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- Thulesius, Helle L., et al.
(författare)
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Can we always trust rhinomanometry?
- 2011
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Ingår i: Rhinology. - 0300-0729. ; 49:1, s. 46-52
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: Rhinomanometry before and after decongestion distinguishes a nasal airway organic stenosis from congestion of nasal mucosa in patients with nasal stuffiness. Together with rhinoscopy and patient history, it is used to decide if nasal surgery would benefit the patient. Rhinomanometry measurements should thus be reliable and reproducible. Materials and methods: We performed repetitive active anterior rhinomanometry in 9 persons during 5 months to test reproducibility of nasal airway resistance (NAR) over time. We also did test-retest measurements in several participants. Xylometazoline hydrochloride was applied in each nasal cavity to minimize effects of mucosal variation and the nasal cavity was examined with rhinoscopy. The participants evaluated subjective nasal stuffiness on a visual analogue scale (VAS). Results: The long term mean coefficient of variation (CV) of NAR over time was 27% for the whole group while the short term CV was 7 - 17% for test-retest within an hour. Mean NAR reduction after decongestion was 33%, but 13% of NAR values were not reduced after decongestion. Participants had difficulties estimating stuffiness on a VAS in 15% of the assessments, but there was no correlation between the VAS estimates and NAR. Conclusion: We found a high NAR variation over a period of five months. This implies low long-term rhinomanometry reproducibility and we suggest future research on standardised decongestion to increase the reproducibility.
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| 3. |
- Thulesius, Helle L, et al.
(författare)
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Pharyngometric correlations with obstructive sleep apnea syndrome.
- 2004
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Ingår i: Acta Oto-Laryngologica. - 0001-6489 .- 1651-2251. ; 124:10, s. 1182-6
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Tidskriftsartikel (refereegranskat)abstract
- OBJECTIVE: The primary objective of this study was to investigate the relationship between obstructive sleep apnea syndrome (OSAS) and pharyngometric dimensions as clinical predictors of OSAS.MATERIAL AND METHODS: Pharyngometry included tonsil size, the breadth of the uvula (UB), the distance between the uvula and the posterior pharyngeal wall and open mouth standardized photographic measurement of the dimension of the free oropharynx (FOP). We also assessed modified Mallampati grade (MMP). In addition, clinical data on body weight, height, nasal obstruction and cardiovascular disease were included in our analysis.RESULTS: A total of 96 consecutive patients of both sexes with sleep disorders were investigated with somnography. Of these, 35 were considered to have OSAS, with an apnea-hypopnea index (AHI) of > or = 10. Body mass index (BMI), FOP, UB, the use of cardiovascular medication and hypertension were significantly related to AHI, and tonsil size showed borderline significance. Regression models were used to determine an OSAS index using the parameters BMI and FOP. The index had a positive predictive value of 82% and a negative predictive value of 77%.CONCLUSIONS: We showed that a photographic assessment of pharyngeal dimensions was significantly associated with OSAS. We also confirmed previous findings of associations between OSAS, BMI and cardiovascular morbidity.
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| 4. |
- Thulesius, Helle L., et al.
(författare)
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Treatment with a topical glucocorticoid, budesonide, reduced the variability of rhinomanometric nasal airway resistance
- 2014
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Ingår i: Rhinology. - 0300-0729. ; 52:1, s. 19-24
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Tidskriftsartikel (refereegranskat)abstract
- Background: Previous rhinomanometry studies have shown significant long-term variability of the nasal airway resistance and questioned the clinical validity of rhinomanonnetry. Research question: Could treatment with a topical glucocorticoid, budesonide, influence the long-term variability of active anterior rhinomanometry? Methods: Eight healthy volunteers participated in an unblinded controlled trial without, and later with, nasal budesonide once a day for 5 months. Their nasal airway resistance was measured every two weeks with active anterior rhinomanometry before and after decongestion with xylometazoline hydrochloride. In addition, subjective nasal obstruction was evaluated on a Visual Analogue Scale before each measurement.The participants had a year earlier been investigated with rhinomanometry every two weeks during 5 months but without budesonide treatment. We compared the variability of nasal airway resistance during the two periods with and without treatment with topical budesonide. Results: Budesonide significantly reduced mean nasal airway resistance and the standard deviation of the mean after decongestion for 6 of 8 participants. The mean reduction of the nasal airway resistance was 40% for the decongested nasal cavity compared to the period without treatment with nasal budesonide. Subjective nasal obstruction assessed by Visual Analogue Scale was reduced in 3 of the 8 participants. Conclusion: The variability of nasal airway resistance was significantly reduced by treatment with topical budesonide for 6 out of 8 healthy volunteers participating in an unblinded repeated 5 month trial where the participants served as their own controls.
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| 5. |
- Thulesius, Helle L, et al.
(författare)
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What happens to patients with nasal stuffiness and pathological rhinomanometry left without surgery?
- 2009
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Ingår i: Rhinology. - 0300-0729 .- 1996-8604. ; 47:1, s. 24-7
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Tidskriftsartikel (refereegranskat)abstract
- In this study we explored long term outcomes of patients with nasal stuffiness and high nasal airway resistance (NAR) that did not undergo nasal surgery. The same investigation was repeated on average 8 years after a baseline investigation with an ENT-examination, a rhinomanometric survey and a rhinomanometry. We did follow-up investigations in 44 out of 59 non-operated patients with a pathological NAR on at least one side. At follow-up 2 persons (4%) had no complaints, 14 (32%) had reduced, 22 (50%) unchanged, and 6 (14%) increased complaints of nasal stuffiness. Rhinomanometry showed that NAR values decreased significantly between baseline and follow-up on both wider and narrower sides after decongestion. There was no correlation between subjective nasal complaints and NAR-values. In logistic regression models increasing age and allergy prevalence at baseline were significantly associated with having no, or reduced nasal stuffiness at follow-up. The results show that both NAR and subjective nasal stuffiness decreased with age. Consequently, we suggest that NAR normal values should be age adjusted. Also, a wait and see policy towards nasal stuffiness seems relevant since 36% of our patients had no or reduced nasal stuffiness while their NAR-values were reduced after 8 years.
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| 6. |
- Thulesius, Helle, et al.
(författare)
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The importance of side difference in nasal obstruction and rhinomanometry: a retrospective correlation of symptoms and rhinomanometry in 1000 patients
- 2012
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Ingår i: Clinical Otolaryngology. - : Wiley. - 1749-4486 .- 1749-4478. ; 37:1, s. 17-22
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Tidskriftsartikel (refereegranskat)abstract
- Objectives: The correlation between subjective and objective outcomes of nasal obstruction is still a matter of controversy. The aim of this study was to determine the minimal level of side difference in nasal airway resistance (NAR measured by Broms' v2) between the two nasal cavities, which could be discerned subjectively by the patient on a visual analogue scale (VAS). Nasal airway resistance was calculated from rhinomanometric measurements of nasal airflow and transnasal pressure after decongestion of the nasal mucosa. Design: A retrospective study. Setting: ENT department, Vaxjo Central Hospital, Sweden. Participants: We studied 1000 active anterior rhinomanometries from patients with nasal obstructions. Main outcome measures: We compared the side difference of nasal airway resistance with the side difference of VAS estimated immediately prior to the rhinomanometry. Each measurement was performed after nasal decongestion. Results: When the difference in nasal airway resistance between the two nasal cavities was larger than 20 degrees (Broms' v(2)) or R-2 > 0.36 Pa/cm(3)/s, we found a significant correlation between side differences of the objective measurement and the subjective assessment (VAS). With a nasal airway resistance side difference over 20 degrees, an additional 20 degrees difference corresponded to a 0.9 centimetre average VAS change. The more obstructed side of the nose could be determined by VAS in 823 (82.3%) of 1000 patients. Yet, 177 (17.7%) patients had a paradoxical sensation of nasal obstruction with the low resistance side of the nose experienced as the most congested side. Conclusion: A significant correlation between the side differences of nasal airway resistance and VAS can serve as a supplement to rhinoscopy in decisions about nasal surgery. This study also showed that in 17.7% of patients, there was a negative correlation between subjective and objective evaluations of nasal airway resistance. But in this group, the nasal airway resistance side difference was mostly under 20 degrees. Results: When the difference in nasal airway resistance between the two nasal cavities was larger than 20 degrees (Broms' v2) or R2 > 0.36 Pa/cm(3)/s, we found a significant correlation between side differences of the objective measurement and the subjective assessment (VAS). With a nasal airway resistance side difference over 20 degrees, an additional 20 degrees difference corresponded to a 0.9 centimetre average VAS change. The more obstructed side of the nose could be determined by VAS in 823 (82.3%) of 1000 patients. Yet, 177 (17.7%) patients had a paradoxical sensation of nasal obstruction with the low resistance side of the nose experienced as the most congested side. Conclusion: A significant correlation between the side differences of nasal airway resistance and VAS can serve as a supplement to rhinoscopy in decisions about nasal surgery. This study also showed that in 17.7% of patients, there was a negative correlation between subjective and objective evaluations of nasal airway resistance. But in this group, the nasal airway resistance side difference was mostly under 20 degrees.
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| 7. |
- Wang, Fei, et al.
(författare)
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Endothelial cell heterogeneity and microglia regulons revealed by a pig cell landscape at single-cell level
- 2022
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Ingår i: Nature Communications. - : Springer Nature. - 2041-1723. ; 13:1
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Tidskriftsartikel (refereegranskat)abstract
- Pigs are valuable large animal models for biomedical and genetic research, but insights into the tissue- and cell-type-specific transcriptome and heterogeneity remain limited. By leveraging single-cell RNA sequencing, we generate a multiple-organ single-cell transcriptomic map containing over 200,000 pig cells from 20 tissues/organs. We comprehensively characterize the heterogeneity of cells in tissues and identify 234 cell clusters, representing 58 major cell types. In-depth integrative analysis of endothelial cells reveals a high degree of heterogeneity. We identify several functionally distinct endothelial cell phenotypes, including an endothelial to mesenchymal transition subtype in adipose tissues. Intercellular communication analysis predicts tissue- and cell type-specific crosstalk between endothelial cells and other cell types through the VEGF, PDGF, TGF-beta, and BMP pathways. Regulon analysis of single-cell transcriptome of microglia in pig and 12 other species further identifies MEF2C as an evolutionally conserved regulon in the microglia. Our work describes the landscape of single-cell transcriptomes within diverse pig organs and identifies the heterogeneity of endothelial cells and evolutionally conserved regulon in microglia.
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