How to improve current therapeutic standards in upper respiratory infections: value of fusafungine.

Despite guidelines and educational programs, systemic antibiotics and anti-inflammatory drugs are often inappropriately prescribed in upper respiratory tract infections (URTIs), although they are most often of viral origin, generally benign, and self-limiting with spontaneous recovery in more than 80% of cases. Reduced use of systemic antibiotics is crucial in the current context of concern about emerging antibiotic resistance and reducing unnecessary costs associated both with drug over-consumption and with the management of the consequences of antibiotic resistance. Local bacterial or viral infection of the airways induces an early inflammatory reaction.

Mediators of inflammation in the early and the late phase of allergic rhinitis.

Purpose Of Review: This review provides the reader with an overview of the early and the late phase of the immediate allergic reaction. Furthermore, recent publications are presented that could reveal important new insights into the mechanisms of allergic inflammation.

Recent Findings: Recent work on the possible roles of nerve growth factor, nitric oxide synthases, several CC chemokines and other mediators is presented.

[Gastroesophageal reflux disease and chronic sinusitis].

Background: It is increasingly suggested that there may be a connection between gastrooesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR) and chronic sinusitis. We therefore wished to establish whether the literature contains sufficient evidence to support this assumption.

Material And Methods: We performed a search in Medline (PubMed) and EMBASE with the key words "GERD, GER, reflux, sinusitis, chronic sinusitis".

Effects of dimethindene maleate nasal spray on the quality of life in seasonal allergic rhinitis.

Objective: To determine if the H1-receptor antagonist dimethindene maleate (DMM), topically applied, is able to improve the quality of life (QoL) in patients with seasonal allergic rhinitis better than placebo.

Methods: The study was a multi-centre, randomised, placebo-controlled, double-blinded phase III trial including 157 patients. Two parallel groups received either DMM nasal spray or placebo for 2 weeks.

[Cluster-immunotherapy in seasonal allergic rhinitis: safety aspects of induction therapy with depot allergoids (Purethal)].

Background: Specific immunotherapy (SIT) represents the only specific treatment that can be offered to allergic patients apart from allergen avoidance. SIT has been widely used in pollen allergic rhinitis. Clinical efficacy has been demonstrated in several controlled clinical trials and depends on the specific allergen the individual patient is sensitive to, the quality and total amount of allergen applied, and the SIT schedule.

[The Cologne internet-manual of pain therapy--33 months online, experiences and evaluation].

Objective: The improvement of ambulant treatment for patients with chronic headache or cancer pain.

Methods: Distribution of accepted guidelines and standards by means of the internet in order to make this knowledge known among general practitioners and to give patients better access to this information.

Results: We have built an internet manual about the treatment of chronic headache and cancer pain.

Topical treatment of rhinosinusitis with fusafungine nasal spray. A double-blind, placebo-controlled, parallel-group study in 20 patients.

In a monocenter, placebo-controlled, double-blind, parallel-group study, 20 patients with acute symptoms of rhinosinusitis were treated with either fusafungine (CAS 1393-87-9, Locabiosol Dosier-Spray) (n = 10) or placebo nasal spray (n = 10). One patient from the placebo group was withdrawn from the study on the day of inclusion for noncompliance reasons. At the beginning of the 2-week treatment period, absence of an acute exacerbation of sinusitis with, e.

The use of handheld computers in clinical trials.

A recently completed, randomized, double-blind placebo-controlled clinical trial is presented in which Palm handheld computers were used as a substitute for normal paper-based patient diaries. In this nasal provocation study, a common antihistamine approved for the treatment of seasonal allergic rhinitis was tested against placebo for evidence of additional properties. In addition to their medical examinations, the 12 study volunteers rated subjective complaints in a diary program on 4 examination days, for a duration of 4.

Generic or disease-specific quality of life scales to characterize health status in allergic rhinitis?

Background: In patients with allergic rhinitis (AR), various instruments have been validated for the measurement of quality of life (QOL), which may be greatly reduced. However, it is not clear which QOL instruments should be used for the different types of AR and whether they are sensitive to treatment.

Methods: The QOL of patients suffering from symptomatic seasonal AR (sSAR) (before and during treatment with a topical or systemic antihistamine), symptomatic perennial AR (sPAR), and asymptomatic seasonal AR (aSAR) was determined with the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) as disease specific and with the Munich Life Dimension List (MLDL) and the Visual Analogue Scale for Quality of Life (VAS-QOL) as generic QOL instruments.

Effect of treatment with Ginkgo biloba extract EGb 761 (oral) on unilateral idiopathic sudden hearing loss in a prospective randomized double-blind study of 106 outpatients.

Objective: Test of dose-response relationship for Ginkgo biloba extract EGb 761 (oral) in outpatients with acute idiopathic sudden sensorineural hearing loss (ISSHL) of at least 15 dB at one frequency within the speech range occurring less than 10 days before study inclusion.

Design: Multicentre, randomized, double-blind phase III study comparing dosages of 120 mg twice daily and 12 mg twice daily over 8 weeks. MAIN ENDPOINT: Recovery (in dB) of the auditory threshold from the initial measurement to the value on the last day of treatment, averaged over those frequencies from 0.

["Notebook computer" in combination with WWW-technology in multicenter clinical trials and for chronic patient care].

Our purpose was to determine conditions, under which the use of hand-held computers in the diagnosis and therapy of patients with chronic diseases seems to be handy. Two scenarios are presented showing the employment of these computers in a doctor's office and in multicenter clinical trials. Security-related aspects involved in transferring medical data via the internet are discussed.

Sequential therapy with azelastine in seasonal allergic rhinitis. Deutsche Rhinitis Studiengruppe (German Rhinitis Study Group).

A sequential therapy treatment with azelastine (Allergodil) in seasonal allergic rhinitis is introduced. In the critical early stage, treatment begins with a combination of azelastine tablets (azelastine hydrochloride, CAS 79307-93-0) and azelastine nasal spray (azelastine, CAS 58581-89-8), and after five days only the nasal spray is administered. This sequential therapy model aims at achieving the quickest and most complete effect without reducing the tolerability.

A new method for the placement of brachytherapy probes in paranasal sinus and nasopharynx neoplasms.

Purpose: In afterloading therapy, the exact placement of the applicator is crucial for the result of radiotherapy. A deviation of few millimeters from the target leads to a significant reduction of radiation energy to the tumor.

Methods And Materials: We present a new method using a computer-assisted device for three-dimensional placing of afterloading probes based on CT scans that allows for the exact placement.

Development of computer-aided surgery for otorhinolaryngology.

Computer-aided surgery (CAS) describes a method that allows intraoperative navigation in the surgical field based on digital image data such as computed tomography, magnetic resonance imaging, and others. A computer processes the image data in real time and is intraoperatively connected to a measuring system for coordinate determination. CAS has been used in ENT surgery since 1986, and we developed several generations of CAS systems.

Azelastine reduces mediators of inflammation in patients with nasal polyps.

Nasal polyps affect approximately 4% of the population in the western world. The etiology of this disease is unknown, although inflammatory mechanisms may play an important role. In preceding studies we and others have shown that besides H1-antagonism, azelastine influences the immigration and activation of inflammatory cells.

Clinical validation of a new olfactory test.

A new approach to clinical olfactometry is presented using nasal sprays. A special dosage valve was used to standardize an aerosol size to 40 microns. For evaluation a 6 x 6 matrix (substance/olfactory quality) with verbal associative clues was used according to test psychological findings.

[Computer-assisted surgery in the ENT specialty. Developments and experiences from the first decade].

Background: Computer-Assisted-Surgery (CAS) names a method that allows intraoperative navigation in the surgical field based on digital image data like CT, MRT, MRA, DSA and others. A computer processes the image data in real time and is intraoperatively connected to a measuring system for coordinate determination. CAS is used in ENT surgery since 1986.

Computer-assisted endoscopic sinus surgery. An international review.

Computer-assisted technology provides the surgeon with accurate guidance during endonasal sinus procedures. This article reviews early experiences in Europe and the United States. Various types of probe technology and their accuracy and ease of use are examined.

The computer-assisted localizer, a navigational help in microneurosurgery.

The computer-assisted-localizer (CAL) achieves a direct linkage between preoperative radiological images and individual intraoperative anatomical findings. Experiences with our system demonstrate that CAL improves the intraoperative orientation and facilitates the neurosurgical procedure. The system described here consists of a mechanical articulated robot arm with six degrees of freedom and a three-dimensional image processor.

Sedation in allergic rhinitis is caused by the condition and not by antihistamine treatment.

Sedation is regarded as a common side-effect of most H1-antihistamines. This view must be accepted, yet can hardly be assessed under treatment of allergic disorders. Since central sedative potency is hard to evaluate, different methods of measurement have been introduced in the four phases of clinical investigation.