensitization which occurs after prolonged exposure to workplace allergens, and exposure to high levels of irritants with little latency period. Diagnosis is based on a history of asthma symptoms in the workplace and pulmonary function tests showing obstruction. Prevention focuses on educating workers and managers about risks to allow early identification of affected individuals.
A description of Work related asthma, Occupational Asthma and Work exacerbated asthma
References: Murray and Nadel's Textbook of Respiratory Medicine
American College of Chest Physicians 2008 Consensus Statement
Hope you find it useful.
Chất lượng sống không còn được đảm bảo, môi trường ngày càng ô nhiễm, thời tiết thất thường, chính những yếu tố khách quan này khiến căn bệnh viêm mũi dị ứng ngày càng phổ biến trong cộng đồng. Vậy chúng ta cần làm gì để phòng tránh? Căn bệnh viêm mũi dị ứng nguy hiểm như thế nào? Cùng chúng tôi tìm hiểu về căn bệnh này ngay sau đây!
Nguồn: Trích https://venusglobal.com.vn/viem-mui-di-ung/
#viêm_mũi_dị_ứng
#viêm_mũi_họng_dị_ứng
#viêm_mũi_dị_ứng_là_gì
#triệu_chứng_viêm_mũi_dị_ứng
#bị_viêm_mũi_dị_ứng
#triệu_chứng_của_viêm_mũi_dị_ứng
Allergic rhinitis is an inflammation of the nasal mucosa caused by an immunoglobulin E-mediated response to airborne allergens like pollen and dander. Common symptoms include nasal congestion, sneezing, runny nose, and watery eyes. Diagnosis involves skin prick tests or radioallergosorbent tests to identify allergen triggers. Treatment focuses on pharmacotherapy with intranasal corticosteroids and oral antihistamines as first-line options, immunotherapy for long-term management, and environmental control measures to avoid allergens.
1) Allergic rhinitis (AR) is a common condition that affects millions of people in the US. It imposes a significant economic burden due to direct and indirect medical costs.
2) The diagnosis of AR can often be made based on a patient's symptoms of sneezing, rhinorrhea, nasal congestion, and watery eyes. It is important to differentiate between seasonal and perennial AR.
3) Other conditions like sinusitis and non-allergic rhinitis should also be considered in patients with nasal symptoms. Examination may reveal signs of conditions like asthma that commonly accompany AR.
Allergic rhinitis and asthma are linked airway diseases that share common inflammatory pathways. Both conditions involve inflammation of the respiratory mucosa and similar inflammatory cells and mediators. Up to 88% of asthma patients also have allergic rhinitis, and allergic rhinitis is a risk factor for the development of asthma. Symptoms of allergic rhinitis and asthma correlate with the early and late phase inflammatory responses in both conditions. Treatment of rhinitis may help control asthma symptoms and reduce exacerbations.
The A to Z of AR management-A comprehensive overview (1).pptxAmberkesarwani1
The document provides an overview of allergic rhinitis (AR) including:
- AR affects 10-25% of the global population and 20-30% in India. The burden is large as it constitutes about 55% of all allergies.
- AR is classified based on symptom duration and severity. Diagnosis involves assessing symptoms, history, and physical exam findings. Tests include allergen tests, nasal provocation tests, and examining nasal cytology.
- Treatment involves intranasal corticosteroids, oral/intranasal antihistamines, leukotriene receptor antagonists, immunotherapy, and symptom-based approaches. The ARIA guideline recommends a step-up treatment approach based
Asthma is a chronic inflammatory disease of the airways that affects over 300 million people worldwide. It is characterized by airway hyperresponsiveness and reversible airway obstruction. The pathogenesis involves various inflammatory cells and mediators that cause symptoms such as coughing, wheezing, and shortness of breath. Asthma has both genetic and environmental triggers, and can range from mild to severe. Spirometry is used to diagnose and monitor asthma, along with assessing response to treatments. The goals of treatment are asthma control through reducing symptoms and exacerbations.
This document provides information about allergic rhinitis. It defines allergic rhinitis as an inflammatory disorder of the nasal mucosa initiated by an IgE-mediated hypersensitivity. It then discusses the epidemiology, noting it is a common global health problem increasing in prevalence, especially in children and young adults. Risk factors include genetics, family history, environment, and comorbid conditions like asthma. The pathophysiology involves sensitization, early and late phase responses, and systemic activation mediated by IgE, mast cells, eosinophils, and other inflammatory cells and mediators. Diagnosis is based on symptoms, examination, and diagnostic tests like skin prick tests and immunoassays to demonstrate allergen-specific Ig
Allergic rhinitis, or hay fever, is a common condition affecting 10-25% of the global population. It is an inflammation of the nasal passages caused by an immune system response to allergens like pollen, dust mites, or pet dander. Symptoms include sneezing, nasal congestion, runny nose, and itchy eyes. Allergic rhinitis can impair quality of life and work or school performance. Intranasal corticosteroids are the most effective treatment for both intermittent and persistent allergic rhinitis. The ARIA guidelines recommend intranasal corticosteroids as first-line treatment alone or in combination with oral antihistamines depending on the severity
Allergic rhinitis involves inflammation of the nasal mucosa triggered by an IgE-mediated response to allergens. It is very common, affecting about 40 million people in the US, with onset typically occurring in childhood. Symptoms include sneezing, rhinorrhea, nasal congestion and itchiness. Management involves allergen avoidance, pharmacotherapy like antihistamines and intranasal corticosteroids, and immunotherapy. Allergic rhinitis can negatively impact quality of life and is associated with increased risk of conditions like asthma and sinusitis.
Allergic rhinitis is an IgE-mediated inflammation of the nasal mucosa induced by exposure to allergens. It is characterized by sneezing, nasal obstruction, rhinorrhea and nasal itching. Seasonal allergic rhinitis symptoms are triggered by pollen allergens during specific seasons, while perennial allergic rhinitis symptoms are present throughout the year. Diagnosis involves a clinical history and examination, skin prick testing, and nasal smears showing eosinophilia. Treatment includes avoidance of allergens, oral antihistamines, intranasal corticosteroids, leukotriene receptor antagonists, and immunotherapy for persistent or severe cases.
Allergic rhinitis is a common chronic inflammatory disease of the nasal mucosa affecting 10-20% of the population. It is caused by an IgE-mediated response to airborne allergens like dust mites, pollen, and animal dander. Symptoms include rhinorrhea, nasal congestion, sneezing, and itching. Allergic rhinitis is classified based on symptom duration and severity. Treatment involves avoidance of triggers, oral antihistamines, intranasal corticosteroids, and immunotherapy to relieve symptoms and inflammation. Allergic rhinitis and asthma often co-exist as part of a combined airway inflammatory disease.
Seasonal allergic rhinitis, also known as hay fever, refers to nasal inflammation and symptoms that occur during specific seasons in response to outdoor airborne allergens such as pollen. It is distinguished from perennial allergic rhinitis which occurs year-round. There is often overlap between the two conditions. Allergic rhinitis is associated with asthma, and inflammation in the nose can lead to changes in the lower airways. Treatment involves allergen avoidance and medications such as antihistamines, decongestants and corticosteroids.
This document discusses an approach to cough management. It begins by describing cough as both a defense mechanism and a factor in disease spread. It then outlines the most common causes of acute and chronic cough, including postnasal drip syndrome, asthma, and gastroesophageal reflux disease. The document proposes a 6-step empiric treatment algorithm beginning with treating postnasal drip and proceeding through evaluations and treatments for asthma, chest abnormalities, GERD, and less common causes before considering psychogenic cough.
The ARIA initiative was developed in collaboration with the World Health Organization to provide evidence-based guidelines for diagnosing and treating allergic rhinitis. The goals of ARIA were to update healthcare professionals' knowledge of rhinitis, highlight its impact on asthma, provide guidance on diagnosis and treatment options, and propose a stepwise management approach. ARIA developed evidence-based guidelines in 1999 and produced additional materials to help improve rhinitis care delivery, particularly in developing countries where rhinitis prevalence is high.
Allergic rhinitis is an inflammation of the nasal passages caused by an immune response to common allergens like pollen, dust mites, or animal dander. It affects about 1 in 5 people in the UK and causes symptoms like sneezing, nasal congestion, and watery eyes. While it is usually diagnosed based on symptoms, skin or blood tests can help identify specific allergens. Treatment involves avoidance of triggers, oral antihistamines, intranasal corticosteroids, and immunotherapy for severe cases. Referral to an ENT specialist is recommended if symptoms persist despite treatment or if red flags for other conditions are present.
This document discusses nonallergic rhinitis, specifically vasomotor rhinitis. It defines vasomotor rhinitis as chronic nasal symptoms that are not due to allergies or infections. Vasomotor rhinitis accounts for at least two-thirds of nonallergic rhinitis cases. Symptoms are triggered by factors like cold air, odors, and alcohol. While the nasal mucosa shows no inflammation, the condition involves increased reactivity to irritants and sensory nerve dysregulation. Symptoms include nasal obstruction and rhinorrhea. Treatment focuses on reducing triggers and using nasal irrigation, decongestants, and antihistamines.
This document discusses non-invasive tests for diagnosing and monitoring asthma, focusing on exhaled nitric oxide (eNO) measurement. It describes how eNO levels are elevated in asthmatic patients due to airway inflammation and correlate with tissue eosinophils. The document outlines the procedure for measuring eNO according to guidelines and how it can help diagnose asthma, monitor treatment response, and detect different asthma phenotypes in a safe, repeatable way without invasive procedures.
Kính chào tất cả mọi người. Tổng hợp 23 loại trái cây giảm cân, giữ dáng, dưỡng da hiệu quả, cung cấp dưỡng chất cho cơ thể. Truy cập vào bài viết để biết thông tin chi tiết!
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#trái_cây_giảm_cân
#những_loại_trái_cây_giúp_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/trai-cay-giam-can/
Kính chào tất cả mọi người. Gợi ý 6 cách nhịn ăn giảm cân không hại đến sức khỏe. Những lưu ý quan trọng khi nhịn ăn giảm cân mà bạn cần nắm rõ
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#cách_nhịn_ăn_giảm_cân
#nhin_an_giam_can_hieu_qua
#VENUSGLOBAL
https://venusglobal.com.vn/cach-nhin-an-giam-can/
More Related Content
Similar to Triệu chứng viêm mũi dị ứng thời tiết | Venus Global
Chất lượng sống không còn được đảm bảo, môi trường ngày càng ô nhiễm, thời tiết thất thường, chính những yếu tố khách quan này khiến căn bệnh viêm mũi dị ứng ngày càng phổ biến trong cộng đồng. Vậy chúng ta cần làm gì để phòng tránh? Căn bệnh viêm mũi dị ứng nguy hiểm như thế nào? Cùng chúng tôi tìm hiểu về căn bệnh này ngay sau đây!
Nguồn: Trích https://venusglobal.com.vn/viem-mui-di-ung/
#viêm_mũi_dị_ứng
#viêm_mũi_họng_dị_ứng
#viêm_mũi_dị_ứng_là_gì
#triệu_chứng_viêm_mũi_dị_ứng
#bị_viêm_mũi_dị_ứng
#triệu_chứng_của_viêm_mũi_dị_ứng
Allergic rhinitis is an inflammation of the nasal mucosa caused by an immunoglobulin E-mediated response to airborne allergens like pollen and dander. Common symptoms include nasal congestion, sneezing, runny nose, and watery eyes. Diagnosis involves skin prick tests or radioallergosorbent tests to identify allergen triggers. Treatment focuses on pharmacotherapy with intranasal corticosteroids and oral antihistamines as first-line options, immunotherapy for long-term management, and environmental control measures to avoid allergens.
1) Allergic rhinitis (AR) is a common condition that affects millions of people in the US. It imposes a significant economic burden due to direct and indirect medical costs.
2) The diagnosis of AR can often be made based on a patient's symptoms of sneezing, rhinorrhea, nasal congestion, and watery eyes. It is important to differentiate between seasonal and perennial AR.
3) Other conditions like sinusitis and non-allergic rhinitis should also be considered in patients with nasal symptoms. Examination may reveal signs of conditions like asthma that commonly accompany AR.
Allergic rhinitis and asthma are linked airway diseases that share common inflammatory pathways. Both conditions involve inflammation of the respiratory mucosa and similar inflammatory cells and mediators. Up to 88% of asthma patients also have allergic rhinitis, and allergic rhinitis is a risk factor for the development of asthma. Symptoms of allergic rhinitis and asthma correlate with the early and late phase inflammatory responses in both conditions. Treatment of rhinitis may help control asthma symptoms and reduce exacerbations.
The A to Z of AR management-A comprehensive overview (1).pptxAmberkesarwani1
The document provides an overview of allergic rhinitis (AR) including:
- AR affects 10-25% of the global population and 20-30% in India. The burden is large as it constitutes about 55% of all allergies.
- AR is classified based on symptom duration and severity. Diagnosis involves assessing symptoms, history, and physical exam findings. Tests include allergen tests, nasal provocation tests, and examining nasal cytology.
- Treatment involves intranasal corticosteroids, oral/intranasal antihistamines, leukotriene receptor antagonists, immunotherapy, and symptom-based approaches. The ARIA guideline recommends a step-up treatment approach based
Asthma is a chronic inflammatory disease of the airways that affects over 300 million people worldwide. It is characterized by airway hyperresponsiveness and reversible airway obstruction. The pathogenesis involves various inflammatory cells and mediators that cause symptoms such as coughing, wheezing, and shortness of breath. Asthma has both genetic and environmental triggers, and can range from mild to severe. Spirometry is used to diagnose and monitor asthma, along with assessing response to treatments. The goals of treatment are asthma control through reducing symptoms and exacerbations.
This document provides information about allergic rhinitis. It defines allergic rhinitis as an inflammatory disorder of the nasal mucosa initiated by an IgE-mediated hypersensitivity. It then discusses the epidemiology, noting it is a common global health problem increasing in prevalence, especially in children and young adults. Risk factors include genetics, family history, environment, and comorbid conditions like asthma. The pathophysiology involves sensitization, early and late phase responses, and systemic activation mediated by IgE, mast cells, eosinophils, and other inflammatory cells and mediators. Diagnosis is based on symptoms, examination, and diagnostic tests like skin prick tests and immunoassays to demonstrate allergen-specific Ig
Allergic rhinitis, or hay fever, is a common condition affecting 10-25% of the global population. It is an inflammation of the nasal passages caused by an immune system response to allergens like pollen, dust mites, or pet dander. Symptoms include sneezing, nasal congestion, runny nose, and itchy eyes. Allergic rhinitis can impair quality of life and work or school performance. Intranasal corticosteroids are the most effective treatment for both intermittent and persistent allergic rhinitis. The ARIA guidelines recommend intranasal corticosteroids as first-line treatment alone or in combination with oral antihistamines depending on the severity
Allergic rhinitis involves inflammation of the nasal mucosa triggered by an IgE-mediated response to allergens. It is very common, affecting about 40 million people in the US, with onset typically occurring in childhood. Symptoms include sneezing, rhinorrhea, nasal congestion and itchiness. Management involves allergen avoidance, pharmacotherapy like antihistamines and intranasal corticosteroids, and immunotherapy. Allergic rhinitis can negatively impact quality of life and is associated with increased risk of conditions like asthma and sinusitis.
Allergic rhinitis is an IgE-mediated inflammation of the nasal mucosa induced by exposure to allergens. It is characterized by sneezing, nasal obstruction, rhinorrhea and nasal itching. Seasonal allergic rhinitis symptoms are triggered by pollen allergens during specific seasons, while perennial allergic rhinitis symptoms are present throughout the year. Diagnosis involves a clinical history and examination, skin prick testing, and nasal smears showing eosinophilia. Treatment includes avoidance of allergens, oral antihistamines, intranasal corticosteroids, leukotriene receptor antagonists, and immunotherapy for persistent or severe cases.
Allergic rhinitis is a common chronic inflammatory disease of the nasal mucosa affecting 10-20% of the population. It is caused by an IgE-mediated response to airborne allergens like dust mites, pollen, and animal dander. Symptoms include rhinorrhea, nasal congestion, sneezing, and itching. Allergic rhinitis is classified based on symptom duration and severity. Treatment involves avoidance of triggers, oral antihistamines, intranasal corticosteroids, and immunotherapy to relieve symptoms and inflammation. Allergic rhinitis and asthma often co-exist as part of a combined airway inflammatory disease.
Seasonal allergic rhinitis, also known as hay fever, refers to nasal inflammation and symptoms that occur during specific seasons in response to outdoor airborne allergens such as pollen. It is distinguished from perennial allergic rhinitis which occurs year-round. There is often overlap between the two conditions. Allergic rhinitis is associated with asthma, and inflammation in the nose can lead to changes in the lower airways. Treatment involves allergen avoidance and medications such as antihistamines, decongestants and corticosteroids.
This document discusses an approach to cough management. It begins by describing cough as both a defense mechanism and a factor in disease spread. It then outlines the most common causes of acute and chronic cough, including postnasal drip syndrome, asthma, and gastroesophageal reflux disease. The document proposes a 6-step empiric treatment algorithm beginning with treating postnasal drip and proceeding through evaluations and treatments for asthma, chest abnormalities, GERD, and less common causes before considering psychogenic cough.
The ARIA initiative was developed in collaboration with the World Health Organization to provide evidence-based guidelines for diagnosing and treating allergic rhinitis. The goals of ARIA were to update healthcare professionals' knowledge of rhinitis, highlight its impact on asthma, provide guidance on diagnosis and treatment options, and propose a stepwise management approach. ARIA developed evidence-based guidelines in 1999 and produced additional materials to help improve rhinitis care delivery, particularly in developing countries where rhinitis prevalence is high.
Allergic rhinitis is an inflammation of the nasal passages caused by an immune response to common allergens like pollen, dust mites, or animal dander. It affects about 1 in 5 people in the UK and causes symptoms like sneezing, nasal congestion, and watery eyes. While it is usually diagnosed based on symptoms, skin or blood tests can help identify specific allergens. Treatment involves avoidance of triggers, oral antihistamines, intranasal corticosteroids, and immunotherapy for severe cases. Referral to an ENT specialist is recommended if symptoms persist despite treatment or if red flags for other conditions are present.
This document discusses nonallergic rhinitis, specifically vasomotor rhinitis. It defines vasomotor rhinitis as chronic nasal symptoms that are not due to allergies or infections. Vasomotor rhinitis accounts for at least two-thirds of nonallergic rhinitis cases. Symptoms are triggered by factors like cold air, odors, and alcohol. While the nasal mucosa shows no inflammation, the condition involves increased reactivity to irritants and sensory nerve dysregulation. Symptoms include nasal obstruction and rhinorrhea. Treatment focuses on reducing triggers and using nasal irrigation, decongestants, and antihistamines.
This document discusses non-invasive tests for diagnosing and monitoring asthma, focusing on exhaled nitric oxide (eNO) measurement. It describes how eNO levels are elevated in asthmatic patients due to airway inflammation and correlate with tissue eosinophils. The document outlines the procedure for measuring eNO according to guidelines and how it can help diagnose asthma, monitor treatment response, and detect different asthma phenotypes in a safe, repeatable way without invasive procedures.
Similar to Triệu chứng viêm mũi dị ứng thời tiết | Venus Global (20)
Kính chào tất cả mọi người. Tổng hợp 23 loại trái cây giảm cân, giữ dáng, dưỡng da hiệu quả, cung cấp dưỡng chất cho cơ thể. Truy cập vào bài viết để biết thông tin chi tiết!
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#trái_cây_giảm_cân
#những_loại_trái_cây_giúp_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/trai-cay-giam-can/
Kính chào tất cả mọi người. Gợi ý 6 cách nhịn ăn giảm cân không hại đến sức khỏe. Những lưu ý quan trọng khi nhịn ăn giảm cân mà bạn cần nắm rõ
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#cách_nhịn_ăn_giảm_cân
#nhin_an_giam_can_hieu_qua
#VENUSGLOBAL
https://venusglobal.com.vn/cach-nhin-an-giam-can/
Kính chào tất cả mọi người. Bí quyết giảm cân thông dụng nhất. Những thói quen hàng ngày cũng có thể giúp bạn giảm cân. Nhấn vào bài viết để tìm hiểu ngay.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#bí_quyết_giảm_cân
#bí_quyết_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/bi-quyet-giam-can/
Kính chào tất cả mọi người. Uống thuốc giảm cân có hiệu quả? Thuốc giảm mỡ bụng nào tốt nhất trên thị trường. Cùng Venus tìm hiểu qua bài viết dưới đây.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#thuốc_giảm_mỡ_bụng
#sản_phẩm_giảm_mỡ_bụng
#VENUSGLOBAL
https://venusglobal.com.vn/thuoc-giam-mo-bung/
Tập gym giảm cân
Kính chào tất cả mọi người. Tập gym giảm cân như thế nào cho đúng cách và hiệu quả tốt nhất? Giáo án tập gym giúp giảm cân hiệu quả chỉ trong 7 ngày.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#tập_gym_giảm_cân
#tập_gym_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/tap-gym-giam-can/
Kính chào tất cả mọi người. Tổng hợp 9 phương pháp giảm cân trong 1 tuần đơn giản - hiệu quả - an toàn nhất. Truy cập vào bài viết để biết thêm thông tin chi tiết
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#giảm_cân_trong_1_tuần
#cách_giảm_cân_hiệu_quả_trong_1_tuần
#VENUSGLOBAL
https://venusglobal.com.vn/giam-can-trong-1-tuan/
Kính chào tất cả mọi người. Hướng dẫn 11 cách làm ngũ cốc giảm cân đơn giản tại nhà giúp bổ sung đủ dinh dưỡng mà vẫn giảm cân hiệu quả
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#cách_làm_ngũ_cốc_giảm_cân
#cách_làm_bột_giảm_cân
#VENUSGLOBAL
https://venusglobal.com.vn/cach-lam-ngu-coc-giam-can/
Kính chào tất cả mọi người. Nhập môn cùng các bài tập yoga giảm cân đơn giản, lấy lại thân hình thon gọn, vóc dáng chuẩn nhanh chóng. Tìm hiểu ngay bài viết để biết cụ thể hơn.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#tập_yoga_giảm_cân
#bài_tập_yoga_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/tap-yoga-giam-can/
Detox giảm cân
Kính chào tất cả mọi người. Bạn muốn giảm cân? Lưu ngay 21 loại nước detox đào thải mỡ thừa, làm đẹp da an toàn và hiệu quả tại nhà.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#detox_giảm_cân
#nước_detox_giảm_cân_đẹp_da
#VENUSGLOBAL
https://venusglobal.com.vn/detox-giam-can/
Kính chào tất cả mọi người. Thực phẩm giàu chất xơ giảm cân được nhiều gymer ưa chuộng. Bạn đang muốn lên kế hoạch ăn kiêng? Xem ngay bài viết để giải quyết vấn đề này.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#thực_phẩm_giàu_chất_xơ_giảm_cân
#VENUSGLOBAL
https://venusglobal.com.vn/thuc-pham-giau-chat-xo-giam-can/
Kính chào tất cả mọi người. Bạn đang cần tìm một giải pháp giảm cân an toàn nhưng vẫn đảm bảo dưỡng chất cho cơ thể? Cùng Venus tìm hiểu ngay một số loại sinh tố giảm cân
ngon- bổ- rẻ.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#sinh_tố_giảm_cân
#các_loại_sinh_tố_giảm_cân_đẹp_da
#VENUSGLOBAL
https://venusglobal.com.vn/sinh-to-giam-can/
Kính chào tất cả mọi người. Uống nước cũng có thể giảm cân? Những loại nước uống giảm cân thần thánh mà bạn không biết sẽ được Venus tổng hợp và chia sẻ trong bài viết.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#nước_uống_giảm_cân
#nước_uống_giảm_cân_đẹp_da
#VENUSGLOBAL
https://venusglobal.com.vn/nuoc-uong-giam-can-hieu-qua/
Kính chào tất cả mọi người. Ăn kiêng nên dùng rau gì? Bạn đang cần tìm những thực phẩm đảm bảo dưỡngchất nhưng không lo tăng cân. Tìm hiểu các loại rau giảm cân an toàn qua
bài viết ngay!
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#rau_giảm_cân
#các_loại_rau_giảm_cân_hiệu_quả
#VENUSGLOBAL
https://venusglobal.com.vn/rau-giam-can/
Kính chào tất cả mọi người. Bạn đã biết đến 6 bài tập giảm cân cực hiệu quả này hay chưa? Hãy tham khảo ngay để nhanh chóng sở hữu vóc dáng mong muốn cùng Venus
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#bài_tập_giảm_cân
#the_duc_giam_can_hieu_qua
#VENUSGLOBAL
https://venusglobal.com.vn/bai-tap-giam-can-hieu-qua/
Kính chào tất cả mọi người. Ăn chay có gây mập không? Tìm hiểu cách ăn chay giảm cân đẹp da hiệu quả cao? Gợi ý thực đơn chay ngon miệng, giảm cân hiệu quả trong 1 tuần
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#ăn_chay_giảm_cân_đẹp_da
#VENUSGLOBAL
https://venusglobal.com.vn/an-chay-giam-can/
Giảm cân hiệu quả bằng mật ong
Kính chào tất cả mọi người. Bạn đang muốn giảm mỡ bụng? Hướng dẫn cách giảm cân hiệu quả bằng mật ong và nguyên liệu thiên nhiên, uống vào buổi sáng hoặc trước khi ngủ.
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#giảm_cân_hiệu_quả_bằng_mật_ong
#VENUSGLOBAL
https://venusglobal.com.vn/uong-mat-ong-giam-can/
Kính chào tất cả mọi người. Chia sẻ kinh nghiệm giảm cân bằng yến mạch hiệu quả, no lâu, không gây ngán, cho chị em và các gymer chỉ trong 1 tuần giảm 2 - 3kg. Xem ngay!
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#kinh_nghiệm_giảm_cân_bằng_yến_mạch
#VENUSGLOBAL
https://venusglobal.com.vn/giam-can-bang-yen-mach/
Kính chào tất cả mọi người. Buổi sáng nên ăn gì để giảm cân hiệu quả? Gợi ý 25 món ăn sáng giúp tan mỡ bụng nhanh, ngon miệng và dinh dưỡng, tiết kiệm thời gian chuẩn bị
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#bữa_sáng_giảm_cân
#sáng_ăn_gì_giảm_cân
#VENUSGLOBAL
https://venusglobal.com.vn/bua-sang-giam-can/
Kính chào tất cả mọi người. Cách giảm cân bằng chanh như thế nào cho hiệu quả? Có nên uống nước chanh buổi tối để giảm cân không? Làm detox chanh giảm cân trong 3 ngày
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#giảm_cân_bằng_chanh
#cách_giảm_cân_hiệu_quả_bằng_chanh
#VENUSGLOBAL
https://venusglobal.com.vn/giam-can-bang-chanh/
Kính chào tất cả mọi người. Các mẹ bỉm mong muốn lấy lại vóc dáng thon gọn thuở ban đầu? Xem ngay cách giảm cân hiệu quả sau sinh và kinh nghiệm lên thực đơn sau sinh mổ
Xem các thông tin liên quan:
1. Google Sites View: https://sites.google.com/view/venus-global/
2. Google My Maps: https://www.google.com/maps?cid=15512314346380263004
3. Twitter: https://twitter.com/venusglobalvn
4. Business Site: https://venusglobal.business.site/
Địa chỉ: Số 38D/24 Dân Lập - Dư Hàng Kênh - Lê Chân - HP
SĐT: 0225 3656 888 - 1900 3139
Follow các kênh xã hội của chúng tôi tại đây:
- Facebook: https://www.facebook.com/CTYhangnguyenvenus/
- Tumblr: https://venusglobal.tumblr.com/
- Instagram: https://www.instagram.com/venusglobalvn/
- Youtube: https://www.youtube.com/channel/UCF-gySJAfi9-9_A63UyoDyg/about
#giảm_cân_sau_sinh
#cach_giam_can_sau_sinh
#VENUSGLOBAL
https://venusglobal.com.vn/giam-can-sau-sinh/
Get Covid Testing at Fit to Fly PCR TestNX Healthcare
A Fit-to-Fly PCR Test is a crucial service for travelers needing to meet the entry requirements of various countries or airlines. This test involves a polymerase chain reaction (PCR) test for COVID-19, which is considered the gold standard for detecting active infections. At our travel clinic in Leeds, we offer fast and reliable Fit to Fly PCR testing, providing you with an official certificate verifying your negative COVID-19 status. Our process is designed for convenience and accuracy, with quick turnaround times to ensure you receive your results and certificate in time for your departure. Trust our professional and experienced medical team to help you travel safely and compliantly, giving you peace of mind for your journey.www.nxhealthcare.co.uk
This particular slides consist of- what is Pneumothorax,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is a summary of Pneumothorax:
Pneumothorax, also known as a collapsed lung, is a condition that occurs when air leaks into the space between the lung and chest wall. This air buildup puts pressure on the lung, preventing it from expanding fully when you breathe. A pneumothorax can cause a complete or partial collapse of the lung.
This particular slides consist of- what is hypotension,what are it's causes and it's effect on body, risk factors, symptoms,complications, diagnosis and role of physiotherapy in it.
This slide is very helpful for physiotherapy students and also for other medical and healthcare students.
Here is the summary of hypotension:
Hypotension, or low blood pressure, is when the pressure of blood circulating in the body is lower than normal or expected. It's only a problem if it negatively impacts the body and causes symptoms. Normal blood pressure is usually between 90/60 mmHg and 120/80 mmHg, but pressures below 90/60 are generally considered hypotensive.
Sectional dentures for microstomia patients.pptxSatvikaPrasad
Microstomia, characterized by an abnormally small oral aperture, presents significant challenges in prosthodontic treatment, including limited access for examination, difficulties in impression making, and challenges with prosthesis insertion and removal. To manage these issues, customized impression techniques using sectional trays and elastomeric materials are employed. Prostheses may be designed in segments or with flexible materials to facilitate handling. Minimally invasive procedures and the use of digital technologies can enhance patient comfort. Education and training for patients on prosthesis care and maintenance are crucial for compliance. Regular follow-up and a multidisciplinary approach, involving collaboration with other specialists, ensure comprehensive care and improved quality of life for microstomia patients.
VEDANTA AIR AMBULANCE SERVICES IN REWA AT A COST-EFFECTIVE PRICE.pdfVedanta A
Air Ambulance Services In Rewa works in close coordination with ground-based emergency services, including local Emergency Medical Services, fire departments, and law enforcement agencies.
More@: https://tinyurl.com/2shrryhx
More@: https://tinyurl.com/5n8h3wp8
End-tidal carbon dioxide (ETCO2) is the level of carbon dioxide that is released at the end of an exhaled breath. ETCO2 levels reflect the adequacy with which carbon dioxide (CO2) is carried in the blood back to the lungs and exhaled.
Non-invasive methods for ETCO2 measurement include capnometry and capnography. Capnometry provides a numerical value for ETCO2. In contrast, capnography delivers a more comprehensive measurement that is displayed in both graphical (waveform) and numerical form.
Sidestream devices can monitor both intubated and non-intubated patients, while mainstream devices are most often limited to intubated patients.
At Malayali Kerala Spa Ajman, Full Service includes individualized care for every client. We specifically design each massage session for the individual needs of the client. Our therapists are always willing to adjust the treatments based on the client's instruction and feedback. This guarantees that every client receives the treatment they expect.
By offering a variety of massage services, our Ajman Spa Massage Center can tackle physical, mental, and emotional illnesses. In addition, efficient identification of specific health conditions and designing treatment plans accordingly can significantly enhance the quality of massaging.
At Malayali Kerala Spa Ajman, we firmly believe that everyone should have the option to experience top-quality massage services regularly. To achieve that goal we offer cheap massage services in Ajman.
If you are interested in experiencing transformative massage treatment at Malayali Kerala Spa Ajman, you can use our Ajman Massage Center WhatsApp Number to schedule your next massage session.
Contact @ +971 529818279
Visit @ https://malayalikeralaspaajman.com/
The Importance of Black Women Understanding the Chemicals in Their Personal C...bkling
Certain chemicals, such as phthalates and parabens, can disrupt the body's hormones and have significant effects on health. According to data, hormone-related health issues such as uterine fibroids, infertility, early puberty and more aggressive forms of breast and endometrial cancers disproportionately affect Black women. Our guest speaker, Jasmine A. McDonald, PhD, an Assistant Professor in the Department of Epidemiology at Columbia University in New York City, discusses the scientific reasons why Black women should pay attention to specific chemicals in their personal care products, like hair care, and ways to minimize their exposure.
English Drug and Alcohol Commissioners June 2024.pptxMatSouthwell1
Presentation made by Mat Southwell to the Harm Reduction Working Group of the English Drug and Alcohol Commissioners. Discuss stimulants, OAMT, NSP coverage and community-led approach to DCRs. Focussing on active drug user perspectives and interests
As Mumbai's premier kidney transplant and donation center, L H Hiranandani Hospital Powai is not just a medical facility; it's a beacon of hope where cutting-edge science meets compassionate care, transforming lives and redefining the standards of kidney health in India.
Management of Post Operative Pain: to make doctors conscious about the benefi...
Triệu chứng viêm mũi dị ứng thời tiết | Venus Global
1. See discussions, stats, and author profiles for this publication at: https://www.researchgate.net/publication/302503327
Allergic Rhinitis
Chapter · January 2010
DOI: 10.1007/978-3-540-68940-9_18
CITATIONS
0
READS
5,291
2 authors:
Some of the authors of this publication are also working on these related projects:
IRIS-Asma Project View project
Dupilumab in various indications View project
Joaquim Mullol
IDIBAPS August Pi i Sunyer Biomedical Research Institute
519 PUBLICATIONS 31,634 CITATIONS
SEE PROFILE
Antonio Valero
University of Barcelona
304 PUBLICATIONS 7,600 CITATIONS
SEE PROFILE
All content following this page was uploaded by Joaquim Mullol on 10 May 2016.
The user has requested enhancement of the downloaded file.
2. 151
2.8 Allergic Rhinitis
Joaquim Mullol and Antonio Valero
2.8.1 Introduction
Allergic rhinitis is a symptomatic disorder of the nose, in-
duced after allergen exposure by an IgE-mediated inflam-
mation of the nasal mucosa. Allergic rhinitis represents a
global health problem. It is a worldwide disease affecting
at least 10–25% of the population [1], and its prevalence
is increasing. In European countries the prevalence of al-
lergic rhinitis has been estimated from 17 to 29% [2]. An
increase in this prevalence has been observed in the past
40 years [3]. Allergic rhinitis is not a severe disease but it
alters a patient’s social life, affecting school performance
and work productivity [4]; the costs incurred by rhinitis
are substantial [5]. Asthma and rhinitis are common co-
morbidities, suggesting the concept of “one airway, one
disease” [6].
Guidelines for the diagnosis and treatment of allergic
rhinitis have already been published [7], but some were
not predicated on evidence-based medicine and few, if
any, considered the patients globally in terms of comor-
bidities. The ARIA (Allergic Rhinitis and Its Impact on
Asthma) initiative [8, 9] has developed a document that
is the state of the art, for the specialist as well as for the
general practitioner to:
Update his/her knowledge of allergic rhinitis
•
Highlight the impact of allergic rhinitis on asthma
•
Provide an evidence-based documented revision on
•
the diagnosis methods and on the treatments avail-
able
Propose a stepwise approach to the management of
•
the disease
2.8.2 Definition and Classification
Symptoms of allergic rhinitis include rhinorrhea, nasal
obstruction, nasal itching, and sneezing, which are re-
versible spontaneously or with treatment. Allergic rhini-
tis was previously classified as seasonal and perennial.
The new ARIA classification of allergic rhinitis is based
on symptoms and quality-of-life parameters. Duration of
symptoms is subdivided into “intermittent” or “persis-
tent” disease, while severity is subdivided into “mild” or
“moderate-severe”, depending on symptoms and quality
of life (Fig. 2.8.1). This classification has been recently
validated [10, 11].
2.8.3 Aetiology and Triggers
2.8.3.1 Allergens
Aeroallergens are very often involved in allergic rhinitis
[12]. The increase in domestic allergens is responsible in
part for the increase in the prevalence of rhinitis, asthma
and allergic respiratory diseases. In the home, the main
allergens are mites, domestic animals, insects or those
derived from plant origin. Outdoor allergens include pol-
lens and moulds.
Occupational rhinitis is less well documented than oc-
cupational asthma is but is often associated with asthma.
Latex allergy has become an increasing concern to pa-
tients and health professionals, who should be aware of
the problem and develop strategies for prevention and
treatment.
2.8.3.2 Pollutants
Pollutants are involved in the aggravation of nasal symp-
toms in patients with allergic and nonallergic rhinitis. The
Moderate-severe
one or more items
- abnormal sleep
- impairment of daily
activities, sport, leisure
- abnormal work and
school
- troublesome symptoms
Persistent
> 4 days per week
and > 4 weeks
Mild
- normal sleep
- no impairment of daily
activities, sport, leisure
- normal work and
school
- no troublesome
symptoms
Intermittent
≤ 4 days per week
or ≤ 4 weeks
Moderate-severe
one or more items
- abnormal sleep
- impairment of daily
activities, sport, leisure
- abnormal work and
school
- troublesome symptoms
Persistent
> 4 days per week
and > 4 weeks
Mild
- normal sleep
- no impairment of daily
activities, sport, leisure
- normal work and
school
- no troublesome
symptoms
Intermittent
≤ 4 days per week
or ≤ 4 weeks
Fig. 2.8.1 Classification of allergic rhinitis (ARIA)
3. 152 2 Nose and Paranasal Sinuses
2.8.5 Comorbidities
Allergic inflammation does not limit itself to the nasal
airway. Multiple comorbidities have been associated with
rhinitis such as asthma [6], rhinosinusitis and conjunc-
tivitis.
2.8.5.1 Asthma
Nasal and bronchial mucosa share many similarities.
Epidemiological studies have shown that asthma and
rhinitis often coexist in the same patients. Most patients
with allergic (80%) and nonallergic (50%) asthma have
rhinitis, while many patients with rhinitis (20–30%) have
also asthma. Allergic rhinitis constitutes a risk factor for
asthma, and many allergic rhinitis patients have bronchi-
al hyperreactivity [18].
Pathophysiological studies also suggest that a strong
relationship exists between rhinitis and asthma. Al-
though differences exist between rhinitis and asthma,
upper and lower airways may be considered as a unique
entity influenced by a common inflammatory process.
Since bronchial challenge leads to nasal inflammation
and nasal challenge leads to bronchial inflammation, al-
lergic diseases may be considered systemic. Consequent-
ly, when considering a diagnosis of rhinitis or asthma, an
evaluation of both the lower and upper airways should
be made.
2.8.5.2 Other Comorbidities
Other comorbidities include rhinosinusitis and conjunc-
tivitis, and the associations between allergic rhinitis, na-
sal polyposis, and otitis media are poorly understood.
2.8.6 Diagnosis
The diagnosis of allergic rhinitis is based on the coordina-
tion between a clinical history (allergic symptoms), nasal
examination and diagnostic tests.
2.8.6.1 Clinical History
It is essential for an accurate diagnosis of rhinitis to assess
its severity and response to treatment. Although not nec-
essarily of allergic origin, the main nasal symptoms are
obstruction, sneezing, itching and rhinorrhea.
interaction between pollutants and rhinitis is suggested
by epidemiological evidence, although the mechanism is
not well understood. Indoor pollution, including domes-
tic allergens and indoor gas pollutants (tobacco smoke),
is of great importance, since in industrialised countries
people spend over 80% of their time indoors.
Urban-type pollution is in many countries primarily
of automobile origin [13], and the principal atmospheric
oxidant pollutants include ozone, nitric oxides, and sul-
phur dioxide. Diesel exhaust fumes may also enhance IgE
formation and allergic inflammation.
2.8.3.3 Aspirin and Nonsteroidal
Anti-inflammatory Drugs
NSAIDs commonly induce rhinitis and asthma [14].
2.8.4 Mechanisms of Action
In allergic rhinitis, the understanding of the mechanisms
of the disease provides a framework for its rational ther-
apy, based on the complex inflammatory reaction rather
than on the symptoms alone. Allergy is classically con-
sidered to result from an IgE-mediated allergy associated
with nasal inflammation of variable intensity [15]. Aller-
gic rhinitis is characterised by an inflammatory infiltrate
made up of different cells, including:
Chemotaxis, activation, differentiation, and survival
•
prolongation of various cell types including eosino-
phils, T cells, mast cells and epithelial cells
Release of mediators by these activated cells: cytok-
•
ines, chemokines, histamine and cysteinyl leukot-
rienes (cys-LT) as the major mediators
Communication with the immune system and the
•
bone marrow
Nonspecific nasal hyperreactivity [16] is an important
feature of allergic rhinitis and is defined as an increased
nasal response to normal stimuli, resulting in sneezing,
nasal congestion and/or secretion. Intermittent rhinitis
can be mimicked by nasal challenge with pollen aller-
gens, and an inflammatory reaction occurs during the
late-phase reaction. In persistent allergic rhinitis, allergic
triggers interact with an ongoing inflammatory reaction,
and symptoms are due to this complex interaction.
The concept of “minimal persistent inflammation”
[17] has been confirmed in perennial allergic rhinitis.
In patients with persistent allergic rhinitis, allergen ex-
posure varies throughout the year, and there are periods
in which there is little exposure. Although symptom free,
these patients still present with nasal inflammation.
4. 153
2.8.7 Management and Treatment
2.8.6.2 Nasal Examination
In patients with mild, intermittent allergic rhinitis, a na-
sal examination is optimal, but all patients with persis-
tent allergic rhinitis need a nasal examination. Anterior
rhinoscopy, using a speculum and mirror, gives limited
information. Nasal endoscopy, which can be performed
only by specialists, is more useful.
2.8.6.3 Diagnostic Tests
In vivo and in vitro tests used to diagnose allergic dis-
eases are directed towards the detection of free or cell-
bound IgE. The diagnosis of allergy has been improved
by allergen standardisation (Table 2.8.1).
2.8.6.3.1 Skin-prick Test
The skin-prick test is used to demonstrate an IgE-medi-
ated allergic reaction and represents a major diagnostic
tool in the field of allergy. If properly performed, it gives
confirmatory evidence for the diagnosis of a specific al-
lergy. Due to the complexity in performance and inter-
pretation of the test, it is recommended that it be carried
out by trained health care professionals [19].
2.8.6.3.2 Serum-specific IgE
Serum-specific IgE has a similar value to that of skin tests
[20].
2.8.6.3.3 Allergen Nasal Challenge
The allergen nasal challenge is mainly used in research
and, to a lesser extent, in clinical practice. It is especially
useful in the diagnosis of occupational rhinitis [21].
2.8.6.3.4 Imaging
Imaging is not usually necessary.
2.8.6.3.5 Diagnosis of Asthma
Guidelines for recognising and diagnosing asthma have
been published by the Global Initiative for Asthma
(GINA) [22] and are recommended. Measurement of
lung function and confirmation of the reversibility of
airflow obstruction are essential steps in the diagnosis of
asthma.
2.8.7 Management and Treatment
The management of allergic rhinitis is based on allergen
avoidance, pharmacological treatment, specific immuno-
therapy, and, when possible, patient education [8, 9, 23].
2.8.7.1 Allergen Avoidance
Most allergen-avoidance studies have dealt with asthma
symptoms, and very few have studied rhinitis symp-
Table 2.8.1 Diagnostic tests for allergic rhinitis
Category of test Specific test
Routine History
Clinical
–
–
Family
–
–
General ENT examination (rhinoscopy)
Nasal airway assessment
Peak nasal inspiratory flow (PNIF)
–
–
Allergy tests
Skin
–
–
Serum-specific IgE
–
–
Additional Endoscopy
Rigid
–
–
Flexible
–
–
Radiology
CT scan
–
–
Optional Nasal challenge
Allergen
–
–
Lysine aspirin
–
–
Nasal samples
Cytology/nasal secretions
–
–
Nasal biopsy
–
–
Nasal swab
–
–
Radiology
MRI
–
–
Mucociliary function
Nasal mucociliary clearance
–
–
(NMCC)
Ciliary beat frequency (CBF)
–
–
Electron microscopy
–
–
Nasal airway assessment
Rhinomanometry (anterior, pos-
–
–
terior)
Acoustic rhinometry
–
–
Smell test (University of Pennsylvania
smell identification test [UPSIT], ZOST,
Barcelona smell test [BAST]-24)
Nitric oxide measurement
5. 154 2 Nose and Paranasal Sinuses
2.8.7.2.1 H1-Antihistamines
Drugs
Old generation: Chlorpheniramine, clemastine,
diphenhydramine, hydroxyzine, keto-
tifen, mequitazine, oxatomide
New generation: Acrivastine, azelastine, cetirizine,
desloratadine, ebastine, fexofenadine,
levocetirizine, loratadine, mizolastine,
rupatadine
Cardiotoxic drugs: Astemizole, terfenadine
Mechanism of Action
The mechanism of action is via blockage of H1 receptor
and some anti-allergic activity. New generation drugs can
be used once daily. There is no development of tachyphy-
laxis is usually noted.
Side Effects
Old generation: Sedation and/or anticholinergic effect
is common
New generation: No sedation for most drugs, no
anticholinergic effect, no cardiotoxic-
ity. Acrivastine has sedative effects,
mequitazine has anticholinergic
effects, and oral azelastine may induce
sedation and has a bitter taste
toms. A single intervention may be insufficient to control
symptoms of rhinitis or asthma. Although more data are
needed to appreciate fully the clinical value of allergens,
allergen avoidance, including house dust mites, should be
an integral part of a management strategy [24, 25].
2.8.7.2 Pharmacological Treatment
Pharmacological management for treatment of allergic
rhinitis involves several classes of drugs (Figs. 2.8.2 and
2.8.3).
sneezing rhinorrhea nasal nasal eye
obstruction itch symptoms
H1-antihistamines
oral +++ +++ 0 to + +++ ++
intranasal ++ +++ + ++ 0
intraocular 0 0 0 0 +++
Corticosteroids
intranasal +++ +++ ++ ++ +
Chromones
intranasal + + + + 0
intraocular 0 0 0 0 ++
Decongestants
intranasal 0 0 ++ 0 0
oral 0 0 + 0 0
Anti-cholinergics 0 +++ 0 0 0
Anti-leukotrienes 0 + ++ 0 ++
Fig. 2.8.2 Pharmacological
management and drug effects on
the symptoms of allergic rhinitis.
0 no effect, + mild, ++ moderate,
+++ intense
intervention SAR
adult children adult children
oral anti -H1 A A A A
intranasal anti -H1 A A A A
intranasal CS A A A A
intranasal chromone A A A A
subcutaneous SIT A A A A
sublingual A A
nasal SIT A A A
allergen avoidance D D D D
intervention SAR PAR
adult children adult children
oral anti-H1 A A A A
intranasal anti-H1 A A A A
intranasal CS A A A A
intranasal chromone A A A A
subcutaneous SIT A A A A
sublingual A A
nasal SIT A A A
allergen avoidance D D D D
Fig. 2.8.3 Strength of evidence for the treatment of allergic
rhinitis. Recommendations are evidence-based on randomised-
controlled trials (RCT) carried out on studies performed with
the previous classification of rhinitis: seasonal (SAR) and pe-
rennial (PAR) allergic rhinitis. Strength of recommendation: A
based on RCT or meta-analysis, D based on the clinical experi-
ence of experts
6. 155
2.8.7 Management and Treatment
Comments
New generation oral H1-antihistamines should be prefer
red for their favourable efficacy/safety ratio and pharma-
cokinetics.Theyarerapidlyeffective(lessthan1h)onnasal
and ocular symptoms and poorly effective on nasal con-
gestion. Cardiotoxic drugs should be avoided [23, 26].
Local Antihistamines
Local antihistamines include Azelastine and levocabas-
tine. They are rapidly effective (less than 30 min) on nasal
or ocular symptoms. Minor local side effects: azelastine
has a bitter taste.
2.8.7.2.2 Corticosteroids
Drugs
Intranasal: Beclomethasone, budesonide, fluni-
solide, fluticasone, momethasone,
triamcinolone
Oral/intramuscular
(IM):
Dexamethasone, hydrocortisone,
methylprednisolone, prednisolone,
prednisone, triamcinolone, betame-
thasone, deflazacort
Mechanism of Action
The mechanism of action is via potent reduction of nasal
inflammation and nasal hyperreactivity.
Side Effects
Intranasal: Minor local side effects, wide margin
for systemic side effects, growth
concerns with some molecules only.
In young children the combination of
intranasal and inhaled drugs should
be considered
Oral/IM: Systemic side effects common in par-
ticular for IM drugs. Depot injections
may cause local tissue atrophy
Comments
Intranasal: The most effective pharmacological
treatment of allergic rhinitis. Effec-
tive on nasal congestion and loss of
smell. Effect observed after 12 h but
maximal effect after a few days
Oral: When possible, intranasal corticoster-
oids should replace oral or IM drugs.
A short course of oral corticosteroids
may be needed with severe symptoms
[23]
2.8.7.2.3 Chromones (Intranasal, Ocular)
Drugs
Drugs used include cromoglycate and nedocromil.
Mechanism of Action
The mechanism of action is not well known.
Side Effects
Side effects are minor and local in nature.
Comments
Intraocular chromones are very effective. Intranasal
chromones are less effective, and their effect is short last-
ing. Overall they have an excellent safety record.
2.8.7.2.4. Nasal Decongestants
Drugs
Oral: Ephedrine, phenylephrine, phenylpro-
panolamine, pseudoephedrine
Intranasal: Oxymethazoline, naphazoline, xylom-
etazoline, and others
Mechanism of Action
Sympathomimetic drugs relieve symptoms of nasal con-
gestion by acting on alpha-adrenergic receptors.
Side Effects
Oral: Hypertension, palpitations, restless-
ness, agitation, tremor, insomnia,
headache, dry mucous membranes,
urinary retention, exacerbation of
glaucoma or thyrotoxicosis
Intranasal: Same side effects as oral deconges-
tants but less intense. Rhinitis medica-
mentosa is a rebound phenomenon
occurring with prolonged use (over
10 days)
7. 156 2 Nose and Paranasal Sinuses
2.8.7.3 Specific Immunotherapy
Specific immunotherapy is effective when optimally
administered. Standardised therapeutic vaccines are fa-
voured when available. Subcutaneous immunotherapy
raises contrasting efficacy and safety issues [29, 30]. The
use of optimal doses of vaccines either labelled in biologi-
cal units or labelled in mass of major allergens has been
proposed. Doses of 5–20 µg of the major allergen are op-
timal doses for most allergen vaccines.
2.8.7.3.1 Subcutaneous Immunotherapy
Subcutaneous immunotherapy (SIT) alters the natural
course of allergic diseases [31]. SIT should be performed
by trained personnel, and patients should be monitored
for 30 min after injection. SIT is indicated in patients in-
sufficiently controlled by conventional pharmacotherapy,
in whom oral H1-antihistamines and intranasal pharma-
cotherapy insufficiently control symptoms, who do not
wish to be on pharmacotherapy, in whom pharmaco-
therapy produces undesirable side effects and who do not
want to receive long-term pharmacological treatment.
2.8.7.3.2 Nasal and Sublingual-swallow
Specific Immunotherapy
Nasal and sublingual-swallow specific immunotherapy
may be used with doses at least 20–100 times greater than
those used for SIT, or in patients who had side effects or
refused SIT. The indications follow those of subcutaneous
injections.
2.8.7.3.3 Immunotherapy in Children
Specific immunotherapy is effective. It is recommended
to start this treatment after the child reaches 5 years of
age.
2.8.7.4 Education
When possible, education is always recommended.
2.8.7.5 Surgery
Surgical intervention may be used as an adjunctive inter-
vention in few and selected patients (e. g. turbinate hyper-
trophy, septal deviation).
Comments
Oral: Oral decongestants should be used
with caution in patients with heart dis-
ease. Oral H1-antihistamine combined
with decongestant may be more ef-
fective than either product alone, but
side effects are combined
Intranasal: Act more rapidly and more effectively
than oral decongestants. Limit dura-
tion of treatment to less than 10 days
to avoid rhinitis medicamentosa [27]
2.8.7.2.5 Anticholinergics
Drug
Ipratropium is the drug of choice.
Mechanism of Action
Anticholinergic drugs block almost exclusively rhinor-
rhea.
Side Effects
There are minor, local side effects; there is virtually no
systemic anticholinergic activity.
Comments
Ipratropium is effective in allergic and nonallergic pa-
tients with rhinorrhea.
2.8.7.2.6 Leukotriene-receptor Antagonists
Drugs
This class of drugs includes montelukast, pranlukast and
zafirlukast.
Mechanism of Action
This class of drugs works by way of blockage of cys-LT
receptor.
Side Effects
Patients are found to have excellent tolerance of these
drugs.
Comments
These drugs are promising used alone or in combination
with oral H1-antihistamines, but more data are needed to
categorize better these drugs [28].
8. 157
2.8.8 Special Considerations
2.8.7.6 Selection of Medications
Medications have no long-lasting effect when stopped.
Therefore, in persistent disease, maintenance treatment is
required (Fig. 2.8.4).
Tachyphylaxis does not usually occur with prolonged
•
treatment.
Medications used for rhinitis are most commonly ad-
•
ministered intranasally or orally.
Some studies have compared the relative efficacy of
•
these medications, of which intranasal corticosteroids
are the most effective. However, the choice of treat-
ment also depends on many other criteria.
The use of alternative care (e. g. homeopathy, herbal-
•
ism, acupuncture) for the treatment of rhinitis is in-
creasing. Scientific and clinical supports are lacking
for these therapies. There is an urgent need for large,
randomised and controlled clinical trials for alterna-
tive therapies of allergic diseases and rhinitis.
IM injection of glucocorticosteroids is not usually rec-
•
ommended due to the possible occurrence of systemic
side effects.
Intranasal injection of glucocorticosteroids is not usu-
•
ally recommended due to the possible occurrence of
severe side effects.
2.8.7.7 Treatment of Concomitant
Rhinitis and Asthma
Treatment of asthma should follow the GINA guidelines
[22]. Some drugs are effective in the treatment of both
rhinitis and asthma (e. g. glucocorticoids, antileukot-
rienes), while others are only effective in the treatment
of either rhinitis or asthma (e. g. α- and β-adrenergic ago-
nists, respectively). Some drugs are more effective in rhin-
itis than in asthma (e. g. H1-antihistamines). Although
more studies are needed, optimal management of rhinitis
may improve coexisting asthma [32]. Drugs administered
by the oral route may affect both nasal and bronchial
symptoms. The safety of intranasal glucocorticoids is well
established. Large doses of inhaled (intrabronchial) glu-
cocorticoids can induce side effects [33]. One of the prob-
lems of dual administration may be the possible additive
side effects. Although the addition of intranasal formu-
lations to inhaled formulations does not produce any
further significant suppression, more data are needed. It
has been proposed that the prevention or early treatment
of allergic rhinitis may help to prevent the occurrence of
asthma or the severity of bronchial symptoms but more
data are also needed.
2.8.7.8 Treatment of Conjunctivitis
The options of treatment are oral and/or ocular H1-anti-
histamines, ocular chromones and saline. Administration
of ocular corticosteroids is not recommended.
2.8.8 Special Considerations
2.8.8.1 Pregnancy
Rhinitis is often a problem during pregnancy since nasal
obstruction may be aggravated by pregnancy itself [34].
Caution must be taken when administering any medi-
cation during pregnancy, as most medications cross the
placenta. For most drugs, limited studies have been done
only on small groups, with no long-term analysis.
2.8.8.2 Paediatric Aspects
Allergic rhinitis is part of the “allergic march” during
•
childhood, but intermittent allergic rhinitis is unusual
before 2 years of age. Allergic rhinitis is most prevalent
during the school-age years [35].
Allergy tests can be done at any age, and they may
•
yield important information. The principles of treat-
ment for children are the same as for adults. Special
care must be taken to avoid the side effects typical of
this age group.
Doses of medication have to be adjusted and must fol-
•
low special considerations. Few medications have been
tested in children younger than 2 years of age.
In children, symptoms of allergic rhinitis can impair
•
cognitive functioning and school performance, which
can be further impaired by the use of sedating oral H1-
antihistamines.
mild
intermittent
mild
persistent
moderate
severe
intermittent
moderate
severe
persistent
immunotherapy
local chromone
oral or local non-sedative H -blocker
1
allergen and irritant avoidance
oral / topical (<10 days) nasal decongestant
intranasal steroid
Fig. 2.8.4 Treatment of allergic rhinitis (ARIA)
9. 158 2 Nose and Paranasal Sinuses
8. Environmental and social factors should be optimised
to allow the patient to lead a normal life.
9. Asthmatic patients should be evaluated (history and
physical examination) for rhinitis.
10. In terms of efficacy and safety, a combined strategy
should be used to treat the upper and lower airway
diseases.
11. In developing countries, a specific strategy may be
needed depending on the availability and affordability
of interventions.
References
1. Strachan D, Sibbald B, Weiland S, Ait-Khaled N, Anabwani
G, Anderson HR, Asher MI et al (1997) Worldwide varia-
tions in prevalence of symptoms of allergic rhinoconjunc-
tivitis in children: the International Study of Asthma and
Allergies in Childhood (ISAAC). Pediatr Allergy Immunol
8:161–176
2. Bauchau V, Durham SR (2004) Prevalence and rate of diag-
nosis of allergic rhinitis in Europe. Eur Respir J 24:7587–64
3. Butland BK, Strachan DP, Lewis S, Bynner J, Butler N, Brit-
ton J (1997) Investigation into the increase in hay fever and
eczema at age 16 observed between the 1958 and 1970 Brit-
ish birth cohorts. BMJ 315:717–721
4. Bousquet J, Bullinger M, Fayol C, Marquis P, Valentin B,
Burtin B (1994) Assessment of quality of life in patients
with perennial allergic rhinitis with the French version of
the SF-36 Health Status Questionnaire. J Allergy Clin Im-
munol 94:182–188
5. Mackoviak J (1997) The health and economic impact of
rhinitis: a roundtable discussion. Am J Managed Care
3:S8–S18
6. Vignola AM, Chanez P, Godard P, Bousquet J (1998) Rela-
tionships between rhinitis and asthma. Allergy 53:833–839
7. Cauwenberge P van, Bachert C, Passalacqua G, Bousquet J,
Canonica GW, Durham SR, Fokkens WJ et al (2000) Con-
sensus statement on the treatment of allergic rhinitis. Eu-
ropean Academy of Allergology and Clinical Immunology.
Allergy 55:116–134
8. Bousquet J, van Cauwenberge P, Khaltaev N, ARIA Work-
shop Group (2001) Allergic rhinitis and its impact on
asthma. ARIA Workshop Report. J Allergy Clin Immunol
108:S147–S334
9. Bousquet J, van Cauwenberge P, Khaltaev N, ARIA Work-
shop Expert Panel (2002) Allergic rhinitis and its impact
on asthma (ARIA). Executive Summary of the Workshop
Report. Allergy 57:841–55
10. Demoly P, Allaert FA, Lecasble M, Bousquet J (2003) Vali-
dation of the classification of ARIA (allergic rhinitis and its
impact on asthma). Allergy 58:672–675
11. Bauchau V, Durham SR (2005) Epidemiological character-
ization of the intermittent and persistent types of allergic
rhinitis. Allergy 60:350–353
Intranasal glucocorticosteroids are an effective treat-
•
ment for allergic rhinoconjunctivitis. Their possible
effect on growth for some but not all intranasal glu-
cocorticoids is of concern. Recommended doses of
intranasal momethasone and fluticasone did not affect
growth in children with allergic rhinoconjunctivitis.
Oral and IM glucocorticosteroids should be avoided
•
in the treatment of rhinitis in young children.
Disodium cromoglycate is commonly used to treat al-
•
lergic rhinoconjunctivitis in children because of the
safety of the drug.
2.8.8.3 Ageing
With ageing, various physiological changes occur in the
connective tissue and vasculature of the nose, which may
predispose or contribute to chronic rhinitis [36]. Allergy
is a less common cause of persistent rhinitis in subjects
older than 65 years of age. Atrophic rhinitis is common
and difficult to control. Rhinorrhea can be controlled with
anticholinergics. Some drugs (reserpine, guanethidine,
phentolamine, methyldopa, prazosin, chlorpromazine
or ACE inhibitors) can cause rhinitis. Some drugs may
induce specific side effects in elderly patients. Deconges-
tants and drugs with anticholinergic activity may cause
urinary retention in patients with prostatic hypertrophy.
Sedative drugs can have greater side effects.
2.8.9 Key Guidance
Key guidance includes the following [8, 9]:
1. Allergic rhinitis is a major chronic respiratory disease
due to its prevalence, impact on quality of life, impact
on work/school performance and productivity, eco-
nomic burden, and links with asthma, rhinosinusitis
and conjunctivitis.
2. Allergic rhinitis is a risk factor for asthma.
3. A new classification of allergic rhinitis has been pro-
posed: intermittent and persistent.
4. The severity of allergic rhinitis has been classified as
“mild” and “moderate/severe” depending on symptom
severity and quality of life outcomes.
5. Depending on the subdivision and severity of allergic
rhinitis, a stepwise therapeutic approach has been pro-
posed that should be used.
6. The treatment of allergic rhinitis combines allergen
avoidance (when possible), pharmacotherapy, and im-
munotherapy.
7. Patients with persistent allergic rhinitis should be
evaluated for asthma by history, chest examination,
and assessment of lung function (before and after
bronchodilator).
10. 159
2.8.9 Key Guidance
12. Platts-Mills TA, Wheatley LM, Aalberse RC (1998) Indoor
versus outdoor allergens in allergic respiratory disease. Curr
Opin Immunol 10:634–639
13. Nel AE, Diaz-Sanchez D, Ng D, Hiura T, Saxon A (1998)
Enhancement of allergic inflammation by the interaction
between diesel exhaust particles and the immune system J
Allergy Clin Immunol 102:539–554
14. Szczeklik A, Stevenson DD. (2003) Aspirin-induced asth-
ma: advances in pathogenesis, diagnosis, and management.
J Allergy Clin Immunol 111:913–921
15. Johansson SG, Bieber T, Dahl R, Friedmann PS, Lanier BQ,
Lockey RF, Motala C, et al (2004) Revised nomenclature for
allergy for global use: report of the Nomenclature Review
Committee of the World Allergy Organization. J Allergy
Clin Immunol 113:832–836
16. Gerth van Wijk RG, de Graaf-in’t Veld C, Garrelds IM
(1999) Nasal hyperreactivity. Rhinology 37:50–55
17. Ciprandi G, Buscaglia S, Pesce G, Pronzato C, Ricca V, Par-
miani S, Bagnasco et al (1995) Minimal persistent inflam-
mation is present at mucosal level in patients with asymp-
tomatic rhinitis and mite allergy. J Allergy Clin Immunol
96:971–979
18. Leynaert B, Neukirch C, Kony S, Guénégou A, Bousquet J,
Aubier M, Neukirch F (2004) Association between asthma
and rhinitis according to atopic sensitization in a popula-
tion-based study. J Allergy Clin Immunol 113:86–93
19. Demoly P, Michel F, Bousquet J (1998) In vivo methods for
study of allergy. Skin tests, techniques and interpretation.
In: Middleton E, Reed C, Ellis E, Adkinson N, Yunginger
J, Busse W (eds). Allergy: principles and practice, 5th edn.
Mosby, St Louis, pp 530–539
20. Bousquet J, Chanez P, Chanal I, Michel FB (1990) Com-
parison between RAST and Pharmacia CAP system: a
new automated specific IgE assay. J Allergy Clin Immunol
85:1039–1043
21. Malm L, Gerth-van-Wijk R, Bachert C (1999) Guildelines
for nasal provocations with aspects on nasal patency, air-
flow, and airflow resitance. Rhinology 37:133–135
22. Global strategy for asthma management and prevention
(1995) WHO/NHLBI workshop report: National Institutes
of Health, National Heart, Lung and Blood Institute, publi-
cation no. 95-3659. National Institutes of Health, Bethesda,
Md.
23. Bousquet J, Van Cauwenberge P, Bachert C, Canonica GW,
Demoly P, Durham SR, Fokkens WJ et al (2003) Require-
ments for medications commonly used in the treatment of
allergic rhinitis. Allergy 58:192–197
24. Wahn U, Lau S, Bergmann R, Kulig M, Forster J, Bergmann
K, Bauer CP et al (1997) Indoor allergen exposure is a risk
factor for sensitization during the first three years of life. J
Allergy Clin Immunol 99:763–769
25. Van den Bemt L, van Knapen L, de Vries MP, Jansen M,
Cloosterman S, van Schayck CP (2004) Clinical effective-
ness of a mite allergen-impermeable bed-covering system in
asthmatic mite-sensitive patients. J Allergy Clin Immunol
114:858–862
26. Simons FE (2004) Advances in H1-antihistamines. N Engl J
Med 351:2203–2217
27. Wang DY, Raza MT, Gordon BR (2004) Control of nasal ob-
struction in perennial allergic rhinitis. Curr Opin Allergy
Clin Immunol 4:165–170
28. Nathan RA (2003) Pharmacotherapy for allergic rhinitis:
a critical review of leukotriene receptor antagonists com-
pared with other treatments. Ann Allergy Asthma Immunol
90:182–191
29. Bousquet J, Lockey R, Malling H (1998) WHO position pa-
per. Allergen immunotherapy: therapeutic vaccines for al-
lergic diseases. Allergy 53:S1–S42
30. Malling HJ (2004) Comparison of the clinical efficacy and
safety of subcutaneous and sublingual immunotherapy:
methodological approaches and experimental results. Curr
Opin Allergy Clin Immunol 4:539–542
31. Durham SR, Walker SM, Varga EM, Jacobson MR, O’Brien
F, Noble W, Till SJ et al (1999) Long-term clinical efficacy of
grass-pollen immunotherapy. N Engl J Med 341:468–475
32. Taramarcaz P, Gibson PG (2004) The effectiveness of in-
tranasal corticosteroids in combined allergic rhinitis and
asthma syndrome. Clin Exp Allergy 34:1883–1889
33. Lipworth BJ (1999) Systemic adverse effects of inhaled cor-
ticosteroid therapy: a systematic review and meta-analysis.
Arch Intern Med 159:941–955
34. Ellegard E, Karlsson G (1999) Nasal congestion during
pregnancy. Clin Otolaryngol 24:307–311
35. Kjellman NI (1994) Natural course of asthma and allergy in
childhood. Pediatr Allergy Immunol 5:S13–S8
36. Edelstein DR (1996) Aging of the normal nose in adults.
Laryngoscope 106:1–25