-
Journal of Otolaryngology - Head & Neck... Apr 2023ClariFix is a novel intranasal cryotherapy device developed for clinic-based cryosurgical ablation of the posterior nasal nerves region. As a relatively new technology,... (Review)
Review
BACKGROUND
ClariFix is a novel intranasal cryotherapy device developed for clinic-based cryosurgical ablation of the posterior nasal nerves region. As a relatively new technology, there is a paucity of studies within the literature assessing the efficacy and safety profile of ClariFix for chronic rhinitis.
METHODS
A systematic review was completed in accordance with PRISMA guidelines. Databases searched included: Ovid Medline, Ovid EMBASE, Pubmed, Cochrane and Web of Science. Inclusion criteria consisted of studies investigating the use of ClariFix in chronic rhinitis (i.e., allergic and non-allergic rhinitis) in patients of all ages.
RESULTS
The initial search identified 1110 studies. Final analysis consisted of 8 articles, evaluating a total of 472 patients. The data showed a significant reduction in scores post-treatment across all studies based on validated outcome measures. In all studies, at all time intervals, there was a significant improvement in outcome scores from baseline. Minor adverse effects included post-procedural pain and discomfort, headache and palate numbness. No major adverse events were identified.
CONCLUSION
ClariFix is a novel intranasal cryotherapy device that was introduced in Canada in 2021. This is the first systematic review evaluating its efficacy and safety profile. Across all studies, there was a significant reduction in validated outcome scores at multiple time intervals. Further, the treatment is safe with only minor adverse effects reported by patients. Overall, the consensus from this study highlights an apparent benefit in using this intervention for chronic rhinitis that is refractory to medical management.
Topics: Humans; Rhinitis; Cryosurgery; Administration, Intranasal; Quality of Life; Canada
PubMed: 37120607
DOI: 10.1186/s40463-023-00645-6 -
Allergy Jan 2016A growing number of studies suggest that maternal stress during pregnancy promotes atopic disorders in the offspring. This is the first systematic review to address... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
A growing number of studies suggest that maternal stress during pregnancy promotes atopic disorders in the offspring. This is the first systematic review to address prenatal maternal stress (PNMS) and the subsequent risk of atopy-related outcomes in the child.
METHODS
The review was performed in accordance to the PRISMA criteria. We searched and selected studies in PubMed, Scopus, Embase and PsychINFO until November 2014.
RESULTS
Sixteen (with 25 analyses) of 426 identified articles met the review criteria. Five main PNMS exposures (negative life events, anxiety/depression, bereavement, distress and job strain) and five main atopic outcomes (asthma, wheeze, atopic dermatitis, allergic rhinitis and IgE) were assessed across the studies. Overall, 21 of the 25 analyses suggested a positive association between PNMS and atopic outcomes. Of the 11 exposure-response analyses reported, six found statistically significant trends.
CONCLUSION
This systematic review suggests a relationship between maternal stress during pregnancy and atopic disorders in the child. However, the existing studies are of diverse quality. The wide definitions of often self-reported stress exposures imply a substantial risk for information bias and false-positive results. Research comparing objective and subjective measures of PNMS exposure as well as objective measures for atopic outcome is needed.
Topics: Child; Child, Preschool; Female; Humans; Hypersensitivity, Immediate; Infant; Maternal Exposure; Odds Ratio; Pregnancy; Prenatal Exposure Delayed Effects; Stress, Physiological; Stress, Psychological
PubMed: 26395995
DOI: 10.1111/all.12762 -
Evidence-based Complementary and... 2021The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified. (Review)
Review
BACKGROUND
The treatment effects and safety of ear acupressure (EAP) for patients with allergic rhinitis (AR) have yet to be clarified.
OBJECTIVE
To evaluate the effects and safety of EAP in AR patients.
DESIGN
Systematic review of published studies.
METHODS
A total of 24 English and Chinese databases (PubMed, EMBASE (Excerpta Medical Database), Cochrane Central Register of Controlled Trials, CINAHL, Informit, ScienceDirect, LILACS (Latin American and Caribbean Health Sciences), ProQuest, AMED, Blackwell Synergy, PsycINFO, Panteleimon, AcuBriefs, KoreaMed, IndMed, Ingenta, mRCT, ISI Web of Knowledge, ERIC, VIP Information (http://www.cqvip.com), China National Knowledge Infrastructure (http://www.cnki.net), Cochrane Library, Chinese Cochrane Centre Controlled Trials Register Platform, and Wanfang Chinese Digital Periodical and Conference Database) were searched from their respective inceptions to August 2020 to collect randomized controlled trials of ear acupressure for allergic rhinitis. We performed literature inclusion, data extraction, and trial quality evaluations. Methodological quality was assessed according to the Cochrane Handbook. Revman5.3 was used for all analyses.
RESULTS
A total of 203 trials were identified and eleven studies involved 1094 participants aged 3-70 years. EAP was better than control group interventions in terms of effectiveness (risk ratio (RR): 0.51; 95% confidence interval (CI): 0.36-0.70; < 0.0001). EAP was superior to sham EAP in terms of improvement of the total nasal symptom score (RR: -0.50; 95% CI: -0.96-0.05; = 0.03), sneezing score (RR: -0.36; 95% CI: -0.59-0.12; = 0.003), global QoL score (RR: 0.42; 95% CI: 0.04-0.08; = 0.03), and eye symptom score (RR: -0.36; 95% CI: -0.67-0.05; = 0.02).
CONCLUSIONS
Despite the positive results, it is premature to confirm the efficacy of EAP for treating AR. More high-quality studies are needed to confirm safety and efficacy.
PubMed: 34007299
DOI: 10.1155/2021/6699749 -
OTO Open 2022This review aimed to systematically determine the optimal nasal saline regimen for different types of sinonasal diseases. (Review)
Review
OBJECTIVE
This review aimed to systematically determine the optimal nasal saline regimen for different types of sinonasal diseases.
DATA SOURCES
PubMed, Embase, SCOPUS, Cochrane Library, Web of Science, ClinicalTrials.gov. The last search was on December 6, 2021.
REVIEW METHODS
Study selection was done by 2 independent authors. Randomized controlled trials and meta-analyses were included. The effects of nasal saline treatment through various devices, saline tonicities, and buffer statuses were evaluated in patients with allergic and nonallergic rhinitis, acute and chronic rhinosinusitis (CRS), CRS with cystic fibrosis, and postoperative care, including septoplasty/turbinoplasty and endoscopic sinus surgery.
RESULTS
Sixty-nine studies were included: 10 meta-analyses and 59 randomized controlled trials. For allergic rhinitis, large-volume devices (≥60 mL) were effective for treating adults, while low-volume devices (5-59 mL) were effective for children. Isotonic saline was preferred over hypertonic saline due to fewer adverse events. For acute rhinosinusitis, saline irrigation was beneficial in children, but it was an option for adults. Large-volume devices were more effective, especially in the common cold subgroup. For CRS, large-volume devices were effective for adults, but saline drop was the only regimen that had available data in children. Buffered isotonic saline was more tolerable than nonbuffered or hypertonic saline. The data for CRS with cystic fibrosis and nonallergic rhinitis were limited. For postoperative care, buffered isotonic saline delivered by large-volume devices was effective.
CONCLUSION
Nasal saline treatment is recommended for treating most sinonasal diseases. Optimal delivery methods for each condition should be considered to achieve therapeutic effects of saline treatment.
PubMed: 35720767
DOI: 10.1177/2473974X221105277 -
Journal of Urban Health : Bulletin of... Jun 2023Several studies have demonstrated an association between the risk asthma/allergic rhinitis and the environment. However, to date, no systematic review or meta-analysis... (Meta-Analysis)
Meta-Analysis Review
Several studies have demonstrated an association between the risk asthma/allergic rhinitis and the environment. However, to date, no systematic review or meta-analysis has investigated these factors. We conducted a systematic review and meta-analysis to assess the association between urban/rural living and the risk of asthma and allergic rhinitis. We searched the Embase and Medline databases for relevant articles and included only cohort studies to observe the effects of time-lapse geographical differences. Papers containing information on rural/urban residence and respiratory allergic diseases were eligible for inclusion. We calculated the relative risk (RR) and 95% confidence interval (CI) using a 2 × 2 contingency table and used random effects to pool data. Our database search yielded 8388 records, of which 14 studies involving 50,100,913 participants were finally included. The risk of asthma was higher in urban areas compared to rural areas (RR, 1.27; 95% CI, 1.12-1.44, p < 0.001), but not for the risk of allergic rhinitis (RR, 1.17; 95% CI, 0.87-1.59, p = 0.30). The risk of asthma in urban areas compared to rural areas was higher in the 0-6 years and 0-18 years age groups, with RRs of 1.21 (95% CI, 1.01-1.46, p = 0.04) and 1.35 (95% CI, 1.12-1.63, p = 0.002), respectively. However, there was no significant difference in the risk of asthma between urban and rural areas for children aged 0-2 years, with a RR of 3.10 (95% CI, 0.44-21.56, p = 0.25). Our study provides epidemiological evidence for an association between allergic respiratory diseases, especially asthma, and urban/rural living. Future research should focus on identifying the factors associated with asthma in children living in urban areas. The review was registered in PROSPERO (CRD42021249578).
Topics: Child; Humans; Asthma; Rhinitis, Allergic; Cohort Studies; Rural Population; Urban Population
PubMed: 37191813
DOI: 10.1007/s11524-023-00735-w -
Brazilian Journal of Otorhinolaryngology 2021Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, mediated by immunoglobulin E, affecting 1 in 6 individuals. The treatment aims at attaining... (Meta-Analysis)
Meta-Analysis Review
INTRODUCTION
Allergic rhinitis is a chronic inflammatory disease of the nasal mucosa, mediated by immunoglobulin E, affecting 1 in 6 individuals. The treatment aims at attaining symptomatic control with minimal side effects, a requirement for new alternative therapies, including phototherapy, as it has an immunosuppressive and immunomodulatory effect.
OBJECTIVE
To identify the effectiveness of phototherapy in the treatment of allergic rhinitis through a meta-analysis.
METHODS
We searched Web of Science, Scielo, PubMed, SCOPUS, PEDro, and LILACS databases, using the terms: "intranasal irradiation", "phototherapy" and "allergic rhinitis". The R software Metafor package was used for the meta-analysis and the effect size was calculated for each symptom individually.
RESULTS
All symptoms decreased considerably after phototherapy: rhinorrhea (ES• = -1.35; p < 0.0001; I = 91.84%), sneezing (ES• = -1.24; p < 0.0001; I = 91.43%), nasal pruritus (ES• = -1.10; p < 0.0001; I = 91.43%); nasal obstruction (ES• = -1.11; p < 0.0001; I = 91.88%). The effects were more significant in perennial allergic rhinitis than in the seasonal type.
CONCLUSION
Considering the effect size and the statistical significance attained in our study, rhinophototherapy showed to be an effective treatment for reducing the nasal symptom scores triggered by AR.
Topics: Humans; Nasal Mucosa; Nasal Obstruction; Phototherapy; Rhinitis, Allergic; Rhinitis, Allergic, Perennial
PubMed: 33663975
DOI: 10.1016/j.bjorl.2020.12.016 -
Clinical Reviews in Allergy & Immunology Oct 2023Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are... (Review)
Review
Many potential environmental risk factors, protective factors, and biomarkers of AR have been published, but so far, the strength and consistency of their evidence are unclear. We conducted a comprehensive review of environmental risk, protective factors, and biomarkers for AR to establish the evidence hierarchy. We systematically searched Embase, PubMed, Cochrane Library, and Web of Science electronic database from inception to December 31, 2022. We calculated summary effect estimate (odds ratio (OR), relative risk (RR), hazard ratio (HR), and standardized mean difference (SMD)), 95% confidence interval, random effects p value, I statistic, 95% prediction interval, small study effects, and excess significance biases, and stratification of the level of evidence. Methodological quality was assessed by AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews 2). We retrieved 4478 articles, of which 43 met the inclusion criteria. The 43 eligible articles identified 31 potential environmental risk factors (10,806,206 total population, two study not reported), 11 potential environmental protective factors (823,883 total population), and 34 potential biomarkers (158,716 total population) for meta-analyses. The credibility of evidence was convincing (class I) for tic disorders (OR = 2.89, 95% CI 2.11-3.95); and highly suggestive (class II) for early-life antibiotic use (OR = 3.73, 95% CI 3.06-4.55), exposure to indoor dampness (OR = 1.49, 95% CI 1.27-1.75), acetaminophen exposure (OR = 1.54, 95% CI 1.41-1.69), childhood acid suppressant use (OR = 1.40, 95% CI 1.23-1.59), exposure to indoor mold (OR = 1.66, 95% CI 1.26-2.18), coronavirus disease 2019 (OR = 0.11, 95% CI 0.06-0.22), and prolonged breastfeeding (OR = 0.72, 95% CI 0.65-0.79). This study is registered in PROSPERO (CRD42022384320).
Topics: Child; Humans; Acetaminophen; Biomarkers; COVID-19; Protective Factors; Rhinitis, Allergic; Risk Factors; Systematic Reviews as Topic
PubMed: 37490237
DOI: 10.1007/s12016-023-08964-2 -
Association of atopic diseases with atrial fibrillation risk: A systematic review and meta-analysis.Frontiers in Cardiovascular Medicine 2022Atopic diseases and atrial fibrillation (AF) seem to share an underlying inflammatory pathology. To date, some population-based studies have explored the relationship...
BACKGROUND
Atopic diseases and atrial fibrillation (AF) seem to share an underlying inflammatory pathology. To date, some population-based studies have explored the relationship between the two. We aimed to conduct a meta-analysis to examine the role of atopic condition in AF risk.
METHODS
All relevant observational studies in PubMed and EMBASE databases up to November 2021 were searched. In RevMan 5.3, we used random-effects or fixed-effects models to pool the effect sizes of hazard ratio (HR), odds ratio (OR) and their corresponding 95% confidence intervals (95% CI). In addition, I and Cochran Q test were used to evaluate the heterogeneity.
RESULTS
A total of 2488 records were retrieved. After screening according to the predetermined criteria, 6 cohort studies and 2 case-control studies were included in this meta-analysis. Herein, the meta-analysis of 6 cohort studies suggested that atopic diseases potentially increased the AF risk with the pooled HR of 1.26 (95%CI,1.14-1.39), while the pooled effect size (OR, 1.04; 95%CI,0.74-1.46) of 2 case-control studies was not statistically significant. Based on the types of atopic diseases, further subgroup analyses of 6 cohort studies revealed that asthma, allergic rhinitis, and atopic dermatitis all potentially increased the risk of subsequent AF with the pooled HR of 1.41 ( = 4; 95%CI, 1.25-1.58), 1.12 ( = 1; 95%CI,1.10-1.14) and 1.06 ( = 3; 95%CI, 1.01-1.12), respectively.
CONCLUSION
This meta-analysis demonstrated that patients with atopic diseases have a higher risk of developing AF, particularly those with asthma.
PubMed: 36110420
DOI: 10.3389/fcvm.2022.877638 -
The Journal of Investigative Dermatology May 2024Prior studies have found associations between atopic dermatitis (AD) and comorbidities, including depression, obesity, asthma, and allergic rhinitis. Although...
Prior studies have found associations between atopic dermatitis (AD) and comorbidities, including depression, obesity, asthma, and allergic rhinitis. Although observational studies often cannot establish robust causality between potential risk factors and AD, Mendelian randomization minimizes confounding when exploring causality by relying on random allelic assortment at birth. In this study, we systematically reviewed 30 Mendelian randomization studies in AD. Body mass index, gut microbial flora, the IL-18 signaling pathway, and gastroesophageal reflux disease were among the causal factors for AD, whereas AD was causal for several medical conditions, including heart failure, rheumatoid arthritis, and conjunctivitis. These insights may improve preventive counseling in AD.
Topics: Humans; Dermatitis, Atopic; Mendelian Randomization Analysis; Risk Factors; Comorbidity; Gastrointestinal Microbiome; Body Mass Index; Gastroesophageal Reflux; Interleukin-18; Genetic Predisposition to Disease
PubMed: 37977498
DOI: 10.1016/j.jid.2023.10.016 -
Mediators of Inflammation 2023Intralymphatic immunotherapy (ILIT) is short-course administration of allergen-specific immunotherapy (AIT). This study is aimed at assessing the clinical efficacy and... (Meta-Analysis)
Meta-Analysis
BACKGROUND
Intralymphatic immunotherapy (ILIT) is short-course administration of allergen-specific immunotherapy (AIT). This study is aimed at assessing the clinical efficacy and safety of ILIT in patients with allergic rhinitis (AR).
METHODS
MEDLINE, PUBMED, and Cochrane Library were used to conduct electronic searches for clinical trials comparing ILIT and placebo in patients with AR. The final search took place on August 24, 2022. Cochrane Handbook for Systematic Reviews of Interventions was used to assess the risk of bias in the included studies. The outcomes included combined symptom and medication scores (CSMS), visual analog scale (VAS), allergic rhinoconjunctivitis quality of life (RQLQ), Skin-prick test (SPT), and adverse events (AEs). Data were synthesized as mean difference (MD)/standard mean difference (SMD) or risk difference (RD) and 95% confidence interval (CI).
RESULTS
Thirteen studies (454 participants) were included in this study. The ILIT group had better clinical improvement on the CSMS (random effects model, SMD-0.85, 95% CI [-1.58, -0.11], = 0.02) and RQLQ (fixed-effects model, MD-0.42, 95% CI [0.69, 0.15], = 0.003) than the placebo group. The booster injection was beneficial for CSMS ( < 0.0001), and the 4-week injection interval was superior to the 2-week injection period for improving VAS ( < 0.0001). Local swelling or erythema was the main AE following injection (random effects model, RD 0.16, 95% CI [0.05, 0.27], = 0.005). . For individuals with AR, ILIT is safe and effective. ILIT alleviates clinical symptoms and reduces pharmaceutical consumption without causing severe AEs. However, the validity of this study is compromised by the substantial heterogeneity and risk of bias in the included researches. CRD42022355329.
Topics: Humans; Quality of Life; Rhinitis, Allergic; Desensitization, Immunologic; Treatment Outcome
PubMed: 37197570
DOI: 10.1155/2023/9377518