fluticasone and Edema

The aim of this study was to compare 2 methods of nasal irrigation after septoplasty. The combined use of low-pressure, high-volume nasal saline (LPHVNS) irrigation, together with fluticasone propionate (FP) (LPHVNS+FP), was compared with high-pressure, low-volume nasal saline (HPLVNS) irrigation during the early postoperative period following septoplasty.. Seventy-three patients undergoing septoplasty for nasal obstruction were recruited for the study. The patients were randomly divided into 2 groups; nasal irrigation was applied for 4 weeks in both groups. Group 1 (n = 40) used HPLVNS irrigation. Group 2 (n = 33) used the LPHVNS+FP combination. The patients were evaluated using the visual analogue scale (VAS), Nasal Obstruction Symptom Evaluation (NOSE), nasal examination scores, acoustic rhinometry, rhinomanometry, and peak nasal inspiratory flowmetry (PNIF) measurements.. In group 2, the increase in VAS results was more prominent than in group 1. NOSE scores were significantly lower in group 2 than in group 1. The nasal examination revealed that group 2 had less edema and less crusting than group 1. The decrease in nasal airway resistance was significantly higher in group 2. The PNIF values increased to a significantly greater extent in group 2 than in group 1.. Nasal irrigation with the LPHVNS+FP combination during the early postoperative period following septoplasty is an effective method, resulting not only in increased patient satisfaction and nasal air flow but also in decreased edema and crust formation.

Topics: Adolescent; Adult; Edema; Female; Fluticasone; Glucocorticoids; Humans; Male; Middle Aged; Nasal Lavage; Nasal Mucosa; Nasal Obstruction; Nasal Septum; Patient Satisfaction; Postoperative Care; Prospective Studies; Random Allocation; Rhinoplasty; Single-Blind Method; Young Adult

Most allergic rhinitis (AR) patients have moderate-to-severe, persistent disease. Meda Pharma's AzeFlu (MP-AzeFlu) combines intranasal azelastine hydrochloride (AZE) and fluticasone propionate (FP) in a novel formulation in a single device to treat AR. This prospective, noninterventional study sought to assess the effectiveness of MP-AzeFlu (one spray/nostril twice daily; 548 µg AZE/200 µg FP daily dose) in relieving AR symptom severity.. A visual analogue scale (VAS) was used prior to MP-AzeFlu treatment on days 0, 1, 3, 7, 14, 21, 28, 35, and 42 by 53 persistent AR (PER) patients seen in routine clinical practice in Ireland. An endoscopy was performed on days 0 and 28, and symptoms of edema, discharge, and redness were scored on a three-point scale (for both nostrils).. Patients using MP-AzeFlu experienced rapid VAS score reduction from 73.4 mm (standard deviation [SD], 20.3) at Day 0 to 31.5 mm (SD, 25.0) at day 28 (P < 0.0001) to 28.1 mm (SD, 24.1) at day 42 (P < 0.0001), a 45.3-mm reduction. On average, patients achieved a clinically relevant VAS score cutoff of 50 mm before Day 7. Total endoscopy score decreased from 7.5 mm (SD, 3.1) at baseline to 3.5 mm (SD, 2.5) at Day 28. The incidence of severe edema on endoscopy decreased from 53.1% at baseline to 3.8% at Day 28. A similar reduction in the incidence of thick/mucousy discharge (from 28.3% to 4.8%) and severe redness (from 34.9% to 0%) was also observed.. MP-AzeFlu provided effective, rapid control of PER as assessed by VAS in a real-world clinical setting in Ireland. Symptom improvement was observed at Day 1, sustained for 42 days, and associated with improved mucosal appearance after 28 days. These results confirm the safety of MP-AzeFlu and exceed the efficacy demonstrated in phase 3 clinical studies for controlling AR in PER patients.

Topics: Adolescent; Adult; Aged; Child; Edema; Endoscopy; Female; Fluticasone; Humans; Ireland; Male; Middle Aged; Nasal Mucosa; Nasal Sprays; Phthalazines; Prospective Studies; Rhinitis, Allergic; Treatment Outcome; Visual Analog Scale; Young Adult

An Afro-Caribbean girl showed localized hair depigmentation during treatment with inhaled fluticasone propionate. Although skin depigmentation is common after topical use of corticosteroids, hair depigmentation has never been reported with inhaled corticosteroids. The mechanisms underlying corticosteroid-induced skin depigmentation are not completely understood, but accepted hypotheses suggest a direct cytotoxic effect, changes in ground substance, vasoconstriction, mechanical effects of edema, or a dysregulation of melanogenesis.

Topics: Androstadienes; Animals; Anti-Allergic Agents; Asthma; Child, Preschool; Conjunctivitis; Edema; Female; Fluticasone; Hair Color; Hair Diseases; Humans; Pyroglyphidae; Respiratory Hypersensitivity; Rhinitis, Allergic, Perennial; Vasoconstriction

A 14-year-old girl had experienced gross peripheral oedema for nearly 2 years. She was under review by several paediatric specialists for a variety of problems. Her local paediatric team were unable to find the cause of her oedema, despite extensive investigations. Eventually, her mother discovered the cause was inhaled fluticasone, prescribed at normal dosage for asthma. As far as the authors are aware, this is the first reported case of peripheral oedema associated with the use of fluticasone. Peripheral oedema is a rare side-effect of fluticasone in the form of either seretide or flixotide. Physicians should be aware of this possibility in cases of resistant peripheral oedema with no other identified cause.

Topics: Abnormalities, Multiple; Adolescent; Androstadienes; Asthma; Bronchodilator Agents; Edema; Female; Fluticasone; Heart Defects, Congenital; Humans; Intellectual Disability; Leg