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International Forum of Allergy & Rhinology

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https://www.readbyqxmd.com/read/29905016/examining-the-july-effect-on-patients-undergoing-pituitary-surgery
#1
Bassel Bashjawish, Shreya Patel, Suat Kılıç, Wayne D Hsueh, James K Liu, Soly Baredes, Jean Anderson Eloy
BACKGROUND: Our aim in this study was to assess the impact of the turnover of residents in July on patients undergoing pituitary surgery. METHODS: This work was a retrospective cohort study of cases from the National Inpatient Sample (NIS). Patients who underwent pituitary surgery from 2005 to 2012 were selected in the NIS. Patients undergoing surgery in July and in non-July months were compared to determine differences in demographics, comorbidities, and complications...
June 15, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29901865/budesonide-irrigation-with-olfactory-training-improves-outcomes-compared-with-olfactory-training-alone-in-patients-with-olfactory-loss
#2
Teresa P Nguyen, Zara M Patel
BACKGROUND: Olfactory training (OT) helps many patients with olfactory loss, but unfortunately it is ineffective for a significant number of patients. Budesonide irrigations are widely used to help patients with paranasal sinus inflammation, but have never been tested as a treatment for olfactory loss. We sought to examine the effect of adding budesonide irrigation to olfactory training on patients with olfactory loss without any visible sign of sinonasal inflammation. METHODS: In this randomized, controlled trial, 138 patients with olfactory loss and without any visible sign of sinonasal inflammation were randomized to either OT with saline irrigations or OT with budesonide irrigations...
June 14, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29901280/role-of-toll-like-receptor-9-signaling-on-activation-of-nasal-polyp-derived-fibroblasts-and-its-association-with-nasal-polypogenesis
#3
Soo Kyoung Park, Soung Yong Jin, Sun Hee Yeon, Sung Bok Lee, Jun Xu, Young Hoon Yoon, Ki Sang Rha, Yong Min Kim
BACKGROUND: Nasal polyposis is characterized by persistent inflammation and remodeling in sinonasal mucosa. Toll-like receptor 9 (TLR9) is a DNA receptor of the innate immune system that plays a pivotal role in fibrosis and inflammatory responses. The aim of this study is to explore the expression, activity, and potential pathogenic role of TLR9 signaling in tissue remodeling in nasal polyp-derived fibroblasts (NPDFs). METHODS: Fibrotic and inflammatory responses elicited by type A CpG oligonucleotides were examined in the NPDFs by a combination of real-time quantitative polymerase chain reaction, Western blot analysis, enzyme-linked immunosorbent assay, and immunofluorescence staining...
June 14, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29901276/shortcomings-in-the-diagnosis-of-chronic-rhinosinusitis-evaluating-diagnosis-by-otolaryngologists-and-primary-care-physicians
#4
Christopher C Xiao, Mitchell Anderson, Lucas D Harless, Jonathan Liang
BACKGROUND: Chronic rhinosinusitis (CRS) is a prevalent illness in the United States that accounts for 18-22 million physician visits annually. The American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) has defined diagnostic criteria, but a recent study demonstrated that nearly all patients diagnosed by nonspecialists did not meet these criteria. In this study we aimed to evaluate the diagnostic rate of CRS by primary care physicians and otolaryngologists. METHODS: We retrospectively reviewed a random sample of adult patients diagnosed with CRS in 2016, based on ICD-10 codes from primary care and otolaryngology departments...
June 14, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29897665/endocannabinoid-receptor-cb2r-is-significantly-expressed-in-aspirin-exacerbated-respiratory-disease-a-pilot-study
#5
Alessia Corrado, Monica Battle, Sarah K Wise, F Eun-Hyung Lee, David M Guidot, John M DelGaudio, Samuel A Molina, Joshua M Levy
BACKGROUND: The endocannabinoid system represents a highly conserved, innate signaling network with direct and indirect control of eicosanoid-mediated inflammation. Activation of the type 2 cannabinoid receptor (CB2R) leads to decreased type 2 inflammation and reduced production of arachidonic acid (AA). Given that altered AA metabolism is associated with aspirin-exacerbated respiratory disease (AERD), we hypothesized that expression of the CB2R gene CNR2 is increased in AERD. METHODS: Nasal polyps from consecutive patients undergoing endoscopic sinus surgery for AERD or allergic fungal rhinosinusitis (AFRS) were prospectively evaluated...
June 13, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29897663/the-effect-of-continuous-positive-airway-pressure-therapy-on-nasal-patency
#6
Kristen D Pitts, Alberto A Arteaga, Elliot T Hardy, Ben P Stevens, Christopher S Spankovich, Andrea F Lewis
BACKGROUND: Nasal congestion and obstruction are reported in the majority of continuous positive airway pressure (CPAP) users and are frequently cited as reasons for noncompliance. To our knowledge, no study has demonstrated a change in objective or subjective nasal patency in patients with obstructive sleep apnea (OSA) after a therapeutic trial of CPAP therapy. METHODS: This prospective nonrandomized trial tested the hypothesis that CPAP therapy would result in both objective and subjective improvements in nasal patency in patients with OSA...
June 13, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29885036/role-of-sublingual-immunotherapy-in-the-treatment-of-asthma-an-updated-systematic-review
#7
Sandra Y Lin, Antoine Azar, Catalina Suarez-Cuervo, Gregory B Diette, Emily Brigham, Jessica Rice, Murugappan Ramanathan, Karen A Robinson
BACKGROUND: The purpose of the systematic review is to evaluate the efficacy and safety of sublingual immunotherapy (SLIT) for the treatment of allergic asthma. METHODS: PubMed, Embase, and CENTRAL databases were searched, updating an earlier review (January 1, 2005 through May 8, 2017). Randomized, controlled studies (RCTs) were included, which reported one of the prespecified outcomes: asthma symptoms measured by control composite scores; quality of life; medication use; pulmonary physiology; and health-care utilization...
June 9, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29883053/mucus-t-helper-2-biomarkers-predict-chronic-rhinosinusitis-disease-severity-and-prior-surgical-intervention
#8
Justin H Turner, Ping Li, Rakesh K Chandra
BACKGROUND: Chronic rhinosinusitis (CRS) is a diverse clinical syndrome with a heterogeneous pathophysiology. Early attempts to identify CRS endotypes and biomarkers have largely relied on analysis of surgically obtained tissue, thus limiting their practical utility. This study examined the ability of mucus T helper 2 (Th2) biomarkers to predict CRS disease severity and clinical characteristics. METHODS: CRS (n = 90) and healthy control subjects (n = 17) were prospectively enrolled prior to surgical intervention and mucus levels of interleukin (IL)-4, IL-5, and IL-13 were determined using a multiplex cytometric bead assay...
June 8, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29883050/size-of-septectomy-does-not-affect-distribution-of-nasal-irrigation-after-endoscopic-modified-lothrop-procedure
#9
Christopher R Roxbury, Dennis Tang, Janki Shah, Jennifer McBride, Troy D Woodard, Raj Sindwani
BACKGROUND: The endoscopic modified Lothrop procedure (EMLP) is commonly performed in recalcitrant frontal sinusitis, in part to achieve better penetration of medicated irrigations postoperatively. Although EMLP requires a septectomy for exposure, it is unknown whether septectomy size affects delivery of irrigations. In this study we evaluated the role of septectomy in delivery of irrigations to the EMLP cavity. METHODS: EMLP was performed on fresh human cadavers with sequentially increasing septectomy (minimal septectomy: drilling across septum to combine frontal sinuses; standard septectomy: 1...
June 8, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29883049/accessory-maxillary-ostium-repair-using-middle-turbinate-flap-a-case-series-of-116-patients-with-chronic-rhinosinusitis
#10
Matti Penttilä
BACKGROUND: The ostiomeatal complex (OMC), comprising a small natural maxillary sinus ostium and narrow infundibulum, transmits the air diffusion into the antrum and mucociliary transport from the antrum, and is considered a key area in chronic rhinosinusitis (CRS). Thin membranous anterior and posterior fontanelle areas below the OMC can rupture forming a perforation, accessory maxillary ostium (AMO), that increases antral airflow changing the anatomy and function of the sinus. The purpose of this study was to report the first case series of CRS patients who had undergone repair of fontanelle defects aiming to reconstruct normal structures...
June 8, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29856526/porcine-small-intestine-submucosal-grafts-improve-remucosalization-and-progenitor-cell-recruitment-to-sites-of-upper-airway-tissue-remodeling
#11
Jayakar V Nayak, Aakanksha Rathor, Jessica W Grayson, Dawn T Bravo, Nathalia Velasquez, Julia Noel, Daniel M Beswick, Kristen O Riley, Zara M Patel, Do-Yeon Cho, Robert L Dodd, Andrew Thamboo, Garret W Choby, Evan Walgama, Griffith R Harsh, Peter H Hwang, Lisa Clemons, Deborah Lowman, Joshua S Richman, Bradford A Woodworth
BACKGROUND: To better understand upper airway tissue regeneration, the exposed cartilage and bone at donor sites of tissue flaps may serve as in vivo "Petri dishes" for active wound healing. The pedicled nasoseptal flap (NSF) for skull-base reconstruction creates an exposed donor site within the nasal airway. The objective of this study is to evaluate whether grafting the donor site with a sinonasal repair cover graft is effective in promoting wound healing. METHODS: In this multicenter, prospective trial, subjects were randomized to intervention (graft) or control (no graft) intraoperatively after NSF elevation...
June 1, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29856520/exhance-12-1-year-study-of-the-exhalation-delivery-system-with-fluticasone-eds-flu-in-chronic-rhinosinusitis
#12
James N Palmer, Kraig W Jacobson, John C Messina, Colette Kosik-Gonzalez, Per G Djupesland, Ramy A Mahmoud
BACKGROUND: Inadequate efficacy of current intranasal steroids in chronic rhinosinusitis (CRS) is attributable to ineffective and/or inconsistent drug delivery to target anatomic sites. A new exhalation delivery system with fluticasone (EDS-FLU) may improve outcomes by significantly increasing superior/posterior corticosteroid delivery. A study was conducted to assess the long-term efficacy and safety outcomes of EDS-FLU in individuals with CRS. METHODS: This was a 12-month, multicenter, single-arm study evaluating the safety and efficacy of EDS-FLU 372 μg twice daily in CRS patients (with [n = 34] or without [n = 189] nasal polyps [NP])...
June 1, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29851273/incidence-and-predictive-factors-for-additional-opioid-prescription-after-endoscopic-sinus-surgery
#13
Aria Jafari, Sarek A Shen, David J Bracken, John Pang, Adam S DeConde
BACKGROUND: Excessive postoperative opioid prescription is a source of prescription diversion in the United States opioid crisis and may contribute to chronic opioid use. Efficient prescription by the surgeon can mitigate opioid abuse and improve postoperative pain control. In this study we sought to better characterize the incidence and predictive baseline characteristics associated with the need for additional opioid prescription after endoscopic sinus surgery (ESS) for chronic rhinosinusitis...
May 31, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29851243/revision-endoscopic-sinus-surgery-rates-by-chronic-rhinosinusitis-subtype
#14
Amar Miglani, Rohit D Divekar, Antoine Azar, Matthew A Rank, Devyani Lal
BACKGROUND: Revision surgery rates following endoscopic sinus surgery (ESS) range between 7% and 50% and are influenced by many factors. This study investigates ESS outcomes for chronic rhinosinusitis (CRS) subtypes. METHODS: Retrospective review of adult CRS patients undergoing ESS with a single surgeon (2010-2015) was conducted. Outcomes were analyzed by CRS subtypes. RESULTS: ESS was performed in 424 CRS patients (CRS with nasal polyps [CRSwNP], n = 170; CRS without polyps [CRSsNP], n = 254)...
May 31, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29782071/evaluation-of-idiopathic-olfactory-loss-with-chemosensory-event-related-potentials-and-magnetic-resonance-imaging
#15
Jia Liu, Jayant M Pinto, Ling Yang, Linyin Yao, Xutao Miao, Yongxiang Wei
BACKGROUND: Idiopathic olfactory loss (IOL) accounts for a sizable fraction of olfactory dysfunction, but very little is known about its etiology and electrophysiological changes in the olfactory pathway. METHODS: We analyzed the physiology of IOL using chemosensory event-related potentials (ERPs) (olfactory and trigeminal: oERP and tERP) and olfactory pathway magnetic resonance imaging (MRI) measured in adult patients with IOL and healthy controls. Subjective olfactory function was measured by Toyota and Takagi (T&T) olfactometry and Sniffin' Sticks (SS)...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29782070/evolving-patterns-in-the-diagnosis-and-management-of-allergy-mediated-disorders
#16
Khashayar Arianpour, Peter F Svider, Brian Yuhan, Zamaan Hooda, Jean Anderson Eloy, Adam J Folbe
BACKGROUND: This analysis explores the increasing heterogeneity of trends in allergy management under the premise that the practice of allergy has undergone significant changes in national economics, healthcare delivery, and treatment options from 2007 to 2016. METHODS: Centers for Medicare and Medicaid Services (CMS) data were obtained for: (1) temporal trends in allergy immunotherapy injection (Current Procedural Terminology [CPT] codes 95115, 95117) and testing (CPT 95004, 95024) from 2007 to 2016; (2) geographic trends; and (3) practitioners administering immunotherapy...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29782068/comparison-of-outcomes-following-culture-directed-vs-non-culture-directed-antibiotics-in-treatment-of-acute-exacerbations-of-chronic-rhinosinusitis
#17
Carol H Yan, Navarat Tangbumrungtham, Ximena A Maul, Yifei Ma, Jayakar V Nayak, Peter H Hwang, Zara M Patel
BACKGROUND: Acute exacerbations in patients with chronic rhinosinusitis (CRS) are often treated with courses of systemic antibiotics. Poor correlation between microbiologic culture results and the sinus microbiome in CRS has caused increased debate as to the relevance of culture-directed antibiotics. There is currently sparse data comparing outcomes of culture-directed antibiotics vs non-culture-directed antibiotics for treatment of CRS. METHODS: This work reports a retrospective review...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29782067/sublingual-immunotherapy-for-pediatric-allergic-conjunctivitis-a-meta-analysis-of-randomized-controlled-trials
#18
Jie Yang, Li Zhang, Zhixiang Zhao, Shiyu Liao
BACKGROUND: Allergic conjunctivitis (AC) is a common chronic condition, especially in children. Ocular symptoms are often overlooked during treatment of allergic rhinoconjunctivitis (ARC). Pediatric ARC can be effectively treated using sublingual immunotherapy (SLIT), which is a guideline-recommended safe treatment approach. However, the therapeutic efficacy of SLIT in terms of ameliorating eye symptoms has not been effectively evaluated. METHODS: We performed a meta-analysis of randomized controlled trials (RCTs) evaluating the use of SLIT for infants, children, and adolescents (aged from 3 to 18 years) with AC or ARC...
May 21, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29742315/solitary-chemosensory-cells-producing-interleukin-25-and-group-2-innate-lymphoid-cells-are-enriched-in-chronic-rhinosinusitis-with-nasal-polyps
#19
Neil N Patel, Michael A Kohanski, Ivy W Maina, Vasiliki Triantafillou, Alan D Workman, Charles C L Tong, Edward C Kuan, John V Bosso, Nithin D Adappa, James N Palmer, De'Broski R Herbert, Noam A Cohen
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is commonly characterized by type-2 inflammation. It is established that group-2 innate lymphoid cells (ILC2s) are a subset of immune cells important in orchestrating mucosal type-2 response. IL-25 is an epithelial-derived cytokine that is a critical activator of ILC2s. Recent evidence demonstrates that specialized taster epithelial cells, such as solitary chemosensory cells (SCCs), may be producers of IL-25. To elucidate the relationship between SCCs and ILC2s in CRSwNP, we sought to quantify ILC2s and SCCs to determine if these cell types are enriched in nasal polyps compared to healthy sinonasal mucosa...
May 9, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29722922/predictive-value-of-snot-22-on-additional-opiate-prescriptions-after-endoscopic-sinus-surgery
#20
Sarek A Shen, Aria Jafari, David Bracken, John Pang, Adam S DeConde
BACKGROUND: Endoscopic sinus surgery (ESS) is generally well tolerated, yet a subset of patients require an additional opiate prescription in the postoperative period. The purpose of this study was to quantify differences in both preoperative and immediate postoperative 22-item Sino-Nasal Outcome Test (SNOT-22) scores between patients with a single prescription and those requiring additional opiate prescriptions (AOPs). METHODS: Patients undergoing ESS between November 2016 and August 2017 were reviewed retrospectively...
May 3, 2018: International Forum of Allergy & Rhinology
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