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Rhinitis is an inflammation of the nasal mucosa and is manifested by nasal congestion, rhinorrhea and associated variable symptoms, such as itching, sneezing and anosmia. Rhinitis is classified as allergic or non-allergic. The cause of acute non-allergic rhinitis is usually a viral infection. Non-allergic rhinitis can also be caused by irritants.

Acute rhinitis, which occurs with edema of the nasal mucosa, rhinorrhea and obstruction of the upper respiratory tract, is usually the consequence of the common cold. Other causes include bacterial infections. It is often associated with coughing, mild fever and sneezing.

Chronic rhinitis is generally a continuation of viral, inflammatory or bacterial rhinitis. In these cases, nasal obstruction, purulent rhinorrhea and frequent bleeding occur. Even conditions of low environmental humidity and the presence of irritants in the air can cause the onset of chronic rhinitis.

Atrophic rhinitis is a form of chronic rhinitis. It is manifested by atrophy and sclerosis of the nasal mucosa. Atrophic rhinitis is associated with old age and some diseases. It leads to an enlargement of the nasal cavities, the formation of crusts, colonization by bacteria, nasal congestion, anosmia and epistaxis which can also become serious.

Vasomotor rhinitis is a chronic disease characterized by periods of remission and exacerbation, in which intermittent congestion of the blood vessels that supply the nasal mucosa causes watery runny nose and sneezing. The causes are uncertain, and the dry climate seems to aggravate this pathology.

The treatment of various forms of rhinitis includes the humidification of the ambient air, the use of decongestant drugs or medical devices, appropriate for the control of symptoms, the use of nasal irrigations, while bacterial infections require adequate antibiotic treatment.

Sinusitis is defined as inflammation of the paranasal sinuses due to viral, bacterial or fungal infections or allergic reactions. Symptoms that characterize it include nasal obstruction and congestion, rhinorrhea with pus, and pain or a feeling of facial pressure. Sometimes general malaise, headache and fever also occur.

The most common risk factors for sinusitis to occur are conditions that hinder the normal drainage of the paranasal sinus, such as allergic rhinitis and nasal polyps.

Sinusitis can be acute, if complete resolution occurs in less than 30 days, subacute, if complete resolution requires 30 to 90 days, recurrent, if 4 or more episodes occur within a year, or chronic, if the duration exceeds 90 consecutive days.

Acute sinusitis is almost always of viral origin, caused by viruses such as those of the common cold, flu and parainfluenza, but in some cases a secondary bacterial infection develops mainly caused by streptococci, pneumococci or staphylococci.

Chronic sinusitis involves many factors that can contribute to causing chronic inflammation, such as chronic allergies, structural abnormalities (e.g. nasal polyps), inhalation of environmental irritants (e.g. air pollutants) or smoking of tobacco. Pathogens, which proliferate on the mucosa due to the suffering situation that has arisen, are commonly bacteria and often give rise to the formation of so-called biofilms on the surface of the mucosa.

Acute and chronic sinusitis have similar symptoms. The symptoms that stand out are purulent rhinorrhea, the feeling of tension and pain in the face, congestion and nasal obstruction, hyposmia, bad breath and productive cough, which gets worse during the night. Pain often occurs more intensely in acute sinusitis. The area of ​​the face above the paranasal sinus affected by sinusitis can be painful, swollen and erythematous.

Therapeutic strategies are based on the topical application of substances that induce nasal vasoconstriction and improve the drainage of the paranasal sinuses. Vasoconstrictor drugs are often used, which however must be used for a few days to avoid the onset of side effects, or medical spray devices. Another possibility is given using nasal irrigations or aerosols. In bacterial forms it is essential to resort to antibiotics to control the infection. Sinusitis that does not respond to antibiotic therapy may require surgery to improve ventilation and drainage and to remove dense mucopurulent material and hypertrophic mucosa. These procedures are carried out intranasally with the help of an endoscope and are accompanied by appropriate therapies to avoid the risk of recurrence.

Acute otitis media is an infection of the middle ear, caused by a virus or bacterium, which typically accompanies an upper respiratory infection. Ear pain occurs especially in children, often accompanied by symptoms such as fever, nausea, vomiting and diarrhea. The treatment involves the administration of analgesics and in some cases of antibiotics.

Acute otitis media can occur at any age but is more frequent between 3 months and 3 years due to the anatomical immaturity of the Eustachian tube. The Eustachian tube allows communication between the tympanic cavity and the nasal portion of the pharynx (nasopharynx). It is about 4 cm long and has a tympanic and a pharyngeal orifice. By establishing direct communication between the eardrum and pharynx, it allows drainage of the mucus produced in the ear into the pharyngeal cavity and maintains a pressure balance between the air enclosed within the ear and atmospheric air. Under 3 years of age, the Eustachian tube is structurally and functionally immature and therefore its angle of inclination on the horizontal plane is less wide and the opening mechanism is less efficient. All this determines a lower draining capacity of the mucus produced in the ear which, stagnating, gives rise to the symptoms of otitis media.

The etiology of acute otitis media can be viral or bacterial. Viral infections are often complicated by bacterial superinfections.

In children, therapy is based on analgesic drugs. Antibiotics are sometimes used, which relieve symptoms faster and can reduce the possibility of complications. However, the appearance of antibiotic-resistant bacteria has led to recommend the use of antibiotics only in some specific cases.

In adults, drugs or decongestant medical devices improve the functionality of the Eustachian tube and facilitate the resolution of acute otitis media.

According to ISTAT (National Institute Of Statistics), chronic obstructive pulmonary disease (COPD) in Italy affects 5.6% of adults (equal to approximately 3.5 million people) and causes 55% of the deaths attributed to respiratory diseases.

Chronic obstructive pulmonary disease consists of a progressive limitation of air flow in the respiratory system caused by an inflammatory response to toxic or irritating substances that are inhaled, often tobacco smoke or other inhaled substances also for professional reasons. The chronic inflammation that occurs, associated with oxidative stress, leads to the progressive destruction of the respiratory tissue and the excessive production of mucus. Genetic causes have also been identified. The symptomatology is characterized by productive cough, difficulty in breathing (the so-called dyspnea) and wheezing that develop over the years.

Chronic bronchitis is defined as the condition in which productive cough occurs almost every day of the week for at least 3 months lasting for 2 consecutive years. Chronic bronchitis becomes chronic obstructive bronchitis when airflow obstruction also appears.

Emphysema is defined as the destruction of lung tissue which increases its tendency to collapse. The result is an air flow limitation and air entrapment. The airspace expands and can eventually form bubbles.

Various factors cause airflow limitation and other complications of chronic obstructive pulmonary disease.

Both viral and bacterial infections of the respiratory tract, to which patients with chronic obstructive pulmonary disease are particularly exposed, can accelerate the progression of the destruction of lung tissue. In fact, about 30% of patients suffering from chronic obstructive pulmonary disease have a bacterial colonization of the lower airways, the obstruction to the air flow worsens the clearance of the mucus, facilitating the onset of infections, which further aggravate inflammation, accelerating the progression of the disease. However, there is no evidence that long-term use of antibiotics can slow the progression of chronic obstructive pulmonary disease.

Acute seizures also occur during the course of chronic obstructive pulmonary disease, characterized by an aggravation of symptoms. Often it is impossible to ascertain the causes of any exacerbation, but they are usually attributed to viral infections of the upper respiratory tract or acute bacterial bronchitis or exposure to irritants. As chronic obstructive pulmonary disease progresses, acute seizures tend to become more frequent, on average about 1 to 3 episodes per year.

Among the numerous, even very serious, complications of chronic obstructive pulmonary disease there is the loss of appetite and muscle mass, mainly caused by inflammation and oxidative stress, up to the trigger of the so-called anorexia-cachexia syndrome, which further aggravates the degree of suffering of the patient. Other important complications are represented by cardiovascular diseases.

The management of chronic obstructive pulmonary disease involves the use of appropriate drugs, food supplements and oxygen both for the treatment of chronic disease, in order to prevent exacerbations and improve, as far as possible, the respiratory function, and for the treatment of exacerbations themselves, both to control complications such as loss of appetite and lean mass.

Bronchitis is the inflammation of the mucous membrane that lines and protects the bronchi, the tree structures that put the lungs in contact with the external environment. Acute bronchitis is usually caused by a viral infection, while chronic bronchitis is the result of damage to the airways caused by tobacco smoke, air pollution or other conditions.

Generally in acute bronchitis, inflammation is triggered by viruses, such as those of the common cold or flu, which having already affected the upper airways, such as the larynx and trachea, extend to the bronchi. The most relevant symptom that the patient perceives is the difficulty in breathing (the so-called dyspnea), which manifests itself with wheezing, persistent coughing, the sensation of shortness of breath, sleep disturbances and a sense of tightness in the chest. Other characteristic symptoms are fever, pain when swallowing, weakness etc. In some cases, especially if viral bronchitis is neglected, bacterial superinfection may develop.

If bronchial inflammation continues over time, chronic bronchitis is defined, which is the typical condition from which chronic obstructive pulmonary disease can develop. Chronic bronchitis is represented by the gradual degeneration of the structures that make up the bronchi and can become irreversible.

The prevention of bronchitis is facilitated by reducing or giving up tobacco smoke. In fact, smoking irritates the mucous membranes of the respiratory tract and promotes the establishment of inflammatory processes. The same goes for air pollutants, from which, however, it is more difficult to defend oneself. It is extremely useful for heated rooms to be humidified.

The treatment of bronchitis differs depending on whether it is an acute episode, whether it is of viral or bacterial origin, or whether it is a chronic form. Generally, in the case of acute bronchitis caused by a viral infection, for the control of symptoms, a period of bed rest, adequate hydration, the use of anti-inflammatory, antipyretic and drugs or food supplements with a mucolytic effect are sufficient, taken orally or applied topically (e.g. for aerosols). In the case of bacterial infections, it is necessary to resort to antibiotic therapy. Chronic bronchitis therapy involves a more complex and articulated treatment that includes several drugs and a specific respiratory rehabilitation therapy.