Biomedical subjects

Matthias F Kramer

Publications and source records attributed to Matthias F Kramer.

4 recordsLinked to original sources

PubMedDate not supplied

NARES: a risk factor for obstructive sleep apnea?

BACKGROUND: Nonallergic rhinitis with eosinophilia syndrome (NARES) constitutes a rare nasal condition characterized by a chronic, eosinophilic inflammation. Patients' major complaints constitute nasal congestion and rhinorrhea. Obstructive sleep apnea syndrome (OSAS) is a potentially life-threatening condition characterized by recurrent episodes of obstruction of the upper airways resulting in oxygen desaturation. Nasal congestion constitutes one predisposing factor for OSAS. OBJECTIVE: The purpose was to study whether NARES constitutes a risk factor for OSAS. METHODS: The study included 26 patients presenting typical symptoms of sleep apnea. Ten patients were diagnosed to suffer from NARES (mean age 56.8 +/- 12.5, body mass index [BMI] 29.3 kg/m(2) +/- 2.8; 9 men:1 woman) and were compared with 16 age- and BMI-matched individuals (mean age 58.8 +/- 11.6, BMI 29.7 kg/m(2) +/- 3.8, 16 men) without any nasal inflammation, such as allergic rhinitis, sinusitis, nasal polyposis, or vasomotor rhinitis. All patients were tested by polysomnography for an OSAS. RESULTS: Patients suffering from NARES revealed significantly (P <.01) impaired polysomnographic parameters (hypopnea index, apnea-hypopnea index, mean and minimal oxygen saturation) compared with patients without any nasal inflammation. CONCLUSIONS: Our data point to NARES as a risk factor for the induction or augmentation of OSAS. NARES patients suffered from severe OSAS, whereas nondiseased individuals suffered only from moderate OSAS, according to the criteria of the American Academy of Sleep Medicine. Our data support results of others, suggesting chronic nasal inflammation to cause OSAS. Mechanisms for our observations are not fully understood yet. Nasal obstruction or neuronal reflexes might be involved.

Aged↗

PubMedDate not supplied

Factors contributing to nasal allergic late phase eosinophilia.

OBJECTIVE: This study focused on factors contributing to eosinophilia after intranasal allergen challenge. METHODS: Nasal secretions of 13 allergic individuals were gained over a period of 8 hours after nasal allergen challenge. Early and late phase reactions were determined by acoustic rhinometry and changes of volume and total protein in nasal secretions. Eosinophilia was demonstrated by nasal eosinophilic cationic protein. Interleukin (IL)-5; the chemokines IL-8, monocyte chemotactic protein (MCP)-1 and MCP-3, and eotaxin; soluble vascular cell adhesion molecule 1 (sVCAM-1); and the leukotriene C4 (LTC4) were analyzed by enzyme-linked immunosorbent assay for their suggested impacts on tissue eosinophilia. RESULTS: By means of rhinometry, we observed in 69% an alternating type of late phase response, followed by a bilateral (15%) or unilateral (8%) type. A biphasic kinetic could be demonstrated by changes in nasal volume and total protein of nasal secretions, reflecting the early and late phase responses. A typical late phase kinetic was observed for IL-5, MCP-1, eotaxin, sVCAM-1, and LTC4. Interleukin 8 was characteristic for early phase reaction but increased in late phase as well. We could not detect any MCP-3 in our samples. CONCLUSIONS: Our data point to a relevant role of the T(H)2 cytokine IL-5; of the chemokines IL-8, MCP-1, and eotaxin; of the adhesion molecule sVCAM-1; and of the leukotriene LTC4 for the allergic late phase eosinophilia.

Adult↗

PubMedDate not supplied

Health-Related Quality of Life in rhino surgery.

BACKGROUND: Health-Related Quality of Life (HRQL) measures the impact of a pathologic condition on patient's daily life. Besides from disease-related symptoms, it includes a wide spectrum of daily life activities such as physical and social activities, emotional problems, general feeling, and so on. HRQL of patients with nasal diseases is known to correlate only moderately to conventional clinical markers. HRQL data about patients undergoing rhino surgery are not available to date. OBJECTIVE: The purpose of this study was to study HRQL in patients undergoing nasal surgery and to measure therapeutic effects 3 months postoperatively. METHODS: We used a specific health profile HRQL questionnaire with 25 items summarized in 6 symptom groups: sleep; nonnasal, nasal, and emotional symptoms; headache; and practical problems (symptom score 1 to 4). A visual analog scale (0 to 10) was given to measure the patient's general feeling related to their nasal disease. One hundred eighty-one patients undergoing nasal surgery for various reasons were included preoperatively. One hundred seven of them could be interviewed 3 months postoperatively to study therapeutic effects of our surgical intervention. RESULTS: Patient's pre- and postoperative HRQL status could be determined, and differences in disease-related subgroups could be identified. Comparing pre- and postoperatively gained HRQL data revealed a significant improvement in symptom score of 23 of 25 items and according to the following in all symptom groups: sleep preoperatively 2.46 versus postoperatively 1.98 (P <.01), nonnasal symptoms preoperatively 2.13 versus postoperatively 1.91 (P <.01), headache preoperatively 2.17 versus postoperatively 1.72 (P <.01), practical problems preoperatively 2.47 versus postoperatively 2.06 (P <.01), nasal symptoms preoperatively 2.39 versus postoperatively 1.90 (P <.01), and emotional problems preoperatively 2.01 versus postoperatively 1.81 (P <.01). The general feeling score improved from preoperatively 6.47 to postoperatively 3.95 (P <.01) as well. CONCLUSIONS: We could measure patient's HRQL status pre- and postoperatively, could work out peculiarities of the studied subgroups, and showed therapeutic benefits of our surgical intervention.

Adult↗

PubMedDate not supplied

An approach of immunoneurological aspects in nasal allergic late phase.

This examination is an approach of the allergic early phase reaction (EPR) and late-phase reaction (LPR) via quality of life (QoL), acoustic rhinometry, and eosinophilic cationic protein (ECP), interleukin (IL)-5, and leukotriene C4 (LTC4). Results are discussed under consideration of a possible neurological participation in the occurrence and persistence of the allergic inflammatory process. Thirteen patients suffering from seasonal allergic rhinitis were challenged intranasally by their specific allergen. In a time window of 8 hours after provocation, patients completed QoL questionnaires, and underwent acoustic rhinometry. Nasal secretions were analyzed for total protein, ECP, IL-5, and LTC4 The need to sneeze and a runny nose were the strongest symptoms during the EPR and LPR. Restriction of overall QoL persisted much longer than any other symptom. Evaluation of acoustic rhinometry revealed an EPR in 100% and a LPR in 92%. The EPR was marked by increases in volume of nasal secretions, total protein, and elevations in LTC4. Allergic LPR was marked by increases in nasal secretions, total protein, ECP, IL-5, and LTC4. Both the need to sneeze as strongest and announcing symptom of the allergic LPR and the persisting restriction in overall QoL seem to propose a possible neurological participation in the development of the allergic late-phase inflammation and consequent hyperresponsiveness of the nasal mucosa. In addition, the persistence and enhancement of the nasal cycle during the allergic LPR can be interpreted in favor of a hypothetical activation of the autonomous nervous system. LTC4 enters this discussion as a promising link at the immunoneurological interface.

Adult↗