The unified airway:
Gespeichert in:
| Format: | Buch |
|---|---|
| Sprache: | English |
| Veröffentlicht: |
Philadelphia [u.a.]
Saunders
2008
|
| Schriftenreihe: | Otolaryngologic clinics of North America
41,2 |
| Schlagworte: | |
| Online-Zugang: | Inhaltsverzeichnis |
| Beschreibung: | XII S., S. 257 - 457 Ill., graph. Darst. |
| ISBN: | 1416060480 9781416060482 |
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| 245 | 1 | 0 | |a The unified airway |c guest ed. John H. Krouse |
| 264 | 1 | |a Philadelphia [u.a.] |b Saunders |c 2008 | |
| 300 | |a XII S., S. 257 - 457 |b Ill., graph. Darst. | ||
| 336 | |b txt |2 rdacontent | ||
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| 490 | 1 | |a Otolaryngologic clinics of North America |v 41,2 | |
| 650 | 4 | |a Asthma | |
| 650 | 4 | |a Comorbidity | |
| 650 | 4 | |a Otitis media | |
| 650 | 4 | |a Respiratory Hypersensitivity | |
| 650 | 4 | |a Respiratory Tract Diseases | |
| 650 | 4 | |a Rhinitis | |
| 650 | 4 | |a Sinusitis | |
| 700 | 1 | |a Krouse, John H. |e Sonstige |4 oth | |
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| 999 | |a oai:aleph.bib-bvb.de:BVB01-016602026 | ||
Datensatz im Suchindex
| _version_ | 1804137811646873600 |
|---|---|
| adam_text | CONTENTS
Preface xi
John H. Krouse
The Unified Airway—Conceptual Framework 257
John H. Krouse
Substantial evidence exists to support the concept that the
respiratory system functions as an integrated unit. Pathophysio-
logical processes that involve the upper airway generally occur in
conjunction with lower airway diseases, and diffuse inflammation
often affects mucosal surfaces of the middle ear, nose, sinuses, and
tracheobronchial tree simultaneously. Support for this relationship
can be found in epidemiological studies, in shared pathophysio-
logical mechanisms, and in observed interactive treatment effects.
This model and its implications are discussed.
Allergic Rhinitis and Rhinosinusitis 267
Nadir Ahmad and Mark A. Zacharek
A relationship between allergic rhinitis and acute and chronic
rhinosinusitis has been postulated for many years. Epidemiologic
evidence suggests that such a relationship is likely. In addition,
evidence of a common pathophysiologic mechanism linking these
diseases is compelling and continues to evolve. Although a clear
and definitive causal relationship remains to be elucidated, an
increasing number of studies support the plausibility of this link.
The current paradigm of the unified airway and evidence to
support this model further strengthen this link. This article reviews
the literature relating allergic rhinitis and acute and chronic
rhinosinusitis.
VOLUME 41 • NUMBER 2 • APRIL 2008 v
Asthma and Rhinitis: Comorbidities 283
Matthew W. Ryan
The connection between asthma and rhinitis is not a new discovery.
Significant progress has been made in understanding the relation¬
ship of these two conditions, however, and the implications of the
asthma-rhinitis link make it increasingly important. Patients who
have asthma and rhinitis tend to have more severe disease with
higher treatment costs. Treatment of rhinitis may improve asthma
control, and early treatment of allergies may prevent the develop¬
ment of asthma. This article more fully explores the epidemiologic,
pathophysiologic, and clinical relationships between asthma and
rhinitis.
Chronic Rhinosinusitis and Asthma 297
Stephanie A. Joe and Kunal Thakkar
Based on considerations of the underlying epidemiology, patho-
physiology histopathology, clinical relationships and treatment
outcomes, the links between rhinosinusitis and asthma become
evident supporting the unified airway concept.
The Link Between Allergic Rhinitis and Chronic Otitis Media
with Effusion in Atopic Patients 311
Amber Luong and Peter S. Roland
The significant incidence of atopy associated with otitis media with
effusion (OME) has suggested a role of allergy in the pathogenesis
of OME. Analysis of inflammatory mediators indicates that the
mucosa of the middle ear can respond to antigen in the same way
as does the mucosa of the lower respiratory tract. Recent
characterization of the mucosa and effusion from atopic patients
with OME reveals a Th2 cytokine and cellular profiles consistent
with an allergic response, supporting the role of allergy in OME. In
addition, animal studies demonstrate that inhibiting characteristic
allergy cytokines can prevent the production of middle ear
effusion. As the understanding of allergy and its role in the
inflammation of OME continues to deepen, this will introduce
focused treatments of OME in the atopic population.
Allergic Rhinitis—History and Presentation 325
Rose J. Eapen, Charles S. Ebert, Jr, and Harold C. Pillsbury, III
Allergic rhinitis is a common disorder that results from a complex
interaction of environmental and genetic causes. This disorder has
a tremendous impact on the quality of life and on health care
expenditures, as evidenced by a large loss of worker productivity.
Care must be taken to promptly diagnose patients with this
condition, evaluate them for associated conditions, and begin
appropriate management to reduce its impact on the individual
and the health care system. Allergic rhinitis represents only a
vi CONTENTS
component of the spectrum of inflammatory diseases involving the
unified airway.
Allergic Rhinitis—Current Approaches to Skin
and In Vitro Testing 331
Richard C. Haydon
This article discusses the currently available techniques used for
the diagnosis of IgE-mediated upper respiratory allergy. These
methods are necessary to confirm the presence and the intensity of
allergy in an effort to select patients for immunotherapy and to
dose immunotherapy properly. Specific techniques discussed
include epicutaneous and intradermal skin tests and in vitro tests
designed to measure antigen-specific IgE antibody.
Allergic Rhinitis—Current Pharmacotherapy 347
John H. Krouse
The use of pharmacotherapy for allergic rhinitis remains a central
strategy in the integrated treatment of the patient. The most
appropriate medical therapy depends upon the nature of specific
rhinitis symptoms, patient tolerance to and preference for certain
classes of medications, and response to treatment. Through an
appreciation of these various physiological mechanisms, the
physician can select the treatment option or options that will be
most likely to effectively manage symptoms.
Injection and Sublingual Immunotherapy in the Management
of Allergies Affecting the Unified Airway 359
Bryan Leatherman
The spectrum of allergic disease involves both the upper and lower
airways. Immunotherapy has been shown to produce immuno-
logic changes that can result in the improvement of allergic
diseases. Numerous clinical trials have demonstrated the effective¬
ness of injection and sublingual immunotherapy in the treatment of
rhinitis and asthma. Recent data suggest that immunotherapy may
have a role in preventing the development of new sensitizations or
in decreasing the progression of allergic disease from rhinitis to
asthma. Models of immunotherapy may therefore transition from
symptom-relieving treatments to preventive methodologies for the
management of allergic disease.
Asthma History and Presentation 375
Bruce R. Gordon
Asthma is suspected from a history of key symptoms, including
cough, wheezing, dyspnea, chest tightness, and increased mucus
production. A positive family or personal history of atopic diseases
and diseases that are comorbid with asthma, such as allergic
CONTENTS vii
rhinitis and rhinosinusitis, is also important. The differential
diagnosis of asthma is broad and includes potentially life-threat¬
ening diseases. Pediatric asthma and psychiatric mimics require
special attention to prevent misdiagnosis. Differentiating asthma
from these other disease states by history alone is not always
possible. Because accurate diagnosis is critical to successful
treatment, objective testing by spirometry and methacholine
challenge should be employed.
Introduction to Pulmonary Function 387
Michael W. Chu and Joseph K. Han
Asthma is a dynamic and complex inflammatory disease. Recent
research suggests that it is a manifestation of a systemic disorder of
the entire respiratory system including both upper and lower
airways. The diagnosis of asthma can be made based on clinical
history, physical findings, and pulmonary function tests such as
spirometry. In children, spirometry may be difficult; therefore,
diurnal changes in peak expiratory flow rate can be used instead to
assist in the diagnosis of asthma. Increasing the use of objective
pulmonary measures will help better identify and monitor treat¬
ment of lower respiratory inflammatory disease.
Asthma: Guidelines-Based Control and Management 397
John H. Krouse and Helene J. Krouse
Guidelines-based management of the patient with asthma allows
maximal levels of function with few adverse effects. A flexible
approach to therapy that emphasizes an ongoing partnership
between the patient and physician allows optimal communication,
facilitating treatment adherence and maximal levels of control.
Through assessment of the patient s initial severity of disease and
an evaluation of the patient s ongoing level of control, appropriate
medical therapy can be initiated and level of therapy can be
modified based on the patient s response. Patient education,
environmental control strategies, and proper use of medications
are vital in achieving maximal benefit in asthma management.
Excellent asthma control is possible and should be a goal of both
physicians and patients.
Environmental Controls of Allergies 411
Berrylin J. Ferguson
Environmental controls of allergy remain a cornerstone in the
management of patients who have allergic rhinitis. In the past,
recommendations for environmental controls were based on
common sense and the demonstration that certain methods of
environmental control reduce antigen quantity. Reduction of
antigen quantity is, however, only an indirect measure of whether
an environmental control strategy actually reduces allergic
symptoms. This article details current recommendations for
viii CONTENTS
reducing antigen exposure based on specific antigen sensitivities.
Strategies for reduction of indoor inhalant allergens—dust mites,
cockroach, molds, and house pet danders—are presented, as well
as techniques for reducing exposure to outdoor inhalant allergens.
Laryngitis: Types, Causes, and Treatments 419
James Paul Dworkin
Inflammatory processes that affect the unified airway can
concurrently exert significant influence on the larynx and
surrounding mucosal surfaces. Laryngeal inflammation can be
present secondary to direct effects of irritants, toxins, and antigens,
but can also involve mechanical and infectious effects as well as
secondary inflammation from behavioral mechanisms. This review
examines laryngeal inflammation in the context of the unified
airway and discusses pathophysiologic mechanisms that are
central to the development of acute and chronic laryngitis.
Laryngitis—Diagnosis and Management 437
Ozlem E. Tulunay
Laryngeal inflammation includes a broad spectrum of pathologies,
from infectious processes that need to be managed as airway
emergencies, to indolent diseases that mimic head and neck cancer.
The importance of a thorough history cannot be emphasized
enough as it is the most important step toward developing a
differential diagnosis. Vocal pathologies often have a noticeable
impact on a person s quality of life and daily activities; therefore, it
is key to counsel patients on the course of the disease process.
Treatment of specific pathologies depends on the causative
pathogen or etiology, as well as the age, vocal demands, and
clinical characteristics of the individual.
Index 453
CONTENTS
|
| adam_txt |
CONTENTS
Preface xi
John H. Krouse
The Unified Airway—Conceptual Framework 257
John H. Krouse
Substantial evidence exists to support the concept that the
respiratory system functions as an integrated unit. Pathophysio-
logical processes that involve the upper airway generally occur in
conjunction with lower airway diseases, and diffuse inflammation
often affects mucosal surfaces of the middle ear, nose, sinuses, and
tracheobronchial tree simultaneously. Support for this relationship
can be found in epidemiological studies, in shared pathophysio-
logical mechanisms, and in observed interactive treatment effects.
This model and its implications are discussed.
Allergic Rhinitis and Rhinosinusitis 267
Nadir Ahmad and Mark A. Zacharek
A relationship between allergic rhinitis and acute and chronic
rhinosinusitis has been postulated for many years. Epidemiologic
evidence suggests that such a relationship is likely. In addition,
evidence of a common pathophysiologic mechanism linking these
diseases is compelling and continues to evolve. Although a clear
and definitive causal relationship remains to be elucidated, an
increasing number of studies support the plausibility of this link.
The current paradigm of the "unified airway" and evidence to
support this model further strengthen this link. This article reviews
the literature relating allergic rhinitis and acute and chronic
rhinosinusitis.
VOLUME 41 • NUMBER 2 • APRIL 2008 v
Asthma and Rhinitis: Comorbidities 283
Matthew W. Ryan
The connection between asthma and rhinitis is not a new discovery.
Significant progress has been made in understanding the relation¬
ship of these two conditions, however, and the implications of the
asthma-rhinitis link make it increasingly important. Patients who
have asthma and rhinitis tend to have more severe disease with
higher treatment costs. Treatment of rhinitis may improve asthma
control, and early treatment of allergies may prevent the develop¬
ment of asthma. This article more fully explores the epidemiologic,
pathophysiologic, and clinical relationships between asthma and
rhinitis.
Chronic Rhinosinusitis and Asthma 297
Stephanie A. Joe and Kunal Thakkar
Based on considerations of the underlying epidemiology, patho-
physiology histopathology, clinical relationships and treatment
outcomes, the links between rhinosinusitis and asthma become
evident supporting the unified airway concept.
The Link Between Allergic Rhinitis and Chronic Otitis Media
with Effusion in Atopic Patients 311
Amber Luong and Peter S. Roland
The significant incidence of atopy associated with otitis media with
effusion (OME) has suggested a role of allergy in the pathogenesis
of OME. Analysis of inflammatory mediators indicates that the
mucosa of the middle ear can respond to antigen in the same way
as does the mucosa of the lower respiratory tract. Recent
characterization of the mucosa and effusion from atopic patients
with OME reveals a Th2 cytokine and cellular profiles consistent
with an allergic response, supporting the role of allergy in OME. In
addition, animal studies demonstrate that inhibiting characteristic
allergy cytokines can prevent the production of middle ear
effusion. As the understanding of allergy and its role in the
inflammation of OME continues to deepen, this will introduce
focused treatments of OME in the atopic population.
Allergic Rhinitis—History and Presentation 325
Rose J. Eapen, Charles S. Ebert, Jr, and Harold C. Pillsbury, III
Allergic rhinitis is a common disorder that results from a complex
interaction of environmental and genetic causes. This disorder has
a tremendous impact on the quality of life and on health care
expenditures, as evidenced by a large loss of worker productivity.
Care must be taken to promptly diagnose patients with this
condition, evaluate them for associated conditions, and begin
appropriate management to reduce its impact on the individual
and the health care system. Allergic rhinitis represents only a
vi CONTENTS
component of the spectrum of inflammatory diseases involving the
unified airway.
Allergic Rhinitis—Current Approaches to Skin
and In Vitro Testing 331
Richard C. Haydon
This article discusses the currently available techniques used for
the diagnosis of IgE-mediated upper respiratory allergy. These
methods are necessary to confirm the presence and the intensity of
allergy in an effort to select patients for immunotherapy and to
dose immunotherapy properly. Specific techniques discussed
include epicutaneous and intradermal skin tests and in vitro tests
designed to measure antigen-specific IgE antibody.
Allergic Rhinitis—Current Pharmacotherapy 347
John H. Krouse
The use of pharmacotherapy for allergic rhinitis remains a central
strategy in the integrated treatment of the patient. The most
appropriate medical therapy depends upon the nature of specific
rhinitis symptoms, patient tolerance to and preference for certain
classes of medications, and response to treatment. Through an
appreciation of these various physiological mechanisms, the
physician can select the treatment option or options that will be
most likely to effectively manage symptoms.
Injection and Sublingual Immunotherapy in the Management
of Allergies Affecting the Unified Airway 359
Bryan Leatherman
The spectrum of allergic disease involves both the upper and lower
airways. Immunotherapy has been shown to produce immuno-
logic changes that can result in the improvement of allergic
diseases. Numerous clinical trials have demonstrated the effective¬
ness of injection and sublingual immunotherapy in the treatment of
rhinitis and asthma. Recent data suggest that immunotherapy may
have a role in preventing the development of new sensitizations or
in decreasing the progression of allergic disease from rhinitis to
asthma. Models of immunotherapy may therefore transition from
symptom-relieving treatments to preventive methodologies for the
management of allergic disease.
Asthma History and Presentation 375
Bruce R. Gordon
Asthma is suspected from a history of key symptoms, including
cough, wheezing, dyspnea, chest tightness, and increased mucus
production. A positive family or personal history of atopic diseases
and diseases that are comorbid with asthma, such as allergic
CONTENTS vii
rhinitis and rhinosinusitis, is also important. The differential
diagnosis of asthma is broad and includes potentially life-threat¬
ening diseases. Pediatric asthma and psychiatric mimics require
special attention to prevent misdiagnosis. Differentiating asthma
from these other disease states by history alone is not always
possible. Because accurate diagnosis is critical to successful
treatment, objective testing by spirometry and methacholine
challenge should be employed.
Introduction to Pulmonary Function 387
Michael W. Chu and Joseph K. Han
Asthma is a dynamic and complex inflammatory disease. Recent
research suggests that it is a manifestation of a systemic disorder of
the entire respiratory system including both upper and lower
airways. The diagnosis of asthma can be made based on clinical
history, physical findings, and pulmonary function tests such as
spirometry. In children, spirometry may be difficult; therefore,
diurnal changes in peak expiratory flow rate can be used instead to
assist in the diagnosis of asthma. Increasing the use of objective
pulmonary measures will help better identify and monitor treat¬
ment of lower respiratory inflammatory disease.
Asthma: Guidelines-Based Control and Management 397
John H. Krouse and Helene J. Krouse
Guidelines-based management of the patient with asthma allows
maximal levels of function with few adverse effects. A flexible
approach to therapy that emphasizes an ongoing partnership
between the patient and physician allows optimal communication,
facilitating treatment adherence and maximal levels of control.
Through assessment of the patient's initial severity of disease and
an evaluation of the patient's ongoing level of control, appropriate
medical therapy can be initiated and level of therapy can be
modified based on the patient's response. Patient education,
environmental control strategies, and proper use of medications
are vital in achieving maximal benefit in asthma management.
Excellent asthma control is possible and should be a goal of both
physicians and patients.
Environmental Controls of Allergies 411
Berrylin J. Ferguson
Environmental controls of allergy remain a cornerstone in the
management of patients who have allergic rhinitis. In the past,
recommendations for environmental controls were based on
common sense and the demonstration that certain methods of
environmental control reduce antigen quantity. Reduction of
antigen quantity is, however, only an indirect measure of whether
an environmental control strategy actually reduces allergic
symptoms. This article details current recommendations for
viii CONTENTS
reducing antigen exposure based on specific antigen sensitivities.
Strategies for reduction of indoor inhalant allergens—dust mites,
cockroach, molds, and house pet danders—are presented, as well
as techniques for reducing exposure to outdoor inhalant allergens.
Laryngitis: Types, Causes, and Treatments 419
James Paul Dworkin
Inflammatory processes that affect the unified airway can
concurrently exert significant influence on the larynx and
surrounding mucosal surfaces. Laryngeal inflammation can be
present secondary to direct effects of irritants, toxins, and antigens,
but can also involve mechanical and infectious effects as well as
secondary inflammation from behavioral mechanisms. This review
examines laryngeal inflammation in the context of the unified
airway and discusses pathophysiologic mechanisms that are
central to the development of acute and chronic laryngitis.
Laryngitis—Diagnosis and Management 437
Ozlem E. Tulunay
Laryngeal inflammation includes a broad spectrum of pathologies,
from infectious processes that need to be managed as airway
emergencies, to indolent diseases that mimic head and neck cancer.
The importance of a thorough history cannot be emphasized
enough as it is the most important step toward developing a
differential diagnosis. Vocal pathologies often have a noticeable
impact on a person's quality of life and daily activities; therefore, it
is key to counsel patients on the course of the disease process.
Treatment of specific pathologies depends on the causative
pathogen or etiology, as well as the age, vocal demands, and
clinical characteristics of the individual.
Index 453
CONTENTS " |
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| index_date | 2024-07-02T21:30:35Z |
| indexdate | 2024-07-09T21:18:14Z |
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| spelling | The unified airway guest ed. John H. Krouse Philadelphia [u.a.] Saunders 2008 XII S., S. 257 - 457 Ill., graph. Darst. txt rdacontent n rdamedia nc rdacarrier Otolaryngologic clinics of North America 41,2 Asthma Comorbidity Otitis media Respiratory Hypersensitivity Respiratory Tract Diseases Rhinitis Sinusitis Krouse, John H. Sonstige oth Otolaryngologic clinics of North America 41,2 (DE-604)BV000003387 41,2 HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016602026&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis |
| spellingShingle | The unified airway Otolaryngologic clinics of North America Asthma Comorbidity Otitis media Respiratory Hypersensitivity Respiratory Tract Diseases Rhinitis Sinusitis |
| title | The unified airway |
| title_auth | The unified airway |
| title_exact_search | The unified airway |
| title_exact_search_txtP | The unified airway |
| title_full | The unified airway guest ed. John H. Krouse |
| title_fullStr | The unified airway guest ed. John H. Krouse |
| title_full_unstemmed | The unified airway guest ed. John H. Krouse |
| title_short | The unified airway |
| title_sort | the unified airway |
| topic | Asthma Comorbidity Otitis media Respiratory Hypersensitivity Respiratory Tract Diseases Rhinitis Sinusitis |
| topic_facet | Asthma Comorbidity Otitis media Respiratory Hypersensitivity Respiratory Tract Diseases Rhinitis Sinusitis |
| url | http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=016602026&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA |
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