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Biomedical subjects

M Bende

Publications and source records attributed to M Bende.

At least 19 recordsLinked to original sources
PubMed2001

Capsaicin cough sensitivity is decreased in smokers.

Although capsaicin provocation has been used to evaluate treatment against cough, which is one of the most common respiratory symptoms, there are still methodological considerations that are not fully known. Capsaicin stimulates the unmyelinated slow C-fibres of the sensory nervous system, which leads to coughing. Smoking often leads to respiratory symptoms with cough and phlegm. The aim of this study was to examine the effect of smoking on capsaicin provocation. Subjectively healthy smokers and non-smokers were challenged with capsaicin in increasing doses. The coughs were counted and irritation of the lower airways was graded on a symptom score. Smokers reacted to provocation with significantly fewer coughs, but there was no difference regarding other symptoms. These results are in agreement with the hypothesis that nicotine inhibits or blocks C-fibres of the sensory nervous system of the lower respiratory tract. Clinically, this may serve to explain increasing airway symptoms that are often seen after cessation of smoking.

Adolescent↗
PubMed2000

Quality of life and capsaicin sensitivity in patients with sensory airway hyperreactivity.

BACKGROUND: A group of patients with asthma-like symptoms and sensitivity to chemical irritants has shown an increased cough sensitivity to inhaled capsaicin compared to patients with asthma and to healthy controls. The condition is called sensory hyperreactivity (SHR), and the patients often feel that they are socially handicapped because of the risk of exposure to chemical irritants in daily life. METHODS: Twenty-six patients with asthma-like symptoms after exposure to nonspecific irritating stimuli, but without IgE-mediated allergy or demonstrable bronchial obstruction, were selected for a study of the response to a capsaicin test and measurement of quality of life by a general health profile (the Nottingham Health Profile [NHP]). We also investigated whether there was a correlation between quality of life and sensitivity to capsaicin. RESULTS: The patients demonstrated a dose-dependent response to the capsaicin provocation, with coughing and respiratory and other symptoms, that significantly differed from 12 healthy controls. The health profile showed that patients with SHR had a significantly reduced quality of life compared to reference values, and there was a significant correlation between the health profile and sensitivity to capsaicin. CONCLUSIONS: Patients with asthma-like symptoms verified by the capsaicin inhalation test for sensory hyperreactivity have a poor quality of life. The correlation between quality of life and sensitivity to capsaicin objectively demonstrates the validity of this general health profile study.

Administration, Inhalation↗
PubMed2000

Effect of nasal air temperature on FEV1 and specific airways conductance.

We investigated whether changes in nasal air temperature affect specific airway conductance (SGaw) and one second forced expiratory volume (FEV1) in 10 asthmatic patients with a history of cold-sensitive asthma and eight healthy subjects. An air-stream (0.6 l s-1) of -15 degrees C, +22 degrees C or +37 degrees C was blown into both nostrils during a Valsalva manoeuvre. Each provocation consisted of 10 puffs of air, each of 15 s duration, at 1 min intervals. Before and at regular intervals after the provocations, SGaw and FEV1 were determined. In asthmatics, after cold air provocation, SGaw fell 23% (P<0.01) and FEV1 8% (P<0.01). After the warm air provocations, SGaw rose 15% (P<0.01) and FEV1 6% (P<0.01). After the ambient air provocations, no significant changes occurred in SGaw or FEV1. In the healthy subjects, the nasal provocations caused no significant changes in lung function. The present study shows that cold air in the nose causes a slight obstruction and warm air possibly a slight dilatation of the lower airways in patients with a history of cold-sensitive asthma but not in healthy subjects.

Adult↗
PubMed2000

Nasobronchial relationship after cold air provocation.

Provocation with cold air in the nose causes broncho-obstruction while warm air causes bronchodilation in patients with asthma, but not in healthy subjects. These findings have suggested the existence of a nasobronchial reflex. The present study aimed to block this effect and evaluate the mechanisms underlying the effect on lung function after cold stimulation of the nose. Lung function, as measured with specific conductance and forced expiratory flow, was reduced after cold stimulation of the nose, but this effect could not be blocked by anesthetizing the nose or by inhaling an anti-cholinergic drug before the provocation. These results confirm the presence of a nasobronchial relationship, but not of a nasobronchial reflex.

Adult↗
PubMed2000

Evaluation of methods for endoscopic staging of nasal polyposis.

Endoscopy is needed for reliable evaluation of the treatment of nasal polyposis. In this study, we compared the reproducibility of various score systems for staging nasal polyposis and the inter-individual variations between investigators. The mass of the polyps was assessed by five methods, three new techniques (numbers 1, 2 and 3) and two established ones (numbers 4 and 5). These were: 1, lateral imaging projecting the extension of the polyps by drawing on a schematic picture of the lateral wall of each nasal cavity; 2, assessment of polyp obstruction estimating the proportion of the total nasal cavity volume occupied by polyps; 3, nasal airway patency--determining the relationship between the patient's patent airway lumen and an imaginary maximal nasal airway lumen; 4, a score system with four steps ad modum Lildholdt et al.--determining their relationship to fixed anatomical landmarks; and 5, a score system with three steps ad modum Lund and Mackay--determining their relationship to the middle meatus. High correlations were found between the first and the second assessments by a given investigator with all five methods used to score nasal polyposis. High correlations were also shown between the various methods. When three investigators examined a given patient, there were no significant differences between the investigators using score systems 1, 3 and 4. However, with score systems 2 and 5, there was insufficient agreement between the investigators. The patient's symptom of nasal blockage was not a good indicator of the size of the polyps, especially as regards small polyps. Two of the best methods tested (1 and 4) were selected for further clinical studies regarding evaluation of the sensitivity of score systems to detect changes in polyp size during treatment.

Adult↗
PubMed1999

An independent association between obstructive sleep apnoea and coronary artery disease.

Previous studies of sleep and breathing suggest an independent association between coronary artery disease (CAD) and obstructive sleep apnoea (OSA) in middle-aged males and females. These studies, however, were criticized because they did not properly adjust for all important confounding factors. In order to better control for the impact of these confounders, a case-control study was performed, matching for age, sex and body mass index (BMI), and additionally adjusting for hypertension, hypercholesterolemia, diabetes mellitus and current smoking. A consecutive selection of 62 patients (44 males and 18 females, mean age 69 yrs, range 44-88 yrs) requiring intensive care for angina pectoris or myocardial infarction at the County Hospital of Skaraborg, Skövde, Sweden, as well as 62 age-, sex- and BMI- matched control subjects without history or signs of heart disease underwent an overnight sleep/ventilatory monitoring study. The time interval between discharge from the intensive care unit and the overnight study ranged between 4 and 21 months. OSA, defined as a Respiratory Disturbance Index (RDI) of > or =10 x h(-1), was present in 19 CAD patients but only in eight control subjects (p=0.017). Using a univariate logistic regression analysis, current smoking (odds ratio (OR) 8.1, 95% confidence interval (CI) 2.2-29.0), diabetes mellitus (OR 4.2, 95% CI 1.1-16.1) and OSA (OR 3.0, 95% CI 1.2-7.5), but not hypertension (OR 1.5, 95% CI 0.7-3.2) and hypercholesterolaemia (OR 1.8, 95% CI 0.7-4.1) were significantly correlated with CAD. In a multiple logistic regression model, current smoking (OR 9.8, 95% CI 2.6-36.5), diabetes mellitus (OR 4.2, 95% CI 1.1-17.1) and OSA (OR 3.1, 95% CI 1.2-8.3) all remained independently associated with CAD. In summary, these data suggest a high occurrence of obstructive sleep apnoea in middle-aged and elderly patients with coronary artery disease requiring intensive care, which should be taken into account when considering risk factors for coronary artery disease.

Adult↗
PubMed1999

Nasal stuffiness during pregnancy.

OBJECTIVE: To investigate the occurrence of nasal stuffiness during pregnancy. STUDY DESIGN: Prospective longitudinal study, with collection of data during 1 year in a cohort of 2,264 pregnant women. METHODS: Self-reported nasal stuffiness in gestational weeks 12, 20, 30, and 36 was correlated to age, parity, body mass index, and smoking habits. RESULTS: The prevalence of nasal stuffiness increased during pregnancy and occurred in 27% of the women at 12 weeks of gestation, in 37% at 20 weeks, in 40% at 30 weeks and in 42% at 36 weeks. Sixty-five percent of the women reported stuffiness at some time when asked. It was commoner in multiparous than in nulliparous women. Age, body mass index, and smoking habits were not associated with nasal stuffiness. CONCLUSION: Self-reported nasal stuffiness for 3 or more weeks was common during pregnancy and could occur at any time in two thirds of the women. Treatment regimens to alleviate this symptom should be developed.

Adult↗
PubMed1998

The Scandinavian Odor-Identification Test: development, reliability, validity and normative data.

The Scandinavian Odor-Identification Test (SOIT) was developed to address the need for a culturally valid odor-identification test for clinical use on the Scandinavian population that (i) has good ability to generalize performance to olfactory status, (ii) assesses olfactory and trigeminal function separately, (iii) requires only limited cognitive demands, (iv) has normative data and good sensitivity and specificity, and (v) is fast, easy to administer and inexpensive. Sixteen odorous test stimuli were selected that were relatively identifiable, familiar, strong in intensity and pleasant according to healthy participants. Four response alternatives were then selected for each test stimulus based on a confusion matrix of identification rates obtained from healthy participants, in a manner that controlled for task difficulty. Results on the SOIT from healthy persons and hyposmic patients showed satisfactory test-retest reliability, split-half reliability and validity. Cut-off scores for olfactory diagnosis (normosmia, hyposmia, anosmia) based on normative data obtained from 171 healthy persons showed a satisfactory sensitivity and specificity of the SOIT. Assessment of 22 anosmic patients with the SOIT revealed that three of the test stimuli were significant trigeminal stimulants.

Adolescent↗
PubMed1998

Sensory hyperreactivity--a possible mechanism underlying cough and asthma-like symptoms.

BACKGROUND: Investigations of patients referred for suspected asthma have revealed a little-known group with symptoms suggesting hyperreactive airways in whom provocation with methacholine does not lead to bronchial obstruction. The underlying mechanisms are not known, and no objective diagnostic method has been available. METHODS: Provocations by inhalation of capsaicin solutions in stepwise increasing concentrations were used. Ten patients with asthma-like symptoms after exposure to nonspecific irritating stimuli, but without IgE-mediated allergy or demonstrable bronchial obstruction, were compared to 10 patients with verified bronchial asthma and 28 healthy controls. RESULTS: The patients with asthma-like symptoms reacted with cough in a dose-dependent way. The number of coughs was significantly greater than in asthmatic patients and healthy controls. The latter two groups did not differ significantly. CONCLUSIONS: The capsaicin provocation test may be a valuable method for showing not only a greater cough sensitivity, but also asthma-like symptoms. The pathophysiology underlying the symptoms may be related to increased sensitivity of free, overactive nerve endings in the respiratory mucosa. Therefore, we suggest that this overreaction in the lower airways be called "sensory hyperreactivity".

Adult↗
PubMed1998

Evaluation of side effects after nicotine nasal spray in patients with chronic rhinitis.

Thirty-three subjects with chronic rhinitis used nicotine nasal spray in an open study as an aid in smoking cessation. Thirty-eight percent of them were completely abstinent at 12 weeks, whereas 35% were completely abstinent at 20 weeks. The nasal spray was associated with irritant nasal side effects, which occurred most often in the early stages of treatment. Clinical nasal examinations could not observe any significant impairment in nasal conditions following spray use. In conclusion, this study confirms the short-term safety of the nicotine nasal spray as an aid in smoking cessation.

Administration, Intranasal↗
PubMed1997

Glucocorticoid treatment for nasal polyps. The use of topical budesonide powder, intramuscular betamethasone, and surgical treatment.

BACKGROUND: The treatment of nasal polyps is controversial, and medical treatment alone has been little investigated to our knowledge. OBJECTIVE: To examine the efficacy of therapy using only topical budesonide powder and topical budesonide powder supplemented with surgical removal or intramuscular betamethasone. DESIGN: Randomized, double-blind comparison of 2 dosages and additional treatment, if therapy failed. After 1 year, treatment with medication was stopped, and the demand for renewed treatment was monitored for another year. PATIENTS: Patients with bilateral nasal polyps who demanded treatment were consecutively enrolled in a hospital outpatient clinic or specialty private practice. During a 15-month period from 1990 to 1992, a total of 126 patients entered the 2-year study. INTERVENTIONS: In phase 1, randomized and double-blind treatment with a topical medication, budesonide powder, 800 micrograms or 400 micrograms daily, or a placebo was given for 1 month. In phase 2, randomized and double-blind treatment with budesonide powder, 800 micrograms or 400 micrograms daily, was given. At the end of phase 1, failed therapy was supplemented by randomly assigned treatment of either surgical removal or a single injection of sustained released betamethasone. In phase 3, treatment with the medication was discontinued, and patients were monitored for another year. The time when treatment was required again was noted. The present article deals with phases 2 and 3. MAIN OUTCOME MEASURES: Patients' scores of treatment efficacy as well as symptoms and signs. Semiquantitative measurement of sense of smell and calculation of peak expiratory flow rate index based on nasal and oral peak expiratory flow. RESULTS: In all outcome measures, a comparison of the data before treatment with the corresponding figures during phase 2 showed statistically significant efficacy. The clinical course was described at the end of phase 2. About 85% of the patients, including those who received additional therapy because the initial therapy failed, rated total or substantial control over the symptoms. The 2 dosages investigated showed equal results. These findings were consistent with the signs recorded and the peak expiratory flow rate index. The results of phase 3 showed that 50% of patients had demanded treatment after 4 months, while 34% managed without medication after 1 year. CONCLUSIONS: The clinical course in this study showed that most patients with nasal polyps do well with medical treatment. Therefore, surgery was required in few patients. However, the potential of medical treatment should be further explored in future studies.

Administration, Inhalation↗
PubMed1997

Perceptual learning in olfaction: professional wine tasters versus controls.

By having professional wine tasters and controls perform olfactory tasks of absolute detection (1-butanol), discrimination (lemon and cloves), and identification (common household odors), the present two experiments studied (a) if perceptual odor learning takes place from odor experience acquired under nonlaboratory conditions, (b) if this learning generalizes to odors for which experience is limited, and (c) if generalized learning can be referred to increased general interest for odors that increases attention to odorous features. The results showed that whereas wine tasters were not better than controls on detection, they were superior to controls on discrimination and identification, the latter due to only a few odors. Ratings of experience with certain odors during professional evaluation suggest that generalized perceptual learning may take place in discrimination but not in identification. Wine tasters did not show more general interest for odorous features than did controls. The nonsuperiority in detection may be explained by the fact wine tasters have no professional experience of a detection task per se, implying that perceptual odor learning does not generalize from the olfactory tasks of discrimination and identification to detection.

Adult↗
PubMed1997

Nasal mucosal congestion during the menstrual cycle.

A relationship between the reactivity of the nasal mucosa and changes in female sex hormones have been debated for a long time, although no evidence has been presented to prove or disprove this relationship. Nasal patency was therefore measured by nasal expiratory peak-flow in 26 women for two months in order to study changes in nasal mucosal congestion during the menstrual cycle. In another eight women, nasal congestion was measured by acoustic rhinometry, and symptoms of nasal stuffiness were registered during periods when there were various levels of plasma oestradiol and progesterone. Finally, nasal mucosal biopsies were taken for preparation of receptors for oestradiol and progesterone. This study could not verify the effects of female sex hormones on the nasal mucosa. This could be explained by the fact that no receptors for oestradiol and progesterone were found.

Adolescent↗
PubMed1997

Infectious mononucleosis treated by an antihistamine: a comparison of the efficacy of ranitidine (Zantac) vs placebo in the treatment of infectious mononucleosis.

This study investigated whether the course of infectious mononucleosis was influenced by medication with ranitidine (Zantac). A double-blind, placebo-controlled study enrolled 117 patients and either ranitidine 300 mg or placebo were given twice daily for 2 wk. Patients were examined on day 5, 10, 15 and 30. Efficacy variables included severity and duration of fever, scores of cervical lymph node size and tonsil size, eating problems, fatigue, influence on general condition, the use of analgesics and blood analyses. Results were analysed in 91/117 patients. Small differences were found between treatment groups in favour of the active drug. However, they were not statistically significant. After 2 wks of treatment abnormal 'liver enzymes' (ALAT/ASAT) were found in 13/48 (0.27) of the ranitidine group in contrast with 18/36 (0.50) of the placebo group (P = 0.03). The conclusion is that the course of infectious mononucleosis is little influenced by ranitidine treatment for 2 wks. The faster normalization of the 'liver enzymes' may reflect modulation of the immune system by ranitidine.

Alanine Transaminase↗
PubMed1997

Reduced hospitalization with cardiovascular and pulmonary disease in obstructive sleep apnea patients on nasal CPAP treatment.

Cardiovascular and pulmonary disease (CVPD) is common in patients with obstructive sleep apnea syndrome (OSAS). This retrospective study addressed the accumulated in-hospital time during 2 years prior to treatment with nasal continuous positive airway pressure (nCPAP) as compared to 2 years after initiating of nCPAP in patients with OSAS and CVPD. A cohort representing all patients (n = 88) receiving nCPAP during the period 1988-1994 at the Skövde Central Hospital, Skövde, Sweden, was studied. Data collection was based on interviews with patients as well as reviews of clinic charts. All hospitalizations and diagnostic codes by any type were thereby successfully gathered for the whole group. Six patients with confounding serious diseases were excluded from the analysis. A CVPD diagnosis (ICD-9, codes 401-435 and 490-496) was found in 54 out of 82 patients (66%), of whom 36 of 58 were nCPAP users (62%) and 18 of 24 were nonusers (75%). In 54 sleep apneics with CVPD, 31 were hospitalized acutely under one or more of these diagnostic codes during the study period of 4 years. The total number of in-hospital days due to CVPD in the nCPAP users (n = 19) before nCPAP prescription was 413 days (median 10, range 3-66) compared to 54 days (median 0, range 0-25) after nCPAP (p < 0.0001). The corresponding values for the nonuser group (n = 12) was 137 days (median 8.5, range 0-42) before and 188 days (median 9.5, range 0-47) after the nCPAP prescription (ns). We conclude that nCPAP treatment reduces the need for acute hospital admission due to CVPD in patients with OSAS. This reduction of concomitant health care consumption should be taken into consideration when assessing the cost-benefit evaluation of nCPAP therapy.

Aged↗
PubMed1996

Effect of oxymetazoline nose drops on acute sinusitis in the rabbit.

This investigation was designed to evaluate the effect of the common topical nasal decongestant oxymetazoline hydrochloride on the early local tissue defense in an experimental bacterial infection. For that purpose, a bilateral infection of the maxillary sinus was induced in 14 rabbits. Nose drops (oxymetazoline) were instilled in one nasal cavity, and placebo in the other. After 48 hours, the degree of infection was judged by using a semiquantitative inflammatory score to evaluate histologic preparations of the maxillary sinuses. On the oxymetazoline-treated side, we found a significantly higher degree of inflammation. We conclude that oxymetazoline nose drops, commonly used in acute rhinitis and sinusitis, interfere with the normal defense mechanisms during bacterially induced sinusitis, possibly by a decrease in mucosal blood flow.

Acute Disease↗
PubMed1996

Effect of systemically administered H1- and H2-receptor antagonists on nasal blood flow as measured with laser Doppler flowmetry in a provoked allergic reaction.

Twelve subjects with seasonal allergic rhinitis were challenged topically with birch pollen extract in a double-blind, double-dummy, placebo-controlled, randomized cross-over study. Pre-treatment was performed with either a selective histamine-1 (H1-) antagonist (terfenadine), a selective H2-antagonist (cimetidine), a combination of these drugs or a placebo. Nasal mucosa microcirculatory blood flow was measured with the use of laser Doppler flowmetry. The allergen challenge induced a decrease in the microcirculatory blood flow of the nasal mucosa. Pre-treatment with the H1-antagonist inhibited this effect and allergic symptoms, while pre-treatment with the H2-antagonist did not. No signs of an additive effect were seen after combination of the antagonists. Thus, H1-receptors but not H2-receptors, seem to be of importance in the pathophysiology of the allergic rhinitis.

Adult↗