PMX is basically established by the inflammatory response, so must be treated with anti-inflammator

Sinus nasal polyps (PMX) is a consequence of degradation edema of the nasal mucosa parkinson much room there is chronic inflammatory nature. PMX is the most common benign tumors in the nasal cavity, is present in more than 25% of patients with asthma, rhinitis and chronic sinusitis. Starting position is usually the outer lining of the nasal cavity, the gap between parkinson the nose, sinuses prepared in advance, maxillary sinus. (1) From sinus tissue to squeeze through the hole in the nasal sinuses to the nasal cavity. Visit visible parkinson by microscopic examination of nasal polyps, tumors form on or before endoscopy.
Broadly speaking: Typically soft blocks, smooth, slightly transparent, pink, blue gray, yellowish, less bleeding. Polyps? nose sometimes alone, but often grow in clusters, fill the nasal cavity, sinuses, both sides. Microscopic: parkinson (1.2) lesions varied in many different levels.
+ Stromal changes are most obvious: the status of the widening of the mucous gland cysts, irregular sizes. Mucous glands absent-service parkinson bar (which is characteristic of the middle and bottom mucosal book). The gathering of inflammatory cells, especially polymorphonuclear eosinophilic cells.
The cause and pathogenesis of PMX has not been fully elucidated. Recent achievements in basic research suggests pathogenesis of PMX is mostly standing inflammation, chronic spot. This disease causes so much coordination: anatomy, genetics, body fluids, cells, nerves, infection, trauma.
The disease occurs when the primary disease, sometimes in collaboration with other medical conditions such as asthma, Widal triad, inflamed cystic fibrosis. PMX can be a manifestation of disorders of the respiratory mucosa exocrine glands (as muco-viscodose), disease of the mucus (Young's syndrome), diseases of cilia movement disorders such as primary parkinson cilia.
PMX is basically established by the inflammatory response, so must be treated with anti-inflammatory drugs. The glucose-type steroids are the leading drug of choice. parkinson Gluco-steroids are powerful anti-inflammatory substances, used in systemic and have in place works well. Unfortunately, polyps often recur after discontinuation.
Impact? is essentially prevents glucocorticoid activity of phospholipase A2-mediated lipocortin. Inflammatory drugs stop the process from the beginning in arachidonic acid reactions from membrane phospholipids and thus prevent the creation of prostaglandins and leucotrien. Through this mechanism, the drug acts on each stage of the inflammatory process parkinson in tissues:
- Cell stage: the reduced chemotaxis, reduction of inflammatory cells congregate, decreased parkinson phagocytic parkinson activity, strengthening of lysosom membrane of polymorphonuclear cells and phagocytes, preventing the release of the single enzyme maintenance parkinson and development of inflammation.
However, there are many side effects of glucocorticoids from mineralocorticoid activity, such as high blood pressure, loss of potassium and water retention. Can cause diabetes, growth retardation and osteoporosis body. Muscle-wasting effects by interfering with their protein synthesis. Due to inhibit the activity of cortical-adrenal axis, glucocorticoids risk of adrenal insufficiency when discontinuing medication or agression. In addition, glucocorticoids also cause peptic ulcers, mental influence.
The harmful side effects of glucocorticoids caused quite physicians must weigh the risks and benefits when prescribing medication, therapy so that the maximum efficiency with minimum risk. This is a cause predisposition promote glucocorticoid used in place over the entire body. Treatment with systemic parkinson glucocorticoids:
- Short-term Treatment: use no more than 10 days. This allows using glucocorticoid sudden stop, no need for dose reduction times. Should have used glucocorticoid kind of short half-life such as prednisone, prednisolone, methyl-prednisolone. Using a single dose of 1mg/kg / daily, in the morning, right on the biological cycle of the glucocorticoid more body. Highly effective on PMX. If there are multiple infections, antibiotic use more. No need special monitoring for patients. However, do not take more than 3 times in a year.
- Treatment parkinson cycle: French school [Rouvier]. Long-term glucocorticoid use, according to certain rules. Usually followed by a short-term treatment. For minimum parkinson effective dose (0.1-0.3 mg / kg / day). So choose prednisolone or prednisone. For example:
With this type of medication, patients must be closely monitored biological constants, according to the regime salt diet, eat less carbohydrate. The control parkinson is often difficult because of the level of response to glucocorticoids are different for each patient.
According to Bernstein, (1) systemic glucocorticoid indicated for severe cases of polyps, nasal obstruction. The policy of using short-term (not more than 2-3 weeks). If not effective, surgery should, if effective, corticosteroids continue in place.?
From 1962, the first test with dexamethasone showed more systemic side effects and in place. [Boxer]. 1974, a significant progress synthetic second generation of glucocorticoid parkinson is beclomethason dipropionat. Then the new topical glucocorticoid turn appears: flunisolid, parkinson Budesonid, fluticason. with higher activity, using doses less safe than