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Biomedical subjects

P Ruoppi

Publications and source records attributed to P Ruoppi.

17 recordsLinked to original sources
PubMed2000

Isolated sphenoid sinus diseases: report of 39 cases.

OBJECTIVE: To detail the underlying pathological conditions, symptoms, signs, and outcomes of patients with isolated sphenoid sinus involvement. DESIGN: A retrospective survey. SETTING: An academic referral center of a university hospital. PATIENTS: All 39 patients, aged 7 to 85 years, treated in the Department of Otorhinolaryngology, Kuopio University Hospital, Kuopio, Finland, from 1988 through 1997 for isolated sphenoid sinus disease. RESULTS: Sinusitis was characterized as acute in 26 patients, subacute in 5 (including 1 pyocele), and chronic in 8 (including 2 fungal infections). No tumors were found. Isolated sinus cysts were excluded from the study. Headache, the main symptom in 32 patients (82%), was localized most commonly on the vertex. Other common complaints were rhinitis, dizziness, eye symptoms, and fever. In 2 patients, the finding was occult. Eight patients (21%) presented with cranial nerve deficits, and 1 patient had an intracranial complication. Sinus irrigation was performed in 16 patients (41%) and sphenoidotomy was performed in 10 (26%). Fifteen patients (38%) were treated with antibiotic drugs alone. Within 3 months, 31 (84%) of 37 patients had recovered from the illness; 5 still experienced headaches despite having normalized radiographic findings; and 1 had permanent unilateral visual loss. Two patients were lost to follow-up. CONCLUSIONS: Sphenoid sinus opacity is mostly inflammatory in origin. Despite the benign nature of the disease, there is a risk of complications with high morbidity and mortality. Early and, if necessary, aggressive therapy to guarantee drainage of the sinus is recommended.

Adolescent↗
PubMed1997

Kikuchi's disease: report of three cases and an overview.

We describe, to our knowledge, the first native Finnish patients with Kikuchi's histiocytic necrotizing lymphadenitis. The diagnosis was based in all cases on histopathological findings in open biopsy. The disease was first detected in Japan in 1972, but in Scandinavia, until this decade, there had been no cases reported. Our patients were young, otherwise healthy women who had cervical lymphadenopathy, fever, and fatigue as their main symptoms. In two of them, the disease was mild and subsided spontaneously within 2-6 months. One patient with more fulminant lymphadenopathy was treated with antimicrobial and antiinflammatory drugs. She became symptomless in 3 months. The cause of Kikuchi's disease is unknown. A viral or postviral hyperimmune reaction has been proposed as its etiology. Malignant lymphoma and systemic lupus erythematosus are differential diagnoses. Histopathological findings are pathognomonic and pathologists must be aware of its typical characteristics.

Adult↗
PubMed1997

Humoral responses to bovine dust in dairy farmers with allergic rhinitis.

During the indoor cattle feeding season, dairy farmers are continuously exposed to allergenic bovine-derived materials for a long time every year. Limited information is available about the dynamics of exposed people's antibody responses under the influence of this kind of exposure. In this study, the level of antibodies to bovine epithelial antigen (BEA) was found to reflect the level of clinical allergy. On the other hand, the level of immunoglobulin (Ig)E, IgA and IgG antibodies to bovine urinary antigen (BUA) was lower in the group of bovine-allergic farmers than among other farmers. It was concluded that antibodies to different allergen extracts reflect different phenomena. Antibodies to BEA seem to be associated more with allergic symptoms, where as anti-BUA antibodies might reflect the level of bovine exposure. The indoor cattle feeding season did not cause any major changes in dairy farmers' humoral responses. The continued allergen exposure did not increase the level of sensitization as determined by antibody responses.

Agricultural Workers' Diseases↗
PubMed1996

Once daily mometasone furoate aqueous nasal spray is as effective as twice daily beclomethasone dipropionate for treating perennial allergic rhinitis patients.

BACKGROUND: Perennial allergic rhinitis is chronic and persistent, may lead to a constellation of secondary complaints including sinusitis, mouth-breathing, and some symptoms resembling a permanent cold, and often requires constant medical intervention. Well-tolerated nasal corticosteroids, alone or in combination with antihistamines, have been found to be very effective in treating this condition. OBJECTIVE: To compare the effectiveness and tolerability of mometasone furoate aqueous suspension, a new once daily nasal spray, to placebo vehicle and to beclomethasone dipropionate, administered twice daily, in patients with perennial allergic rhinitis. METHODS: This was a randomized, double-blind, placebo-controlled, double-dummy, parallel group study, in 427 patients age 12 years and older at 24 centers in Canada and Europe. Patients allergic to at least one perennial allergen, confirmed by medical history, skin testing, and adequate symptomatology were eligible to receive one of the following regimens for 3 months: mometasone furoate, 200 micrograms only daily; beclomethasone dipropionate, 200 micrograms twice daily (400 micrograms total dose); or placebo vehicle control. The primary efficacy variable was the change from baseline in total AM plus PM diary nasal symptom score over the first 15 days of treatment. RESULTS: Three hundred eighty-seven patients were valid for efficacy. For the primary efficacy variable, mometasone furoate was significantly (P < or = .01) more effective than placebo and was indistinguishable from beclomethasone dipropionate. Similar trends were seen among individual symptoms, physician symptom evaluations, and therapeutic response. There was no evidence of tachyphylaxis. All treatments were well tolerated. CONCLUSIONS: Mometasone furoate nasal spray adequately controls symptoms of perennial allergic rhinitis, offers the advantage of once daily treatment, and is well tolerated.

Administration, Intranasal↗
PubMed1996

Astemizole in combination with pseudoephedrine in the treatment of seasonal allergic rhinitis.

The efficacy and side effects of once-daily astemizole-D, a combination of 10 mg astemizole and 240 mg pseudoephedrine, were compared with those of twice-daily brompheniramine-D, a combination of 12 mg brompheniramine and 50 mg phenylpropanolamine (Lunerin), in 64 patients with seasonal allergic rhinitis caused by birch pollen. Efficacy was monitored by patient's diary scores, investigator assessments of nasal and eye symptoms and need of rescue medication during the 4-week study period. Both astemizole-D and brompheniramine-D reduced nasal and eye symptoms of allergy. There were no significant differences between the treatment groups regarding obstruction, but brompheniramine-D alleviated symptoms of rhinorrhoea and itchy eyes significantly more than astemizole-D. On the other hand, the patients in the brompheniramine-D group reported dry mouth, tiredness and drowsiness more often than those in the astemizole-D group. The results indicate that the two drugs are effective in the treatment of seasonal allergic rhinitis, but astemizole-D is better tolerated than brompheniramine-D.

Adolescent↗
PubMed1994

A modification of the pressure-flow technique for measuring breathing of cold air and its effect on nasal cross-sectional area.

The purpose of this article was to develop a method based on the pressure-flow technique for measuring cold air breathing and to observe the immediate reactions of breathing function to cold air inhalation in 40 subjectively healthy adults. The pressure-flow technique was used to measure airflow rate and oral/nasal pressure and to calculate the smallest cross-sectional area of the nasal airway. The equipment was modified to allow measurements both at room temperature and with cooled air by connecting the nasal mask to a freezer with a two-valve cylinder and tubing. Nasal cross-sectional area showed a significant decrease from 42.3 mm2 at room temperature to 37.6 mm2 with cooled air. Correspondingly, the airflow rate changed from 411 ml/s to 369 ml/s, whereas the differential pressure remained about the same, 1.2 and 1.3 cm H2O, respectively. The interindividual variation was fairly large. The results suggest that the breathing of cold air seems to cause changes in nasal cross-sectional area and airflow rate. In general, the cross-sectional area diminishes, the change being quantitatively more pronounced in subjects with an initially large area.

Adult↗
PubMed1993

Acute frontal sinusitis: etiological factors and treatment outcome.

A retrospective analysis of patients with acute frontal sinusitis treated at Kuopio University Hospital between 1981 and 1990 was performed to define etiological factors, clinical course and response to treatment. The study comprised 91 patients, 67 men and 24 women, aged from 9 to 65 years with a mean age for men of 32 years and for women of 29 years. Thirty-nine patients (43%) had previously been suffering from seasonal or chronic rhinitis, which in 22 was allergic, in 15 vasomotoric and in 2 due to intolerance to acetylsalicylic acid. In one case there was a recent and in another an old nasal trauma. Forty-seven patients (52%) were hospitalized, the others treated as outpatients. All received medical treatment. In 49 patients (54%) there was contemporary maxillary sinusitis which was treated with irrigations. Nasal polyps were detected and removed in 18 patients (20%). Anterior ethmoidectomy was made in 11 patients (12%) and trephination of the diseased frontal sinus to avoid complications in 8 patients (9%). No complications occurred. In 5 patients (5%) acute frontal sinusitis recurred once and a chronic course was seen in another 5 patients of whom 3 had chronic allergic and one vasomotor rhinitis.

Adolescent↗
PubMed1992

Nasal sensitization of dairy farmers to bovine epithelial and urinary antigens.

Nineteen dairy farmers with nasal symptoms associated with working in cowhouses participated in the study. Nasal challenge with bovine epithelial antigen (BEA) and bovine urinary antigen (BUA) was made before and after the indoor feeding season. Nasal challenge made before the indoor feeding season with BEA was positive in five patients and three of them showed positive reaction in nasal challenge also with BUA. After the indoor feeding season the results in nasal challenge with BEA were approximately equal to BEA and four of them showed positive response in nasal challenge to BUA. However, we did not find any significant increase in sensitivity in nasal challenge to BEA or BUA after the indoor feeding season. In addition to these patients, two patients who were excluded from nasal challenge before the indoor feeding season showed positive results in nasal challenge after the indoor feeding season with both BEA and BUA. Our results suggest that BUA in addition to BEA may have significance to nasal symptoms.

Adult↗
PubMed1990

Comparative analysis of bovine extracts by immunoblotting and ELISA inhibition. Rabbit and human responses against cow epithelial and urine antigens.

Bovine epithelial and urine antigen extracts were compared using enzyme-linked immunosorbent (ELISA) inhibition assay and sodium-dodecyl-sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) with immunoblotting. According to ELISA inhibition results, the two extracts share about 2% of their antigenic components. Urine-derived antigens seem to be antigenically closer to serum proteins than epithelial antigens, as determined by rabbit immune sera. The IgG responses of allergic farmers against epithelial antigens were directed mainly against a protein of 20 kD, while non-allergic farmers had only very weak reactions. Generally, the IgG response against urinary antigens seemed to be more heterogeneous than against epithelial antigens. Almost all cow-allergic farmers reacted with a band at 20 kD in IgE immunoblotting against urinary and epithelial antigen while all non-allergic farmers showed negative results.

Animals↗
PubMed1987

One-dose beclomethasone dipropionate aerosol in the treatment of seasonal allergic rhinitis. A preliminary report.

Forty-one patients were treated during the birch pollen season for three weeks in a randomized, double-blind placebo controlled preliminary study. Ten patients were treated with beclomethasone dipropionate aerosol 400 micrograms once daily, 10 patients with placebo once daily, 10 patients with 400 micrograms beclomethasone dipropionate in the morning and placebo in the evening and 11 patients with 200 micrograms beclomethasone twice daily. The severity of the nasal symptoms was compared before the trial, during the pollen season without treatment, at the time of peak pollen counts and at the end of the treatment. Symptoms were equally controlled by beclomethasone dipropionate 400 micrograms once daily (two puffs of 100 micrograms per nostril), and 200 micrograms twice daily (two puffs of 50 micrograms per nostril twice). All active drug regimens were better than placebo. In conclusion, this study shows that one-dose beclomethasone dipropionate of 400 micrograms is effective in the treatment of seasonal allergic rhinitis.

Adult↗
PubMed1986

Long-term safety and efficacy of budesonide nasal aerosol in perennial rhinitis. A 12-month multicentre study.

A long-term safety study of intranasally administered budesonide, a topical glucocorticoid, has been performed. 104 patients with perennial rhinitis, allergic or non-allergic, participated in a multicentre study in seven ENT-clinics utilising an identical protocol. A budesonide dosage of 400 micrograms/day was used as starting dose, but the patients were at liberty to reduce the daily dose to 200 micrograms. The patients were observed at intervals up to 12 months. At the entry and follow-up visits the following parameters were recorded: rhinoscopic findings, nasal symptom scores, blood chemistry, hematology, urinalysis and determination of plasma cortisol levels before and after stimulation with ACTH (Synacthen). Nasal biopsies taken from 50 of the patients at the beginning and completion of the study were examined in a blinded way by an independent pathologist. The analysis revealed no histopathological changes of the nasal mucosa. At rhinoscopy no signs of atrophy or candida were reported. Lividity of the nasal mucosa was significantly reduced during the trial, which was also the case for nasal congestion and secretion. All nasal symptom parameters assessed by the patients were significantly reduced from baseline during the follow-up period. No clinically significant changes in the hematological and blood chemistry parameters were observed. Plasma cortisol analysis before and after challenge with ACTH revealed no influence on the hypothalamic pituitary adrenal axis. No tachyphylaxis was observed; on the contrary, there was a clear tendency for reduction of the daily dose of budesonide necessary to keep the patients symptom-free.(ABSTRACT TRUNCATED AT 250 WORDS)

Administration, Intranasal↗
PubMed1986

Balanced physiological saline in the treatment of chronic rhinitis.

The effects of a special balanced physiological saline on nasal symptoms of 93 patients with chronic rhinitis were studied. The main diagnoses of the patients were allergic rhinitis, atrophic rhinitis and ozaena, rhinitis sicca, chronic sinusitis, nasal polyposis and postoperative condition after nasal surgery. The tested solution was administered by a simple metered dose pump. 85 (91%) of the patients reported beneficial effects of the tested solution on nasal symptoms. In addition, 22 (71%) of those patients who used continuous anti-allergic medication, mainly intranasal steroids, reported that the tested solution improved the efficacy of their ordinary drug. So the tested solution proved to be beneficial in humidifying atrophic or otherwise dry mucosa, douching crusty nose and as adjuvant therapy in the treatment of allergic rhinitis.

Adolescent↗
PubMed1983

Two-dose beclomethasone dipropionate aerosol in the treatment of seasonal allergic rhinitis.

Seventy patients with seasonal allergic rhinitis and with positive skin test to birch pollen were treated during the birch pollen season for three weeks in a randomized, double-blind placebo controlled, multicenter study. Nineteen patients were treated with beclomethasone dipropionate aerosol (50 micrograms/puff) one puff per nostril X 4 (daily dose 400 micrograms), 20 patients with beclomethasone dipropionate aerosol two puffs per nostril X 2 (daily dose 400 micrograms), 15 patients with placebo one puff per nostril X 4, and 16 patients with placebo two puffs per nostril X 2. Efficacy of the therapy was assessed through rhinoscopy (swelling and secretion of the mucous membrane) and measuring the nasal peak expiratory flow (NPEF) before, during and at the end of the trial. Nasal symptoms and the use of antihistamine tablets were recorded for five days before the trial and daily throughout the trial. Atmospheric pollen concentrations were recorded daily and the treatment was started two days after the air pollen counts had exceeded 10/m3. The severity of the nasal symptoms was compared in the statistical analysis before the trial, during the pollen season without treatment and at the time of peak pollen counts during the treatment. Both active regimens controlled the symptoms effectively (p less than 0.01) and both placebos showed no significant effect on the symptoms. In rhinoscopy, both active drugs reduced the swelling of the mucous membrane and the difference was significant (p less than 0.05). No statistical differences were found in the NPEF or in the use of antihistamine tablets between the four groups. In conclusion this study showed that two-dose beclomethasone dipropionate with a daily dose of 400 micrograms is effective in the treatment of seasonal allergic rhinitis.

Administration, Intranasal↗
PubMed1979

Abscess tonsillectomy à tiède.

During recent years, primary tonsillectomy, tonsillectomy à chaud, has again become popular as the standard therapy for the peritonsillar abscess, whereas the traditional tonsillectomy à froid, made 4--6 weeks after the incision, has been partially eclipsed. It seems, however, that the intermediate form between these two, tonsillectomy à tiède, an abscess tonsillectomy made 3--4 days after the incision, would be highly practical in many cases, compared with the other two mentioned above. The tonsillectomy à chaud requires such a high state of readiness for anaesthesia, even during the emergency hours, that it is not practical in all otolaryngological departments. Tonsillectomy à tiède needs a longer hospitalization, yet requires fewer days off work than does the classical tonsillectomy à froid method. Furthermore, a significant proportion of the patients fail to present themselves for tonsillectomy at the agreed time and consequently get a recurrence of the disease later on. Tonsillectomy à tiède is almost as easy an operation as the normal tonsillectomy, both for the surgeon as for the patient. During the years 1976--77, 153 cases of peritonsillar abscess were seen. 105 cases were treated with the tonsillectomy à tiède method. The average duration of treatment was 6 1/2 days. The only complications were 6 cases of light secondary bleeding. A tonsillectomy à chaud was performed on 9 children in the age group 3--9 years.

Adolescent↗