Rhinomanometry: A Comprehensive Review of Its Applications and Advancements in Rhinology Practice

Patil N, Jain S (May 30, 2024) Rhinomanometry: A Comprehensive Review of Its Applications and Advancements in Rhinology Practice. Cureus 16(5): e61370. doi:10.7759/cureus.61370

Abstract

Emerging trends in rhinomanometry research

Rhinomanometry is a pivotal diagnostic technique in rhinology, providing a quantitative assessment of nasal airflow and resistance. This review comprehensively examines the historical development, principles and clinical applications of rhinomanometry, emphasising its role in diagnosing nasal obstructions, preoperative evaluations and monitoring therapeutic outcomes. Recent advancements, including the integration with imaging technologies and the application of artificial intelligence (AI), have significantly enhanced the accuracy and utility of rhinomanometry.

Association Between Atopic Dermatitis and Aging: Clinical Observations and Underlying Mechanisms.

Chen PY, Shen M, Cai SQ, Tang ZW.  J Inflamm Res. 2024;17:3433-3448 https://doi.org/10.2147/JIR.S467099

Potential mechanisms underlying the association between AD and aging.

Abstract: As one of the most prevalent chronic inflammatory skin diseases, atopic dermatitis (AD) increasingly affects the aging population. Amid the ongoing global aging trend, it’s essential to recognize the intricate relationship between AD and aging. This paper reviews existing knowledge, summarizing clinical observations of associations between AD and aging-related diseases in various systems, including endocrine, cardiovascular, and neurological.

Chronic Pruritus A Review

Butler DC, Berger T, Elmariah S, et al. JAMA. Published online May 29, 2024. doi:10.1001/jama.2024.4899 

Abstract

Importance  Chronic pruritus, defined as itch experienced for 6 weeks or longer, affects approximately 22% of people in their lifetime. Approximately 1% of physician visits are for the chief concern of chronic pruritus. Chronic pruritus is associated with adverse outcomes, including impaired sleep and reduced quality of life.

Categories of Chronic Pruritus

Observations  Chronic pruritus can be categorized by etiology into inflammatory, neuropathic, or a combination of inflammatory and neuropathic pruritus. Chronic pruritus is due to inflammation in approximately 60% of patients and may be caused by eczema, psoriasis, or seborrheic dermatitis. Chronic pruritus is due to a neuropathic or mixed etiology in approximately 25% of patients. Neuropathic causes of chronic pruritus include postherpetic neuralgia and notalgia paresthetica and are typically due to localized or generalized nerve dysregulation.

Relevance of individual bronchial symptoms for asthma diagnosis and control in patients with rhinitis: A MASK-air study

Sousa-Pinto B, Louis G, Vieira RJ, et al. Clin Transl Allergy. 2024;e12358. https://doi.org/10.1002/clt2.12358

Abstract

Rationale

It is unclear how each individual asthma symptom is associated with asthma diagnosis or control.

Objectives

To assess the performance of individual asthma symptoms in the identification of patients with asthma and their association with asthma control.

Methods

Flow chart illustrating participants' selection.

In this cross-sectional study, we assessed real-world data using the MASK-air® app. We compared the frequency of occurrence of five asthma symptoms (dyspnea, wheezing, chest tightness, fatigue and night symptoms, as assessed by the Control of Allergic Rhinitis and Asthma Test [CARAT] questionnaire) in patients with probable, possible or no current asthma. We calculated the sensitivity, specificity and predictive values of each symptom, and assessed the association between each symptom and asthma control (measured using the e-DASTHMA score). Results were validated in a sample of patients with a physician-established diagnosis of asthma.

Serum eosinophil-derived neurotoxin: a new promising biomarker for cow’s milk allergy diagnosis.

Bahbah, W.A., Abo Hola, A.S., Bedair, H.M. et al.  Pediatr Res (2024). https://doi.org/10.1038/s41390-024-03260-x

Abstract

Background

Cow’s Milk Allergy (CMA) diagnosis is often a challenge due to the non-specific nature of symptoms and lack of a confirmatory diagnostic test. To our knowledge no previous studies investigated serum Eosinophil-Derived Neurotoxin (sEDN) in CMA. So, we aimed to assess the role of sEDN in CMA diagnosis.

Methods

Forty-five infants with CMA were compared to 45 infants with functional gastrointestinal disorders (FGIDs) and 45 healthy controls. For all participants, Cow’s Milk-related Symptom Score (CoMiSS) was documented, and sEDN level with hematological parameters were measured before starting elimination diet.

Results

Serum Eosinophil-Derived Neurotoxin level among the 3 studied groups.

Receiver operation characteristic (ROC) curve identified sEDN > 14 ng/mL and CoMiSS > 9 as the optimal cut-off points to discriminate CMA from other groups with sensitivity 86.67%, 97.78% and specificity 60.00%, 78.89% respectively. Additionally, absolute neutrophil count (ANC) showed the highest sensitivity and specificity (80.0% and 78.89%) among hematological parameters.

Factors Affecting Usage of a Digital Asthma Monitoring Application by Old-Age Asthmatics Living in Inner Central Portugal

Abreu MIT, Santos AF, Gama JMR, Valente S, Valente MJ, Pereira H, Regateiro F, Sousa-Pinto B, Ventura MT, Bousquet J, Taborda-Barata L. Clin Interv Aging. 2024;19:971-979

Purpose: To analyse factors affecting the ability to use the digital asthma monitoring application Mask-Air® in old-age individuals living in inland Portugal.

Patients and Methods: In this observational study, patients with medically confirmed asthma who agreed to participate were interviewed and subdivided into Non-users Group: those who could not use the application and Users Group: those who could. Sociodemographic and psychological data, comorbidities, and asthma status were compared between groups. Assessment of reasons for refusal was based on a 6-item questionnaire.

Reasons for not using MASK-Air App by Non-users Group asthmatics.
Most frequent reasons given by Non-users Group (44 patients) for not using
MASK-air;these results show lack of possibility to use the App versus not
wanting to use the App (A).
Venn diagram showing specific reasons and combinations of reasons
given by Non-users Group (44 patients) for not using MASK-Air App (B)

Results: Among the 72 sequentially recruited patients (mean age±SD 73.26± 5.43 yrs; 61 women; 11 men), 44 (61.1%; mean age±SD 74.64± 5.68 yrs; 38 women; 6 men)) were included in Non-users Group and 28 (38.9%; mean age±SD 71.11± 4.26 yrs; 23 women; 5 men) in Users Group. Non-users Group patients were significantly older, had lower socioeconomic level, and more frequently had severe asthma (25% vs 3.6%; Odds ratio=0.08 (95% CI=0.01– 0.81; p=0.033)) and diabetes (32.6% vs 7.4%; Odds ratio=0.17 (95% CI=0.03– 0.80; p=0.025)) than Users Group.

Immunotherapy and biologics in the management of IgE-mediated food allergy: Systematic review and meta-analyses of efficacy and safety

Riggioni C, Oton T, Carmona L, Du Toit G, Skypala I, Santos AF, the EAACI Food Allergy Guidelines Expert Group and the EAACI Research and Outreach Committee FA Group  Allergy. 2024; 00: 1-31. doi:10.1111/all.16129

Abstract

Food allergy (FA) is a potentially life-threatening chronic condition that is becoming an increasing public health problem worldwide. This systematic review (SR) was carried out to inform the development of clinical recommendations on the treatment of IgE-mediated FA with biologics and/or IT for the update of the EAACI guidelines. A SR of randomized-controlled trials or quasi-controlled trials was carried out. Studies were identified via comprehensive search strategies in Medline, Embase, and Cochrane Library, up to April 2022. Population: Human adults, children, and adolescents with IgE-mediated FA. Intervention: IT and/or biologics. Comparator: Placebo or standard-of-care (allergen avoidance).

Metanalysis of omalizumab versus placebo in IgE-mediated food allergies:
Primary outcome (Desensitization)

Outcome: Efficacy (desensitization, sustained unresponsiveness (SU), remission), quality of life, and safety (systemic and local adverse reactions (AR)). The Cochrane RoB tool was used to assess the risk of bias. It was reported according to PRISMA and registered in PROSPERO CRD4202229828.

The Multiple Trajectories of the Allergic March.

 

de Las Vecillas L, Quirce S.  J Investig Allergol Clin Immunol. 2024 Apr 12;34(2):75-84. doi: 10.18176/jiaci.0983.

Abstract

Etiologic features and risk factors related to the development of the allergic march and preventive
interventions to impact its course. TH2 indicates type 2 helper T cell; AIT, allergen immunotherapy

The allergic march comprises the sequential appearance of a series of allergic comorbidities. However, variability in the onset and progression of allergic diseases generates a heterogeneous scenario that does not follow a linear and single trajectory.

Almost half of the pediatric population presents at least 1 allergy symptom. However, only 4%-6% present multimorbidity, with several allergic diseases co-occurring. It has recently been shown that although they share etiological mechanisms and risk factors, allergic diseases arise independently. In most cases, progression is not consecutive, or at least not the same in all patients.