Background: Many studies in rhinology are based on results from symptom scoring. Numerous methods are used to estimate symptoms. With some of them the patients choose between various alternatives for estimating the severity of their symptoms, but the commonest method is the visual analogue scale (VAS), which is regarded as reliable. Methods: In this study, we evaluate a new method for assessing symptoms, with which the patient uses the telephone to call a computer. We compare the results using the new method with those using symptoms estimation with VAS. Results: The results are based on 487 observations in patients with birch pollen allergic rhinitis in the pollen season. A high correlation was found between the results using the new method and those using the VAS. In a questionnaire, the patients answered questions concerning the two methods. Most patients preferred the new telephone method. They found it easier to estimate their symptoms properly and easier to perform. Conclusion: We conclude that telephone scoring of symptoms is a reliable and adquate method when symptom scoring is used as hard data in a study.
Phenylpropanolamine (PPA) is widely used as a nasal decongestant administered orally in sustained release preparations and, in Sweden, the recommended dose nowadays is 50 mg twice daily for adults. The aim of this placebo-controlled, cross-over study was to determine the onset and duration of the decongestive effect of 50 and 100 mg PPA in 15 healthy subjects. All subjects arrived at the laboratory at 07.30 h. After an acclimatisation, the nasal mucosal baseline was established with rhinostereometry and the minimal cross-sectional area was measured using acoustic rhinometry. The systolic and diastolic blood pressures were also determined. Then all subjects were given their study drugs for the day and the measurements were repeated every hour for 8 h. This procedure was repeated for 3 days at 48 h intervals between the days. For purposes of comparison, the decongestive effect of oxymetazoline nasal spray was studied on a separate day. The decongestive effect of 100 mg PPA was similar to that of topical oxymetazoline. It develops after 1 h and lasts for approximately 6 h. The decongestive effect of oxymetazoline was significantly greater than that of 50 mg PPA and that of 100 mg PPA was significantly greater than that of 50 mg PPA using rhinostereometry, but not when using acoustic rhinometry. However, 50 mg PPA had no significant decongestive effect, compared with placebo, with rhinostereometry or acoustic rhinometry. In the first 3 h after administration of PPA, there was a dose-response increase in the systolic and diastolic blood pressures, which then returned to baseline. In conclusion, this study shows that PPA in double the recommended dose, i.e. 100 mg, has a significant decongestive effect on the nasal mucosa in healthy subjects. However, when the dose of PPA is increased the systolic and diastolic blood pressures also increase.
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