Achieving symptom relief in patients with myalgic encephalomyelitis by targeting the neuro-immune interface and optimizing disease tolerance.

Myalgic encephalomyelitis (ME) previously also known as chronic fatigue syndrome is a heterogeneous, debilitating syndrome of unknown etiology responsible for long-lasting disability in millions of patients worldwide. The most well-known symptom of ME is post-exertional malaise, but many patients also experience autonomic dysregulation, cranial nerve dysfunction and signs of immune system activation. Many patients also report a sudden onset of disease following an infection.

Resting-state fMRI study of acute migraine treatment with kinetic oscillation stimulation in nasal cavity.

Kinetic oscillatory stimulation (KOS) in the nasal cavity is a non-invasive cranial nerve stimulation method with promising efficacy for acute migraine and other inflammatory disorders. For a better understanding of the underlying neurophysiological mechanisms of KOS treatment, we conducted a resting-state functional magnetic resonance imaging (fMRI) study of 10 acute migraine patients and 10 normal control subjects during KOS treatment in a 3 T clinical MRI scanner. The fMRI data were first processed using a group independent component analysis (ICA) method and then further analyzed with a voxel-wise 3-way ANOVA modeling and region of interest (ROI) of functional connectivity metrics.

Kinetic oscillation stimulation as treatment of acute migraine: a randomized, controlled pilot study.

Objective: To assess the relief of migraine pain, especially in the acute phase, by comparing active treatment, ie, kinetic oscillation stimulation (KOS) in the nasal cavity, with placebo.

Background: Exploratory trials testing the efficacy of KOS on migraine patients indicated that this treatment could be a fast-acting remedy for acute migraine pain.

Method: Thirty-six patients were randomized 1:1 using a placebo module to active or placebo treatment in this double-blinded parallel design study.

Kinetic oscillation stimulation as treatment of non-allergic rhinitis: an RCT study.

Conclusion: Kinetic oscillation stimulation (KOS) of nasal mucosa at low frequency seems to be a possibly effective and safe short-term treatment of non-allergic nasal stuffiness.

Objective: To assess the relief of rhinitis symptoms, especially stuffiness, by comparing active treatment, i.e.

Non-malignant respiratory tract fistula from the oesophagus. A lethal condition for which novel therapeutic options are emerging.

Objectives: Fistulas between the oesophagus and the respiratory tract can occur as a complication to anastomotic dehiscence after oesophageal resection, without any signs of local residual tumour growth. Other causes that are, by definition, benign may rarely prevail. The traditional therapeutic approach is to divert the proximal portion of the oesophagus and transpose the conduit into the abdominal cavity.

Tracheobronchial transplantation with a stem-cell-seeded bioartificial nanocomposite: a proof-of-concept study.

Background: Tracheal tumours can be surgically resected but most are an inoperable size at the time of diagnosis; therefore, new therapeutic options are needed. We report the clinical transplantation of the tracheobronchial airway with a stem-cell-seeded bioartificial nanocomposite.

Methods: A 36-year-old male patient, previously treated with debulking surgery and radiation therapy, presented with recurrent primary cancer of the distal trachea and main bronchi.

Evaluation of nasal mucosal swelling and microcirculation throughout nasal and bronchial provocation tests with lysine-aspirin in asthmatics with nasal polyposis.

According to the GA2LEN recommendations, nasal challenge test with lysine-aspirin should be performed only in patients with severe asthma, because the sensitivity of this test has been lower than in bronchial and oral challenge tests. The AIA patient group often have severe asthma with impaired lung function, and therefore improvement of the nasal challenge is warranted. The outcomes of this study clearly indicate that a prolonged detection time from two to three hours might improve the sensitivity of the nasal challenge as a method for diagnosing aspirin intolerance.

The role of pain-mediating sensory nerves in histamine-induced inflammation of nasal mucosa.

Topical application of histamine on the nasal mucosa causes an inflammatory reaction with increased mucosal swelling and perfusion. In the nasal mucosa histamine receptors are found in the vascular epithelium and at free sensory nerve endings. The aim of this randomized double-blind placebo controlled study was to investigate if this inflammatory reaction to locally administered histamine was dependent upon the stimuli of pain-mediating sensory nerves, or if it mainly was the result of direct stimuli of the vascular epithelium.

Treatment of postoperative esophagorespiratory fistulas with dual self-expanding metal stents.

Background: Fistulas between the esophagus and the respiratory tract can occur as a complication to anastomotic dehiscence after esophageal resection. The traditional therapeutic approach is to deviate the proximal portion of the esophagus and transpose the conduit into the abdominal cavity. With the introduction and development of self-expandable metal stents (SEMS), new therapeutic options have emerged for these severe complications.

Nasal hyperresponders and atopic subjects report different symptom intensity to air quality: a climate chamber study.

Unlabelled: Short-term exposure to dust and dust added with beta-(1,3)-d-glucan or aldehydes may cause sensory reactions. In random order, we exposed 36 volunteers in a climate chamber to clean air, office dust, dust with glucan, and dust with aldehydes. Three groups of subjects were exposed, eleven were non-atopic with nasal histamine hyperreactivity, 13 were non-atopic, and 12 were atopic.

Effects on human eyes caused by experimental exposures to office dust with and without addition of aldehydes or glucan.

Unlabelled: Thirty-six volunteers (in three susceptibility groups: 11 subjects were non-allergic with nasal histamine hypersensitivity, 13 were non-allergic with normal sensitivity, and 12 were pollen allergic with or without nasal hypersensitivity) were exposed for three and a half hours in a climate chamber. Each subject was exposed to clean air (dust 45 +/- 38 microg/m(3) total suspended particle, TSP), house dust at 357 +/- 180 microg/m(3) TSP, house dust 382 +/- 175 microg/m(3) TSP with added glucan (50 ng/m(3)) and house dust 394 +/- 168 microg/m(3) TSP with added aldehydes corresponding to a gaseous phase of 300 microg/m(3) in the air. The study was explorative by nature.

Swine dust exposure is a model for rapid induction of non-allergic neutrophil inflammation in the nasal mucosa of healthy volunteers, and the symptoms as well as the microcirculation are modified by nasal lavage.

Background: The pathophysiological mechanism of non-allergic rhinitis is not clear and there is a lack of models in healthy volunteers. It has previously been shown that swine dust exposure is an excellent method for inducing inflammatory changes in the lower airways. We have shown earlier that exposure to swine dust increases the histamine sensitivity of the nasal mucosa as measured by rhinostereometry.

Upper-airway inflammation in relation to dust spiked with aldehydes or glucan.

Objectives: Organic dust is associated with adverse effects on human airways. This study was done to investigate whether the addition of beta-(1,3)-D glucan or aldehydes to office dust causes enhanced inflammation in human airways.

Methods: Thirty-six volunteers were exposed randomly to clean air, office dust, dust spiked with glucan, and dust spiked with aldehydes.

Laser Doppler measurements of the vocal fold blood micro-circulation.

The authors have developed a laser Doppler method, referred to as LDF+LS (laser Doppler flowmetry by laryngostereometry), for measuring the vocal fold micro-circulation. The vocal folds of 103 patients were examined during general anesthesia. A laser Doppler probe was placed on defined positions at the vocal fold edge: midmembranous position (MP), 2 mm and 4 mm behind, and 1 mm anterior to MP.

Nasal mucosal histamine reactivity among teachers six years after working in a moisture-damaged school.

Objectives: The objective of this study was to determine whether verified increased nasal mucosal reactivity among teachers, who had been working in a school with severe moisture problems, still persisted 6 years after remedial measures had been taken. The increased nasal mucosal reactivity, measured as the mucosal swelling reaction upon histamine provocation, had earlier been shown both 1 and 3 years after the renovation.

Methods: Twenty-four teachers in the target school and sixteen teachers in the control school, who participated in all the investigations (1995, 1997 and 2000), answered a standardized questionnaire and underwent a nasal histamine provocation test.

Nasal histamine reactivity among adolescents in a remediated moisture-damaged school--a longitudinal study.

Unlabelled: In a previous study, in the spring of 1995, we found that teachers, who had been working for several years in a moister-damaged school, 1 year after the renovation still reported a higher frequency of complaints and symptoms and showed significantly higher mucosal histamine reactivity compared with teachers in a control school, although the school seemed to be properly renovated. A longitudinal study of 90 randomly selected senior high school students entering the two schools was initiated to exclude or verify if the indoor air still exerted an irritant effect on the upper airways of an earlier unexposed group. The students went through a nasal histamine provocation test and answered a questionnaire on three occasions, in 1995, 1996 and 1997.

Eye trigeminal sensitivity, tear film stability and conjunctival epithelium damage in 182 non-allergic, non-smoking Danes.

Unlabelled: The population distributions of CO(2)-induced irritation sensitivity in the eyes (COI), tear film stability (break-up time, BUT), and epithelium damage (ED) and the relation of these to basic potential confounders were assessed in an age- and gender-stratified random sample of citizens in Aarhus County, Denmark. One hundred eighty-two non-allergic, non-smoking persons participated. A general health questionnaire and an indoor air questionnaire was filled out before the measurements.

Nasal mucosal histamine reactivity among young students and teachers, having no or prolonged exposure to a deteriorated indoor climate.

Background: In a study performed in the spring of 1995, we found a significantly greater nasal mucosal histamine reactivity among teachers, who had worked for several years in a recently renovated moisture-damaged school, than in those in a control school. In the present study we investigated the students who begun their high-school studies at both schools in the autumn of 1995 and compared them with the teachers as regards mucosal reactivity, atopy and symptoms.

Methods: Twenty-eight teachers in the target school, 18 teachers in the control school and 45 students from each school underwent a nasal histamine provocation test and a skin-prick test.

Slowly decreasing mucosal hyperreactivity years after working in a school with moisture problems.

In our first study in 1995, teachers, who had worked in a water-damaged school for more than 5 years, were tested for nasal histamine reactivity by rhinostereometry. They were found to have significantly increased reactivity compared with teachers in a school without these indoor-climate problems. This finding could not be explained by differences in atopy or other personal characteristics.

Nasal and bronchial histamine responsiveness in pollen-exposed patients with seasonal rhinitis.

In a previous study, we found an increased nasal responsiveness as measured by rhinostereometry and histamine challenge out of season in a sample of 12 patients suffering mainly from hay fever. The aim of the present study was to investigate whether airway responsiveness in these patients was further increased after direct pollen exposure, after a single nasal pollen provocation as well as by repeated exposure during the pollen season. In spite of increased allergic symptoms, the basal degree of nasal mucosal swelling was unchanged before histamine challenge under these circumstances.

Nasal hyperreactivity among teachers in a school with a long history of moisture problems.

Upper airway symptoms have frequently been reported in people working or residing in damp buildings. However, little information has been available on objective pathophysiologic findings in relation to these environments. Twenty-eight teachers, who had worked for at least five years in a recently renovated school that had had severe moisture problems for years, were randomly selected for this study.

Airway reactivity and exhaled NO following swine dust exposure in healthy volunteers.

Short-time exposure to swine dust causes an intense inflammation of upper and lower airways and induces increased bronchial responsiveness to methacholine in previously non-exposed healthy volunteers. The objective to this study was to investigate the nasal inflammatory response and mucosal reactivity to swine dust exposure and whether nitric oxide metabolism is involved in the inflammatory process. Nitric oxide in expired air, nasal histamine test (NH), nasal lavage (NAL) and bronchial histamine challenges were studied before and after a 3 h exposure to swine dust in a swine confinement building in 17 non-smoking healthy subjects not previously exposed to farm dust.

The eye irritation and odor potencies of four terpenes which are major constituents of the emissions of VOCs from Nordic soft woods.

Eye goggles were used to estimate human thresholds for sensory eye irritation from four monoterpenes: (+)3-carene, (-)limonene and (+)alpha-pinene and (rac)alpha-terpineol all known as air pollutants emitted from wood. Only a ranking of the irritation thresholds relative to that of n-butanol is given. The measurements showed that the thresholds for eye irritation of the terpenes ranged from subthreshold to below 1,250 mg/m3.