General reviews
Monosymptomatic posterior rhinorrhea
Codruț Sarafoleanu, Raluca Enache, Dorin SarafoleanuMonosymptomatic posterior rhinorrhea
Abstract
Monosymptomatic posterior rhinorrhea is a common syndrome found in medical practice, being the starting point for many pulmonary and ENT diseases. It is a solitary symptom, not accompanied by other clinical manifestations (nasal obstruction, anterior rhinorrhea, impaired smell, itching or sneezing) and it is giving the patient the sensation that something is dripping down into the oro and hypopharynx. Border pathology, posterior rhinorrhea consequences may bring the patient in Respiratory or ENT Clinics. A correct diagnosis and an appropriate treatment is the main objective in the management of this syndrome. The purpose of the article is to present this syndrome with its consequences and the main therapeutic methods.
Key words: posterior rhinorrhea, chronic cough, tubal dysfunction, botulinum toxin, ipratropium bromide
Contact: Raluca Enache, Clinica ORL "Sfânta Maria" Bd. Ion Mihalache nr. 37-39, Sector 1, București, E-mail: enache.raluca@yahoo.com
Article
Controverses and dillemas on the use of -blockers in treatment of associated cardiovascular disease in patients with chronic obstructive pulmonary disease
Camelia Pescaru1, Voicu Tudorache2, Cristian Oancea2Controverses and dillemas on the use of -blockers in treatment of associated cardiovascular disease in patients with chronic obstructive pulmonary disease
Abstract
In the last decade, chronic obstructive pulmonary disease (COPD) has been considered a syndrome with multiple phenotypical facets and systemic components. Chronic diseases are associated, in time, with several comorbidities. Cardiovascular disease represents the most common comorbidity in COPD, increases its handicap and mortality indices. Most entities associated with cardiovascular disease require treatment with β-blockers. However, β-blockers are a "two-edged sword" when administered in obstructive pulmonary disorder. The use of β-blockers should be assessed by their action on three areas: their effect on FEV1, their effect on bronchial hyperreactivity, the result obtained when additionally administering β-agonists. The result of β-blocker administration is influenced by the involvement of several other factors: the cardioselectivity of the β-blocker, the dosage, the concomitant administration of β-agonists, the stage of the disease (stable or exacerbation of COPD), smoker status etc.
Their administration under strict monitoring results in a decreased morbidity and mortality, including in patients who had undergone cardiovascular surgery.
The overall conclusion is that β-blockers may be administered in COPD associated with cardiac comorbidity, but this administration requires utmost care.
Key words: beta blockers, COPD, cardiovascular comorbidities.
Contact: Dr. Corina Pescaru, corina.c.pescaru@gsk.com