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chronic rhinosinusitis and asthma

Jantina C de Groot, Huib Storm, Marijke Amelink, Selma B de Nijs, Edwin Eichhorn, Bennie H Reitsma, Elisabeth H D Bel, Anneke Ten Brinke
Adult-onset eosinophilic asthma is increasingly recognised as a severe and difficult-to-treat subtype of asthma. In clinical practice, early recognition of patients with this asthma subtype is important because it may have treatment implications. Therefore, physicians need to know the distinct characteristics of this asthma phenotype. The objective of the present study was to determine the characteristic profile of patients with adult-onset eosinophilic asthma. 130 patients with adult-onset (>18 years of age) asthma and high blood eosinophil counts (≥0...
April 2016: ERJ Open Research
Naghmeh Radhakrishna, Tunn Ren Tay, Fiona Hore-Lacy, Robert Stirling, R Hoy, Eli Dabscheck, Mark Hew
Objective Multiple extra-pulmonary comorbidities contribute to difficult asthma, but their diagnosis can be challenging and time consuming. Previous data on comorbidity detection have focused on clinical assessment, which may miss certain conditions. We aimed to locate relevant validated screening questionnaires to identify extra-pulmonary comorbidities that contribute to difficult asthma, and evaluate their performance during a difficult asthma evaluation. Methods MEDLINE was searched to identify key extra-pulmonary comorbidities that contribute to difficult asthma...
October 7, 2016: Journal of Asthma: Official Journal of the Association for the Care of Asthma
Jeremy D Waldram, Ronald A Simon
Aspirin-exacerbated respiratory disease (AERD) is characterized by chronic rhinosinusitis with nasal polyps, asthma, and reactions to cyclooxygenase-1-inhibiting drugs. This condition is often refractory to standard medical treatments and results in aggressive nasal polyposis that often requires multiple sinus surgeries. Aspirin desensitization followed by daily aspirin therapy is an important treatment option, and its efficacy has been validated in multiple research studies. Aspirin desensitization is not without risk, but specific protocols and recommendations exist to mitigate the risk...
November 2016: Immunology and Allergy Clinics of North America
Donald D Stevenson, Andrew A White
Aspirin-exacerbated respiratory disease is a significant endotype of both asthma and chronic rhinosinusitis with nasal polyps. The disease demonstrates what seems to be a unified inflammatory mechanism culminating in highly eosinophilic nasal polyp disease and asthma. The rate of polyp recurrence and morbidity from asthma exacerbations are significant and warrant separating this group diagnostically from aspirin-tolerant peers. Given the unique anti-inflammatory effects of aspirin and the evolving landscape of new, targeted biologic treatments, it is even more incumbent to consider this diagnosis and offer patients treatment specific for the disease...
November 2016: Immunology and Allergy Clinics of North America
Caroline Bengtsson, Eva Lindberg, Lars Jonsson, Mats Holmström, Fredrik Sundbom, Jan Hedner, Andrei Malinovschi, Roelinde Middelveld, Bertil Forsberg, Christer Janson
STUDY OBJECTIVES: To analyse the prevalence of sleep problems in subjects with CRS and to determine whether the disease severity of CRS affects sleep quality. METHODS: Questionnaires were sent to a random sample of 45 000 adults in four Swedish cities. Questions on CRS, asthma, allergic rhinitis, co-morbidities, tobacco use, educational level and physical activity were included. CRS was defined according to the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) epidemiological criteria...
September 26, 2016: Sleep
Federica Porcaro, Antonio Di Marco, Renato Cutrera
Aspirin hypersensitivity associated with chronic rhinosinusitis-with or without nasal polyposis-and asthma resistant to conventional therapy defines the aspirin-exacerbated respiratory disease (AERD). We describe the case of a 15-year-old female patient with adverse reaction to aspirin, chronic rhinosinusitis, and severe asthma. She also experienced chronic idiopathic urticaria worsened by non-steroidal anti-inflammatory drug administration. AERD was diagnosed based on clinical history and symptoms. Given the poor responsiveness to standard therapy for respiratory and cutaneous symptoms, omalizumab was administered for 24 weeks with control of respiratory symptoms and short term improvement of cutaneous symptoms...
September 29, 2016: Pediatric Pulmonology
Jeremiah A Alt, Vijay R Ramakrishnan, Michael P Platt, Preeti Kohli, Kristina A Storck, Rodney J Schlosser, Zachary M Soler
BACKGROUND: Endoscopic sinus surgery (ESS) has been shown to improve sleep in patients with chronic rhinosinusitis (CRS). However, it is unknown how this improvement compares with non-CRS control subjects' sleep, and medically treated CRS patients. METHODS: Patients meeting diagnostic criteria for CRS and controls from the same reference population were recruited from 4 academic centers. Patients chose either medical or surgical treatment. The Pittsburgh Sleep Quality Index (PSQI) was administered to patients before treatment and after 6 months, whereas controls received the PSQI at enrollment...
September 27, 2016: International Forum of Allergy & Rhinology
Ravi Jain, Michael Hoggard, Kristi Biswas, Melissa Zoing, Yannan Jiang, Richard Douglas
BACKGROUND: Endoscopic sinus surgery (ESS) improves symptoms for many chronic rhinosinusitis (CRS) patients by enlarging the size of sinus ostia, improving mucociliary clearance, and facilitating access for topical therapies. However, the effect of surgery on the sinonasal microbiota remains poorly understood. This study examined changes in bacterial communities in CRS patients before and after surgery. METHODS: Swab samples were taken from the middle meatus of 23 patients undergoing ESS...
September 19, 2016: International Forum of Allergy & Rhinology
Rodney J Schlosser, Timothy L Smith, Jess Mace, Zachary M Soler
BACKGROUND: Patients with chronic rhinosinusitis (CRS) often have comorbid asthma. Prior studies have not examined the impact of CRS or endoscopic sinus surgery (ESS) upon asthma quality-of-life (QOL) and asthma control using validated outcome metrics. METHODS: Patients with CRS, both with and without polyps, and comorbid asthma completed the Mini-Asthma QOL Questionnaire (miniAQLQ) and Asthma Control Test (ACT) at baseline and 6 months postoperatively as part of a multi-institutional, prospective study...
September 17, 2016: Allergy
Peter J Kahrilas, Kenneth W Altman, Anne B Chang, Stephen K Field, Susan M Harding, Andrew P Lane, Kaiser Lim, Lorcan McGarvey, Jaclyn Smith, Richard S Irwin
BACKGROUND: We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. METHODS: Two PICO questions were addressed by systematic review: 1) can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and 2) are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux? RESULTS: We found no high quality studies pertinent to either question...
September 7, 2016: Chest
F Sbrana, B Loggini, S Galimberti, M Coceani, M Latorre, V Seccia, S L'Abbate, M Mosca, E M Pasanisi, C Baldini
Eosinophilic granulomatosis with polyangitis (EGPA) is an uncommon ANCA-associated systemic small-vessel necrotizing vasculitis. At times, EGPA presenting manifestations can be very different from the usually recognized disease patterns. We report a 52-year-old female patient with 3 years history of itching. During the time occurred a chronic skin lichenification on her legs and gradually developed a full-blown ANCA-MPO positive EGPA in combination with blood hypereosinophilia, eosinophilic vasculitis at skin biopsy, subclinical asthma and chronic rhinosinusitis...
April 2016: Acta Reumatológica Portuguesa
Mehdi Bakhshaee, Mohamad-Reza Majidi, Vahideh Gharavi, Fatemeh-Sadat Alavizadeh, Rahman Movahed, Parasto Asnaashari, Amir-Mohammad-Hashem Asnaashari
INTRODUCTION: The coexistence of asthma and chronic rhinosinusitis (CRS) is more common than expected given their individual prevalence in the general population and may affect patient's quality of life. The aim of this study was to evaluate the prevalence of asthma in chronic rhinosinusitis in Mashhad, Northeast Iran. MATERIALS AND METHODS: This study was performed in two university hospital from November 2012 for 12 months. In total, 153 patients with chronic rhinosinusitis were enrolled and referred to a particular pulmonologist for asthma evaluation...
July 2016: Iranian Journal of Otorhinolaryngology
Ritesh Agarwal, Sandeep Bansal, Arunaloke Chakrabarti
Aspergillus fumigatus can cause several allergic disorders including Aspergillus-sensitized asthma, allergic bronchopulmonary aspergillosis (ABPA), and allergic fungal rhinosinusitis (AFRS). ABPA is an immunological pulmonary disorder caused by allergic reactions mounted against antigens of A. fumigatus colonizing the airways of patients with asthma (and cystic fibrosis). Allergic bronchopulmonary mycosis is an allergic fungal airway disease caused by thermotolerant fungi other than A. fumigatus On the other hand, AFRS is a type of chronic rhinosinusitis that is also a result of hypersensitivity reactions to the presence of fungi that become resident in the sinuses...
September 6, 2016: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
Kwang Ha Yoo, Hae Ryun Ahn, Jae Kyoung Park, Jong Woong Kim, Gui Hyun Nam, Soon Kwan Hong, Mee Ja Kim, Aloke Gopal Ghoshal, Abdul Razak Bin Abdul Muttalif, Horng Chyuan Lin, Sanguansak Thanaviratananich, Shalini Bagga, Rab Faruqi, Shiva Sajjan, Santwona Baidya, De Yun Wang, Sang Heon Cho
PURPOSE: The Asia-Pacific Burden of Respiratory Diseases (APBORD) study is a cross-sectional, observational one which has used a standard protocol to examine the disease and economic burden of allergic rhinitis (AR), asthma, chronic obstructive pulmonary disorder (COPD), and rhinosinusitis across the Asia-Pacific region. Here, we report on symptoms, healthcare resource use, work impairment, and associated costs in Korea. METHODS: Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled...
November 2016: Allergy, Asthma & Immunology Research
Jessica Han Ying Tan, Anne Ann Ling Hsu
BACKGROUND: Patients with aspirin-exacerbated respiratory disease (AERD) also recently known as nonsteroidal anti-inflammatory drug (NSAID) exacerbated respiratory disease (NERD) must avoid aspirin and all other oral NSAIDs. The effect of topical NSAID (tNSAID), especially salicylates which are commonly present in topical medicated preparations, on asthma control of this phenotype is studied. METHODS: The study inclusion criteria were adults with: 1) NSAID hypersensitivity; 2) nasal polyposis/chronic rhinosinusitis; 3) not well-/poorly controlled asthma and 4) exposure to tNSAID...
September 2016: Respiratory Medicine
Shu-Yu Tai, Ling-Feng Wang, Chih-Feng Tai, Yu-Ting Huang, Chen-Yu Chien
Few studies have investigated the relationship between chronic rhinosinusitis (CRS) and erectile dysfunction (ED). This case-control study aimed to investigate the association between CRS and the risk of ED in a large national sample. Tapping Taiwan's National Health Insurance Research Database, we identified people 30 years or older with a new primary diagnosis of CRS between 1996 and 2007. The cases were compared with sex- and age-matched controls. We identified 14 039 cases and recruited 140 387 matched controls...
2016: Scientific Reports
Marcin Fraczek, Maciej Guzinski, Monika Morawska-Kochman, Tomasz Krecicki
The aim of the study was to compare visualisation of the surgically relevant anatomical structures via low- and standard-dose multidetector CT protocol in patients with chronic rhinosinusitis (CRS) and higher risk for perioperative complications (i.e. presence of bronchial asthma, history of sinus surgery and advanced nasal polyposis). 135 adult CRS patients were divided randomly into standard-dose (120 kVp, 100 mAs) or low-dose CT groups (120 kVp, 45 mAs). The detectability of the vital anatomical structures (anterior ethmoid artery, optic nerve, cribriform plate and lamina papyracea) was scored using a five-point scale (from excellent to unacceptable) by a radiologist and sinus surgeon...
August 23, 2016: European Archives of Oto-rhino-laryngology
Joo Hee Kim, Sunghoon Park, Yong Il Hwang, Seung Hun Jang, Ki Suck Jung, Yun Su Sim, Cheol Hong Kim, Changhwan Kim, Dong Gyu Kim
Immunoglobulin G subclass deficiency (IgGSCD) is a relatively common primary immunodeficiency disease (PI) in adults. The biological significance of IgGSCD in patients with chronic airway diseases is controversial. We conducted a retrospective study to characterize the clinical features of IgGSCD in this population. This study examined the medical charts from 59 adult patients with IgGSCD who had bronchial asthma or chronic obstructive pulmonary disease (COPD) from January 2007 to December 2012. Subjects were classified according to the 10 warning signs developed by the Jeffrey Modell Foundation (JMF) and divided into two patient groups: group I (n = 17) met ≥ two JMF criteria, whereas group II (n = 42) met none...
October 2016: Journal of Korean Medical Science
Emine Güven Sakalar, Nuray Bayar Muluk, Murat Kar, Cemal Cingi
Aspirin-exacerbated respiratory disease (AERD) refers to the combination of asthma, chronic rhinosinusitis with nasal polyposis, and acute upper and lower respiratory tract reactions to the ingestion of aspirin (acetylsalicylic acid, ASA) and other cyclooxygenase-1 inhibiting non-steroidal anti-inflammatory drugs. AERD affects 0.3-0.9 % of the general population. AERD generally occurs due to abnormalities in mediators and expression of arachidonic acid biosynthesis. Local IgE responses to staphylococcal enterotoxins may also be responsible for eosinophilic activation in the nasal polyp tissues of AERD patients...
August 18, 2016: European Archives of Oto-rhino-laryngology
M Soledad Cabrera-Ramírez, M Sandra Domínguez-Sosa, Silvia Andrea Borkoski-Barreiro, Juan Carlos Falcón-González, Ángel Ramos-Macías
INTRODUCTION AND OBJECTIVES: Endoscopic sinus surgery is currently the surgical procedure chosen in cases of sinonasal polyposis refractory to medical treatment. The aim of this study was to show our experience in managing such patients operated using endoscopic sinus surgery. METHOD: A retrospective study of 246 patients with chronic rhinosinusitis and nasal polyps who were operated by endoscopic surgery. We studied the characteristics of the population, symptoms, grade of affectation, complications and recurrences...
August 8, 2016: Acta Otorrinolaringológica Española
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