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Biomedical subjects

F Gani

Publications and source records attributed to F Gani.

13 recordsLinked to original sources
PubMed2003

Sport, immune system and respiratory infections.

In the recent years, the importance of sports in everyday life has rapidly increased. Asthma and respiratory allergy are among the most common problems to be afforded in those individuals practising sports and therefore, the diagnostic and therapeutic aspects of allergy in athletes have received in recent times a great interest. The experimental studies performed on allergy and sport have lead to take in consideration a more general aspect, that is the effects of exercise on the immune system. In fact, it has been observed that exercise can induce significant and measurable immunological changes, involving a transient immune suppression (changes in number and activity of neutrophils, lymphocytes, macrophages, and secretion of cytokines). This is probably the reason why athletes seem to be more prone to upper respiratory viral infections. These infections usually appear after exercise discontinuation (within 3 days) particularly in those athletes practising sports which require a long term effort and resistance. The problem is further complicated by the effect of nutrition, since nutrition regimen itself and dietary supplementation were demonstrated able to interfere with the immune response. In the present article we will review the present knowledge and experimental data concerning the effects of sport on immune system and some of the most important clinical implications.

Asthma↗
PubMed2003

Rhinitis in pregnancy.

About 30% of women suffer from nasal symptoms during pregnancy. The hormonal changes occurring during pregnancy favour per se mucosal oedema and relaxation of smooth muscles, thus contributing to nasal congestion. The most common forms of rhinitis are allergic, drug-induced, infectious and vasomotor rhinitis. In addition to the detrimental effects that rhinitis can have on quality of life, it is important to correctly treat rhinitis itself since it can influence concomitant asthma, as underlined in ARIA document. In pregnancy, the safety profile of drugs is the primary item to be considered. The American FDA pointed out that foetal damage could not be totally excluded with the majority of antirhinitis drugs. It is recommended to use "older drugs" because more data about their safety are available. Cromones are the safest drugs but, although they need multiple daily administrations. Antihistamines should be considered as second choice drugs, and their use is not recommended during the first three months of pregnancy. Topical steroids are useful in moderate-severe rhinitis, being beclometasone the most documented molecule. Topical vasoconstrictors should not be used continuously because they can induce pharmacological rhinitis. It is not recommended to start specific immunotherapy in pregnancy but it can be continued in patients who benefit from its use. Infective rhinitis should be treated with beta-lactams, cephalosporins or macrolides. Finally it is important to evaluate the cost/usefulness ratio before any drug prescription.

Abnormalities, Drug-Induced↗
PubMed2001

The role of patient training in the management of seasonal rhinitis and asthma: clinical implications.

BACKGROUND: Allergic rhinitis is an inflammatory disease often associated with bronchial asthma. Intranasal corticosteroids and oral antihistamines are the first-choice drugs. Patient training is relevant to asthma management, but little is known about its impact on rhinitis. We evaluated the role of patient training in the treatment of allergic rhinitis and its effects on nasal and bronchial symptoms. METHODS: One hundred and one patients (M/F = 62/39, age range 12-62 years) with pollen-induced rhinitis (32 with concomitant mild asthma) were enrolled. They were randomized into three groups: A (n = 30) with drug therapy alone, B (n = 35) with drug therapy plus training on the use of nasal spray, and C (n = 36) the same as B plus a lesson on rhinitis and asthma. All patients received mometasone furoate nasal spray for 8 weeks as regular therapy, plus rescue medications on demand. Symptoms and drug consumption were evaluated during the pollen season. RESULTS: The rate of noncompliance/dropout was highest in the untrained patients (P = 0.001). No difference in nasal symptoms was seen among the three groups. On the other hand, group C had significantly fewer asthma symptoms (P = 0.02) and less albuterol use (P = 0.005) than group A. Moreover, the trained group globally used less rescue medication than the other groups (P = 0.02). CONCLUSIONS: Detailed training of patients seems to improve compliance with treatment, reduce concomitant asthma symptoms, and reduce the use of symptomatic drugs.

Administration, Intranasal↗
PubMed2001

[Anisakiasis: a borderline disorder].

Anisakis simplex is a nematode which can parasitize many different kinds of fish or cephalopods (codfish, salmon, tuna, mackerel, hake, etc). Anisakis simplex can cause different diseases in humans. The human being acquires the larvae by eating raw or undercooked seafood. Acute anisakiasis is probably caused by an inflammatory and/or allergic response in the digestive tract mucosa with abdominal pain. It can also induce IgE-mediated reactions with several clinical manifestations ranging from urticaria/angioedema to anaphylaxis. Chronic anisakiasis results from abscesses or eosinophilic granulomas caused by parasite invasion. This later form can mimic appendicitis, duodenal ulcer, inflammatory bowel diseases and intestinal obstruction. An early gastroduodenoscopy can confirm the diagnosis and prevent the complications. Serodiagnosis of anisakiasis is difficult since many Anisakis antigens show cross-reativity complications. In fact many people have high IgE titles in the absence of obvious allergic reactions to seafoods. As preventive measures heating for 10 min over 65 degrees C or freezing (minus 20 degrees for 24 h) destroys the infectivity of the larval stage but not always prevent allergic reactions.

Animals↗
PubMed2000

[Rhino-bronchial syndrome].

A close anatomical and functional relationship between superior and inferior airways is well documented. A typical example is offered by the close relationship between allergic rhinitis and asthma whose close connection is documented by epidemiological and pathological data. The mechanisms which can explain this phenomenon are not fully known but naso-bronchial reflexes, mouth-breathing due to nasal obstruction and aspiration of nasal secretions seem all to be important. Moreover it has been recently proved that the treatment of rhinitis can improve the concomitant asthma thus confirming their relationship. Another less frequent association is between sinusitis and asthma. Such a connection seems to be frequent in patients suffering of atopic rhinitis but also in patients presenting a nasal obstruction of different nature such as deviations of the nasal septum, adenoid hypertrophy etc. Also in this case a correct medical or surgical treatment of sinusitis can improve asthma symptomathology. Finally a classic example of involvement of superior and inferior airways is represented by the syndrome of ASA intolerance. These patients in fact initially complain of rhinitis which afterwards is complicated by the onset of nasal polyposis and asthma which can prove clinically very severe. Nowadays, anyway, there is no evidence that the treatment of rhinitis or polypectomy can improve the clinical course of asthma. In conclusion, diseases of superior and inferior airways must be considered in strict connection and need the same global treatment.

Asthma↗
PubMed1998

[Cytokines and asthma].

Asthma is a chronic inflammatory lung disease in which eosinophils are one of the most important involved cells. These cells accumulate in the lung because of cytokines, which are able to regulate cellular responses. The role of cytokines is well known in allergic asthma: IL4, IL5, IL3, GMCSF are the principally cytokine involved. IL4 regulate IgE synthesis while IL5, (and IL3) cause the activation and accumulation of eosinophils. In non allergic asthma, whilst only IL5 seemed to be important recent data, shows that also IL4 plays an important role. Therefore nowadays no relevant difference seems to exist between allergic and non allergic asthma; instead the primer is different: the allergen in allergic asthma and often an unknown factor in the non allergic asthma. Recently other cytokines have been proved to play a role in the pathogenesis of asthma. IL8 is chemotactic not only for neutrophils but also for eosinophils and might cause chronic inflammation in severe asthma. IL13 works like IL4, while RANTES seems to be a more important chemotactic agent than IL5. Finally IL10, which immunoregulates T lymphocyte responses, may reduce asthma inflammation. In conclusion cytokine made us to learn more about the pathogenesis of asthma even if we do not yet know when and how asthma inflammation develops.

Asthma↗
PubMed1998

[The natural history of asthma].

Asthma is a chronic inflammatory disease of airways with a multifactorial pathogenesis. Both genetic and environmental factors contribute to the development of the disease which can vary in the same patient through time. Due to its complexity, natural history of asthma is poorly well-known. Generally, in the history of asthma three periods of life are taken into consideration: early childhood, adolescence and adult life. It has been demonstrated that less than one third of children who are affected by wheezing in early childhood develop a true asthma afterwards. Usually in these subjects who are male and atopic, viruses and subsequently allergens represent the most important factors responsible for the development of asthma. During adolescence airborne allergens represent the main cause of the disease: mites in infancy and pollens in late childhood. The incidence of asthma during adolescence is growing according to recent studies, and even if the symptomatology of asthma improves through time, about two thirds of patients remain asthmatic in their adult life. As regards adults etiology, it is less known, women are more frequently affected than men and the prognosis is generally poorer. Several factors negatively influence the course of asthma such as age, smoking, the severity of the disease during infancy, the persistence of functional obstructive alterations and the increased aspecific bronchial reactivity. Adequate therapy is crucially important to cope with these factors and can change the course of the disease.

Adolescent↗
PubMed1994

Pituitary-adrenal function in asthmatic patients treated with high dose of beclomethasone.

Ten asthmatic patients receiving long term treatment with high dose of inhaled beclomethasone dipropionate (BDP) (750 to 2,250 micrograms/die, average 1,400 +/- 474 micrograms) underwent evaluation of hypothalamic-pituitary-adrenal (HPA) axis under basal conditions (serum cortisol and ACTH levels at 8.00 AM and 8.00 PM, 24-hours free urinary cortisol) and by means of pharmacological tests (short tetracosactide and Corticotrophin Releasing Factor Tests). Basal ACTH serum levels at 8.00 PM were lower than the normal values in all patients: three patients had reduced 24-hr free urinary cortisol and six subjects showed lower cortisol serum levels at 8.00 PM. A normal response to the short tetracosactide test was observed in all patients, whilst Corticotrophin Releasing Factor (CRF) induced an increase in ACTH and cortisol levels (expressed as delta AUC) that was significantly lower in the BPD treated patients compared with a control group of five healthy subjects (p < 0.05). Thus BPD, in high doses, may cause a partial inhibition of HPA axis. Our results show that determination of basal ACTH level and CRF test are more sensitive than serum cortisol levels and short tetracosactide test to evaluate a suppression of HPA axis in patients receiving long term inhaled high doses of BDP.

Adrenocorticotropic Hormone↗
PubMedDate not supplied

Cold-induced rhinitis in skiers--clinical aspects and treatment with ipratropium bromide nasal spray: a randomized controlled trial.

Cold-induced rhinitis (CIR) is common among skiers and is perceived as a troublesome disease. We studied the clinical characteristics of CIR in a population of skiers and we evaluated the effectiveness of ipratropium bromide nasal spray (IBNS) in relieving symptoms in a double-blind placebo-controlled fashion. By means of specific questionnaires, we evaluated 144 subjects (69% men; mean age, 42.2 years). The prevalence of CIR was 48.6% and the distinctive symptom was rhinorrhea (96%), often severe. The prevalence of atopy was higher in the CIR patients (chi2; p = 0.004). Twenty-eight CIR subjects participated in a double-blind placebo-controlled cross-over trial for evaluating the effectiveness of IBNS (80 microg twice per day [b.i.d.]). The severity of symptoms was assessed by a visual analog scale, and the number of cleaning tissues used also was evaluated. The actively treated group showed a significant improvement of rhinorrhea (p = 0.0007) and a reduction in the number of cleaning tissues used (p = 0.0023). Only four mild local side effects were reported. We conclude that IBNS could be regarded as an optimal therapeutic option for treating CIR symptoms in skiers.

Adolescent↗
PubMedDate not supplied

[Epidemiology of allergic respiratory diseases: many questions, few answers].

Over the last twenty years an increase of allergic respiratory diseases has been observed, even if a broad variability of incidence has been reported. Asthma and allergic rhinitis are more common among young subjects, but there are data of an increase of allergic respiratory diseases in older patients. Moreover it has to be underlined the increase of the severity of these diseases, as shown by the higher use of anti-allergic drugs and by the increase of fatal asthma. The reasons of this trend are not understood. One reason can be the more appropriate diagnosis of asthma by the general practitioners. Other factors must be considered: the most important one can be air pollution; many air components (i.e. SO2, NO2, O3), particularly in industrialized countries, may play a role in allergic sensitization through an irritative-inflammatory mechanism. Socio-economic factors can also influence the incidence of allergic diseases. Other factors as cigarette smoke, foods, allergenic load have to be mentioned. Finally a viral etiology has been reported. Very recently, the allergic inflammation has been considered as the crucial event in the pathogenesis of allergic respiratory diseases. As allergic diseases can lead to chronic inflammation, an early and long-lasting treatment is mandatory.

Adolescent↗
PubMedDate not supplied

[New drugs in the treatment of respiratory allergic diseases].

The drugs recently available for the treatment of allergic respiratory diseases include: 1) topical steroids as fluticasone and budesonide; 2) nasal and ocular sodium nedocromil; 3) nasal N-acetyl-aspartyl-glutamic acid; 4) topical antihistamines as levocabastine and azelastine; 5) antileukotrienes and anti PAF (experimental). Topical steroids are the most effective drugs; the new molecules have a low gastric absorption and a rapid liver-metabolism which decreases the risks of systemic side effects. In the treatment of allergic conjunctivitis ocular sodium nedocromil seems to be more effective than cromoglycate, however further studies are needed to evaluate the effectiveness of the nedocromil nasal formulation. In allergic rhinitis good clinical results are obtained using NAAGA. In the treatment of allergic rhino-conjunctivitis topical antihistamines seem as effective as the antihistamines administered by oral route; moreover they cause less side effects. The anti-leukotrienes drugs can be used in the treatment of moderate asthma. In the treatment of bronchial asthma no clinical and functional improvement has been reported using PAF or thromboxane A2 receptor antagonists.

Administration, Topical↗