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Biomedical subjects

S Masieri

Publications and source records attributed to S Masieri.

17 recordsLinked to original sources
PubMed1997

Screening patients affected by common variable immunodeficiency.

Chronic immunoglobulin administration decreases the incidence of bronchial and pulmonary infections in patients affected by chronic variable immunodeficiency (CVI). In this study, an ENT screening was carried out in 22 patients affected by chronic variable immunodeficiency and treated with chronic immunoglobulin administration. All the patients underwent ENT physical examination, nasal endoscopy by fiberoptics, mucociliary transport test (MTT), anterior rhinorheomanometry (RRM), nasal provocation test with cold water (ANPT), audiometry and impedentiometry, olfactory evaluation, and paranasal sinus X rays. Dysphagia was present in 91% of the patients, nasal secretion and obstruction in 77%, and hypoacusia, tinnitus, and otodinia in 57%. Rhinitis and pharyngitis were observed in 86% of the patients, and serous middle ear effusion in 50%. Confirmed maxillary sinusitis was observed in five patients. Hyposmia was observed in 50% of the patients. MTT was significantly longer in the patients than in the controls (18.0 +/- 10.5 vs. 11.2 +/- 2.4 min; p < .05). Nasal resistance was lower in patients than in controls (0.46 +/- 0.32 vs. 1.11 +/- 0.22 Pa/L.s-1; p < .001). ANPT was positive in 9 patients out of 25 versus 1 control out of 15 (p < .05). Finally, seven patients were affected by transmissive hypoacusia, and one patient by neurosensorial hypoacusia. Our results suggest that chronic immunoglobulin administration in CVI patients is not effective against ENT disorders, probably because of the important role played by nasal hyperreactivity. Frequent ENT examination and early treatment of ENT disorders are therefore suggested in order to prevent chronic disease.

Adolescent↗
PubMed1995

[Long-term results of a hearing screening in critically ill patients dismissed from an intensive care unit].

AIM: To evaluate the auditive function of a group of critical patients after discharge from an ICU. DESIGN: An audiological screening was carried out 90-120 days after discharge. PATIENTS: Eighteen patients, that had been admitted to a polyvalent ICU for head injury, stroke or complicated neurosurgical procedures. They had all been in a coma. INTERVENTIONS: all the patients had undergone orotracheal intubation and mechanical ventilation lasting more than a week as well as ototoxic drugs (aminoglycosides and furosemide) administration. Antibiotic plasma levels had been monitored. MEASUREMENTS AND RESULTS: At examination, only 7 subjects were aware of being hypoacusic; no other symptom was reported. However audiometry and impedentiometry revealed the presence of mono or bilateral middle ear effusion in 11 subjects (61%) and high frequency neurosensorial hypoacusia in 2 cases (11%). Human voice frequencies were poorly affected by both transmissive and neurosensorial damages so that subjects did not report any hearing loss. CONCLUSIONS: Neurosensorial hypoacusia was probably caused by amynoglycoside toxicity in spite of blood level monitoring; ABR could be effective in preventing toxic damage by detecting early hearing impairment. Middle ear effusion occurrence is difficult to be prevented but appropriate medical therapy is usually effective after the recovery from coma.

Adult↗
PubMed1992

Tympanometry for middle-ear effusion in unconscious ICU patients.

Eighty-six bilateral impedance audiometries were performed weekly in 35 unconscious ICU patients. Tympanometry showed the presence of middle-ear effusion in 43.3% of the examinations (80% of the patients). The incidence of effusion was significantly higher in patients older than 50 years, in intubated and mechanically ventilated patients and in the presence of microbial colonization of the upper airways. The acoustic reflex (AR) was characterized by increased threshold values in 23.8% of the examinations and was absent in 41.3%. Abnormal or absent ARs were usually associated with middle-ear effusion or tube malfunction.

Acoustic Impedance Tests↗
PubMed1989

Airway secretion electrolytes: reflection of water and salt states of the body.

Water and electrolyte content influences the rheology of respiratory mucus. Nasal secretions can be obtained from almost all patients and may be regarded as a possibly useful model of the electrolyte composition of lower airway secretions that are difficult to collect in most patients. Na, K, and Cl were determined from nasal secretions in 35 ICU patients. We studied the relationship of those values to the patients' water and salt states. Our study indicates that: a) lower K and Cl levels and higher Na levels than those found in plasma are common to both nasal and bronchial secretions; b) variations of electrolyte levels in nasal secretions are interrelated; c) patients with lower values of free-water clearance show lower Na and higher Cl levels in nasal secretions, possibly due to increased epithelial transport; d) the amount of K in nasal secretions appears correlated with its urinary fractional excretion (this could be explained by the variations in intracellular K levels); and e) in hyperchloremic patients, plasma/secretion differences of Na are decreased, possibly due to decreased epithelial transport.

Adolescent↗
PubMed1988

pH and electrolytes in nasal secretum of intensive care unit patients.

Na, K and Cl levels and pH were determined in 26 samples of nasal secretum and plasma obtained from orally intubated intensive care unit patients. In nasal secretum K and Cl were higher and Na lower than in plasma: pH was higher in secretum than in plasma, probably because of the fall of CO2, which freely diffuses to the air. The epithelial activities of lowering pH, secreting K, and reabsorbing Na appeared closely linked together. The chloride difference (DCl) probably balanced the decrease of other anions, such as bicarbonate. Finally, some influences of plasmatic values on ion active transport rates may be hypothesized on the ground of the correlations of chloride and potassium values in nasal secretion and plasma.

Adult↗
PubMed1986

Urea to calculate the dilution of nasal secretum collected by lavage.

Urea, creatinine (24 cases) and albumin (22 cases) were determined in nasal secretum and in serum in 50 subjects. The correlation between the values in the secretum and in the serum significative only for urea and creatinine. The regression coefficient of urea was particularly high and we suggest that the values of urea in nasal secretum may be calculated as 1, 3 times its serum levels. This relationship may be useful to calculate the dilution of the samples of respiratory secretum collected by lavage, utilizing the ratio between the actual urea in the sample and its theorical value.

Adolescent↗
PubMed1984

Transtympanic iontophoresis: personal experience.

After having described the method of application used for iontophoresis and the results of previous studies carried out by other authors in the hope of finding a definite use for its clinical application, the authors present their personal experience carried out with the use of various chemical substances applied to both the guinea pig and to man. The chemicals taken into consideration were those used in the treatment of otitis media: anti-inflammatory, antibiotic, and mucolytic products. Iontophoresis proved to be a simple and effective method for the treatment of certain middle ear diseases, and offered a more rapid recovery in comparison with subjects treated uniquely by traditional methods.

Acetylcysteine↗
PubMed1983

Mucociliary flow in the nose during general and epidural anesthesia.

By means of the coloured indicator transport test (phenol red 3% in calcium-hydrogen-phosphate), mucociliary function in nose and pharynx was studied in 50 patients who underwent general or ocular surgery and in 10 healthy adult subjects. Patients were anesthetized with halothane, enflurane, NLA, and epidural analgesia. At the end of surgery, mucociliary function was significantly depressed (p less than 0.001) after halothane or enflurane anesthesia, but not after NLA or epidural analgesia. Six hours following enflurane anesthesia we still found a significant depression (p less than 0.001) of mucociliary function. No difference between halothane or enflurane was noted.

Adult↗
PubMedDate not supplied

Nasal obstruction improvement induced by topical furosemide in subjects affected by perennial nonallergic rhinitis.

Inhaled furosemide decreases bronchial response to several physical and chemical irritants. To evaluate the effect of topical furosemide on nasal resistance in patients affected by perennial nonallergic rhinitis, we studied 12 patients. This diagnosis of perennial nonallergic rhinitis was based on the history of rhinorrhea, sneezing, and nasal obstruction, on anterior rhinoscopy and endoscopy, on negative allergic tests, and on the absence of eosinophilia in nasal secretion. The study was performed on two nonconsecutive days. On the first day, one puff (100 microliters) of 0.9% saline was sprayed into both nostrils and nasal resistance was measured by anterior rhinomanometry before the puff and 15 and 30 minutes later. On the second day, one puff (100 microliters) of a solution of furosemide (10 mg/mL) was sprayed into both nostrils and nasal resistance was measured before the puff and 15, 30, 45, 60, 90, 120, and 180 minutes later. Initial nasal resistance was abnormally high in all patients on both days. A slight but significant increase was observed after spraying isotonic saline (base: 1.38 +/- .69; 15 minutes: 1.47 +/- 0.72; 30 minutes: 1.44 +/- 0.73); by contrast a marked decrease was observed after spraying the furosemide solution. Nasal resistance was lowest between 30 and 90 minutes after giving furosemide. Then it progressively increased, but values at 180 minutes were still lower than the initial ones (base: 1.43 +/- 0.67; 15 minutes: 0.70 +/- 0.47; 30 minutes: 0.48 +/- 0.24; 45 minutes: 0.49 +/- 0.21; 60 minutes: 0.50 +/- 0.20; 90 minutes: 0.56 +/- 0.23; 120 minutes: 0.62 +/- 0.32; 180 minutes: 0.67 +/- 0.30). After topical furosemide, all patients had subjective relief of nasal obstruction that lasted more that 12 hours in 9 subjects.

Administration, Inhalation↗
PubMedDate not supplied

[Immunohistochemical profile of the nasal mucosa during the acute phase of cluster headache].

We studied 20 patients with cluster headache (11 males, 9 females) and 10 subjects free from this disorder. Nasal cavities were endoscopically studied to evaluate the mucociliary transport, pH, IgG, IgA and IgM levels in nasal secretion and in serum, and Na, K and Cl serum levels. We observed in all patients in the study group in comparison with the control group an increase of pH, and of serum IgA and IgM levels (but not of IgG). Na, K, and Cl serum levels in the patients with cluster headache were lower than those in the control subjects.

Acute Disease↗
PubMedDate not supplied

Specific local immunotherapy in nasal allergy (preliminary report).

The preliminary results are presented of a study carried out on 23 subjects with nasal allergy to graminacea, 10 of whom were used as a control group to verify the clinical advantages and the possible side effects of a specific local immunotherapy carried out in spray form using progressively increasing doses of allergen in aqueous solution. From a clinical point of view, on the grounds of the score in the clinical diary, we were able to show that during the preseasonal stage only 5 patients treated with the allergen were free of symptoms as were the controls, whereas during the critical phase they were all free of symptoms in contrast to the crisis presented in the control group. The increase in the threshold of nasal provocation and in the serum level of blocking antibodies, revealed in the majority of the subjects affected by pollinosis and treated locally with the allergen, are to be considered fundamental to the clinical advantage obtained. In agreement with what has already been revealed after specific nasal provocation, local treatment with allergens caused in a majority of cases a slight increase in the time of mucociliar clearance, a phenomenon which must be taken carefully into consideration in as much as it could eventually represent an adverse side effect which needs an adequate countermeasure.

Adolescent↗
PubMedDate not supplied

Local treatment of aspecific nasal hyperreactivity with capsaicin.

Ten patients with vasomotor rhinitis underwent local treatment with capsaicin (30 micromol.), once per week for five weeks; controls were carried out at weekly intervals and 1, 3 and 6 months after therapy. Assessment was made using symptom score and nasal resistance scores both basal and subsequent to aspecific nasal provocation. Results showed abatement of symptoms, and reduction of nasal resistance and aspecific hyperreactivity already during the second week. This trend continued for six months, with endoscopic improvement also. Hence, this treatment proved to be efficient in reducing nasal reactivity.

Adolescent↗
PubMedDate not supplied

Nasal hypersensitivity in purulent middle ear effusion.

The existence of a physiopathologic connection between nose and middle ear is widely accepted so that chronic purulent middle ear effusion (CPMEE) could be expected to be usually associated with nasal chronic disease or impaired function. Nevertheless such association is less frequently observed in clinical practice than one could expect, possibly because of inadequate nasal function evaluation. Thirty-five patients affected by CPMEE were included in this study in order to assess the incidence of nasal disorders. E.N.T. clinical history was obtained and E.N.T. physical examination, nasal endoscopy by fiber optics, anterior rhino-rheo-manometry, non-specific nasal provocation test with histamine, mucociliary transport test, and allergic skin tests were performed. In the clinical history assessment 26 patients were affected by chronic rhinopathies, 16 by chronic pharyngitis, and 20 by frequent headache. At rhinoscopy we registered nasal septum deviation in 24 cases and mean and inferior turbinates hypertrophy in 31 cases. CPMEE and nasal septum deviation or turbinates hypertrophy were more frequently ipsilateral (p < .001 and p < .05, respectively). Total nasal resistance was 0.99 +/- 0.49; it was abnormally high in 11 subjects bilaterally and in 4 subjects monolaterally and increased significantly in 32 patients following nasal provocation test. Mucociliary transport time was longer in CPMEE subjects than in 10 healthy subjects (18 +/- 5 vs 13 +/- 4 min; p < .05). Finally 10 patients presented positive skin tests. On the whole, 96% of non allergic patients included in this study showed signs of non-specific nasal hypersensitivity which could theoretically cause purulent middle ear effusion to chronicize. Indeed recurrent histamine release in response to specific and/or aspecific stimuli could cause the obstruction of the Eustachian tube and consequently inadequate middle ear ventilation.

Adolescent↗