OBJECTIVE: To compare the effect of the medical and surgical treatment of pediatric chronic rhinosinusitis (CRS). METHOD: Seventy-two cases of pediatric CRS were randomly divided into medical group (35 cases) and surgical group (37 cases). The patients in medical group received a 12-week course of clarithromycin, alkaline nasal douche and intranasal mometasone furoate. The patients in surgical group underwent adenoidectomy or (and) tonsillectomy or ESS. All patients underwent pre- and post-treatment assessments of visual analogue score (VAS) and nasal endoscopy. The assessments of CT were arranged before starting the treatment and post-treatment in 12-month. RESULT: Both groups of pediatric CRS significantly improved in VAS and endoscopic parameters of CRS in all stages. There were no significant difference between two groups in 1-month (P > 0.05). The surgical group demonstrated greater change than medical group in 3-month, 6-month and 12-month (P < 0.01). In surgical group, 37 cases underwent three different styles of operation: adenoidectomy (n = 19), adenoidectomy and tonsillectomy (n = 10) and ESS (n = 8). VAS and endoscopic parameters were not significantly different among three groups in all stages except in 1-month. CONCLUSION The results of this study warrant further that both medical and surgical treatment of pediatric CRS significantly improve in VAS and endoscopic parameters of CRS. The mainstay of management is medical treatment. Long-term, low-dose macrolide is an effective therapy and a valid alternative in pediatric CRS. Surgical intervention is necessary for cases that do not respond to prolonged course medical treatment. Adenoidectomy or (and) tonsillectomy seems to be a recommended surgical procedure for children with adenoid or (and) tonsil hypertrophy.
Adenoidectomy ; Adolescent ; Child ; Chronic Disease ; Clarithromycin ; therapeutic use ; Female ; Humans ; Male ; Mometasone Furoate ; Pregnadienediols ; therapeutic use ; Sinusitis ; drug therapy ; surgery ; Tonsillectomy ; Treatment Outcome

OBJECTIVETo analyze the clinical feature and treatment methods of Artemisia pollinosis.

METHODSSkin prick test results of 14 426 cases from Beijing Tongren hospital and pollen concentration of Beijing observatory from 2007 to 2011 were analyzed to identify the clinical feature of Artemisia pollinosis patients and its correlation with the pollen concentration. Patients were given leukotriene receptor antagonists (Montelukast) for 2 weeks, followed by 4 weeks of mometasone furoate nasal spray (EIT group: n = 21), or only 4 weeks of mometasone furoate nasal spray (POT group: n = 16). The nasal symptom score was compared between 2 groups.SPSS 16.0 software was used to analyze the data.

RESULTSArtemisia pollinosis accounted for 30.8% (4 442/14 426) of all SPT positive allergic rhinitis patients, and most Artemisia SPT positive results were strong positive(3 793/4 442, 85.4%); onset age peak of Artemisia pollinosis patients was at the age of 19 to 30, onset time concentrated in August to September, was consistent with the peak period of Artemisia pollen concentration; EIT treatment using leukotriene receptor antagonists two weeks before pollen season significantly improved sneeze, sniveling and rhinocnesmus symptoms (t value was 3.28, 3.92, 3.09, respectively, all P < 0.01) compared with post-onset treatment (POT). But nasal obstruction and cough symptoms had no significant difference between two groups (t value was 0.85, 1.52, respectively, all P > 0.05).

CONCLUSIONArtemisia pollen is the main pollen allergen in Beijing, EIT treatment was effective to pollinosis.

Acetates ; therapeutic use ; Adolescent ; Adult ; Age of Onset ; Allergens ; immunology ; Artemisia ; Child ; China ; Female ; Humans ; Male ; Middle Aged ; Mometasone Furoate ; Pollen ; immunology ; Pregnadienediols ; therapeutic use ; Quinolines ; therapeutic use ; Rhinitis, Allergic, Seasonal ; diagnosis ; drug therapy ; prevention & control ; Seasons ; Treatment Outcome ; Young Adult

OBJECTIVETo evaluate the effects of nasal mometasone furoate on moderate to severe allergic rhinitis.

METHODSPatients with moderate to severe allergic rhinitis were enrolled and received mometasone furoate nasal spray 200 microg once daily for four weeks. Four hundreds and sixty-three patients completed the study. We weekly interviewed the patients to evaluate the symptoms, and the affection of disease on night sleep and daily life. Mini Rhinoconjunctivitis Quality of Life Questionnaire (Mini-RQLQ) and Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ) were used to evaluate the quality of life.

RESULTSThe individual and total symptomatic scores of week 1, week 2 and week 4 decreased compared with baseline. The scores of Mini-RQLQ and NRQLQ of week 1, week 2 and week 4 decreased compared with baseline too. The scores of the next visit were significantly lower than those of the previous visit (P < 0.01).

CONCLUSIONSA four-week administration of mometasone furoate nasal spray can effectively treat allergic rhinitis.

Administration, Intranasal ; Adolescent ; Adult ; Aged ; Anti-Allergic Agents ; administration & dosage ; therapeutic use ; Child ; Female ; Humans ; Male ; Middle Aged ; Mometasone Furoate ; Pregnadienediols ; administration & dosage ; therapeutic use ; Quality of Life ; Rhinitis, Allergic, Perennial ; drug therapy ; Surveys and Questionnaires ; Young Adult

OBJECTIVETo evaluate the outcome of mometasone furoate nasal spray (MFNS) used for 3 months on non-allergic rhinitis (NAR).

METHODSIn this multicenter study, NAR patients were enrolled from eight hospitals and received MFNS 200 microgram once daily for 3 months. The patients were followed-up for three times (at baseline, month 1 and month 3) to record the symptom scores and nasal endoscopic appearances. At the same time, the adverse events frequency was recorded and analyzed.

RESULTSA total of 188 NAR cases were enrolled in the study. The total nasal symptom score assessment descended significantly at month 1 (1.70 ± 0.75) and month 3 (0.95 ± 0.79) visits versus at baseline (2.67 ± 0.68, Z value were from -11.603 to -10.491, all P < 0.01). The individual symptoms, including nasal stuffiness, nasal discharge, nasal stuffiness-related dizziness or headache, hyposmia, sleep quality, daily life activity, work or study efficiency, mental status, and whole body fatigue, also showed less scores at month 1 and month 3 visits versus at baseline (Z value were from -11.313 to -6.802, all P < 0.01). At the same time, nasal mucosal appearances assessed by endoscopy had lower scores at month 1 (1.40 ± 0.62) and month 3 (0.75 ± 0.71) visits versus at baseline (2.27 ± 0.73, Z value were from -11.484 to -10.002, all P < 0.01). Additionally, adverse events were only observed in 5.3% cases with light rhinorrhagia and nasal dryness. No other side effect was found.

CONCLUSIONSA 3-months administration of intranasal mometasone can effectively and safely improve NAR patients' clinical symptom and nasal mucosal appearances.

Adolescent ; Adult ; Anti-Allergic Agents ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mometasone Furoate ; Nasal Sprays ; Pregnadienediols ; administration & dosage ; therapeutic use ; Rhinitis ; classification ; drug therapy ; Treatment Outcome ; Young Adult

Objective: To analyze and summarize the clinical and pathological characteristics, management, and efficacy of patients with vulvar lichen sclerosus (VLS) through a single center large sample study, and preliminarily to explore the frequency of maintenance treatment medication for VLS. Methods: The clinical data of VLS patients in Obstetrics and Gynecology Hospital of Fudan University from 2018 to 2021 were retrospectively collected. The clinicopathological characteristics (patients' age, course of disease, complicated disease history, family history, symptoms, signs and pathology), treatment and effects were retrospectively analyzed. The patients in the maintenance treatment stage were followed up regularly to explore the minimum frequency of individual medication to maintain the stability of the disease. Results: (1) General situation: a total of 345 patients with VLS were included in this study. The average age was (50.4±14.7) years (ranged from 8 to 84 years old), prevalence was highest in the 50-59 years group (30.1%, 104/345). Immune diseases occurred in 18.6% (33/177) of patients, 24.3% (43/177) of patients had allergic skin diseases, and 5.6% (10/177) of the patients' immediate family members had chronic vulvar pruritus or vulvar hypopigmentation. (2) Clinical features: the most common symptom was vulvar pruritus (96.1%, 196/204) among 204 patients with recorded symptoms. The most common sign was hypopigmentation of the vulva (96.3%, 206/214). The most common involved sites were labia minora (70.3%, 142/202), labia majora (67.8%, 137/202), and labial sulcus (59.4%, 120/202). The cumulative number of sites involved in 62 vulvar atrophy patients (2.7±1.1) was significantly higher than that in 152 non-atrophy patients (2.2±1.0; t=3.48, P=0.001). The course of vulvar atrophy was (9.3±8.5) years, which was significantly longer than that of non-atrophy patients [(6.6±5.6) years; t=2.04, P=0.046]. (3) Pathological features: among the 286 patients with electronic pathological sections, the most common pathological feature in the epidermis was epithelial nail process passivation (71.3%, 204/286). The common pathological features in the dermis were interstitial collagenization (84.6%, 242/286), and inflammatory cell infiltration (73.8%, 211/286). (4) Treatment: 177 patients received standardized treatment after diagnosis and were followed up regularly in our hospital. In the initial treatment stage, 26.0% (46/177) of the patients were treated with 0.05% clobetasol propionate cream, and 74.0% (131/177) of the patients were treated with 0.1% mometasone furoate ointment. The complete remission rates of the two methods were respectively 80.4% (37/46) and 74.0% (97/131), and there was no statistically significant difference (χ²=0.76, P=0.385). During maintenance treatment, 27.1% (48/177) of the patients took the medication twice a week, 35.0% (62/177) took the medication once a week, and 37.9% (67/177) took the medication once every 10 days. During follow-up after 6 months of maintenance treatment, there were no patients with recurrence of pruritus or progression of vulvar signs. Conclusions: The majority of VLS patients have itching, hypopigmentation, involvement of labia minora and labia majora, progressive atrophy, and inflammatory infiltration of dermis. Local treatments of mometasone furoate and clobetasol propionate have good initial therapeutic effects. The frequency exploration of individualized maintenance treatment could minimize the occurrence of adverse reactions when ensuring the stability of the patients' condition.
Female ; Humans ; Child ; Adolescent ; Young Adult ; Adult ; Middle Aged ; Aged ; Aged, 80 and over ; Vulvar Lichen Sclerosus/pathology* ; Clobetasol/adverse effects* ; Retrospective Studies ; Mometasone Furoate/therapeutic use* ; Pruritus/drug therapy* ; Atrophy/drug therapy* ; Hypopigmentation/drug therapy*

Administration, Intranasal ; Adult ; Aerosols ; Androstadienes ; therapeutic use ; Anti-Inflammatory Agents ; administration & dosage ; therapeutic use ; Budesonide ; therapeutic use ; Child ; Female ; Fluticasone ; Humans ; Male ; Mometasone Furoate ; Nasal Polyps ; drug therapy ; Pregnadienediols ; therapeutic use ; Rhinitis, Allergic, Perennial ; drug therapy ; epidemiology ; pathology ; Rhinitis, Allergic, Seasonal ; drug therapy ; Singapore ; epidemiology ; Sinusitis ; drug therapy ; Triamcinolone Acetonide ; therapeutic use

OBJECTIVE: To evaluate the effects of nasal mometasone furoate on oral and nasal nitric oxide (NO) production in patients with allergic rhinitis. METHOD: Twenty-seven patients with moderate to severe symptoms of persistent allergic rhinitis were treated with mometasone furoate nasal spray (200 microg/d. qd) for 2 weeks. Nasal and oral exhaled nitric oxide concentrations, symptoms of rhinitis and quality of life were investigated before and after the treatment. RESULT: There was a significant improvement in nasal exhaled nitric oxide concentrations, symptoms of rhinitis and quality of life, but not in oral exhaled nitric oxide concentrations. Subjective improvements in symptoms and quality of life did not correlate significantly with objective measurements. CONCLUSION Our study provides subjective and objective evidence on the efficacy of intranasal mometasone furoate in improving nasal symptoms and quality of life, as well as reducing nasal inflammation.
Administration, Intranasal ; Adolescent ; Adult ; Anti-Allergic Agents ; administration & dosage ; therapeutic use ; Female ; Humans ; Male ; Middle Aged ; Mometasone Furoate ; Nitric Oxide ; metabolism ; Pregnadienediols ; administration & dosage ; therapeutic use ; Quality of Life ; Rhinitis, Allergic, Perennial ; drug therapy ; metabolism ; physiopathology ; Rhinitis, Allergic, Seasonal ; drug therapy ; metabolism ; physiopathology ; Young Adult