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chronic sinusitis and treatment

Griffin D Santarelli, Joseph K Han
Propel and Propel Mini sinus implants are mometasone furoate-coated bioabsorbable stents used as an adjunct in the management of chronic rhinosinusitis after endoscopic sinus surgery. The original sinus implant was deployed in the ethmoid sinuses to provide medialization of the middle turbinate, decrease scarring and mucosal adhesions, limit polyp regrowth, and reduce mucosal inflammation. A structurally smaller version of the Propel, the Propel Mini, was developed and now has been approved for endoscopic placement in the frontal sinuses...
October 19, 2016: Expert Opinion on Drug Delivery
Michel Komajda
Ivabradine is a blocker of the funny current channels in the sinoatrial node cells. This results in pure heart rate reduction when elevated without direct effect on contractility or on the vessels. It was tested in a large outcome clinical trial in stable chronic heart failure (CHF) with low ejection fraction, in sinus rhythm, on a contemporary background therapy including betablockers (SHIFT: Systolic Heart Failure Treatment with the If inhibitor Trial).The primary composite endpoint (cardiovascular mortality or heart failure hospitalization) was reduced by 18% whereas the first occurrence of heart failure hospitalizations was reduced by 26%...
October 18, 2016: Handbook of Experimental Pharmacology
Joachim Alexandre, Xavier Humbert, Marion Sassier, Paul Milliez, Antoine Coquerel, Sophie Fedrizzi
Cluster headache (CH) is a primary headache disorder with relatively effective treatments. Although few sufficiently controlled trials are available, verapamil is recommended as the first-line prophylactic drug for CH by the French Headache Society (with a low level of evidence, level B) and by the EFNS (European Federation of Neurological Societies, level A). Daily doses of more than 480 mg (and up to 1200 mg daily) are frequently used off-label, while 360 mg daily is the only dosage to have demonstrated its effectiveness in a double-blind trial against placebo, and the usual label posology used by cardiologists is 240 mg daily in hypertension...
December 2015: Drug Saf Case Rep
Sylvia Natalie Kłodzińska, Petra Alexandra Priemel, Thomas Rades, Hanne Mørck Nielsen
Bacterial biofilm-associated chronic sinusitis in cystic fibrosis (CF) patients caused by Pseudomonas aeruginosa infections and the lack of available treatments for such infections constitute a critical aspect of CF disease management. Currently, inhalation therapies to combat P. aeruginosa infections in CF patients are focused mainly on the delivery of antimicrobials to the lower respiratory tract, disregarding the sinuses. However, the sinuses constitute a reservoir for P. aeruginosa growth, leading to re-infection of the lungs, even after clearing an initial lung infection...
October 9, 2016: International Journal of Molecular Sciences
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
Francesco Giannini, Andrea Aurelio, Alaide Chieffo
Refractory angina is a chronic condition characterized by the presence of disabling symptoms due to severe obstructive coronary artery disease not improved by either optimal medical therapy and/or percutaneous or surgical revascularization. Mortality rates associated with this condition are quite low in clinically stable patients on optimal medical therapy. However, rehospitalization rates are high. In this subgroup of patients there is thus a clinical need for new therapies targeting an improvement of symptoms but taking into account the potential impact in terms of healthcare and costs...
October 2016: Giornale Italiano di Cardiologia
Barry H Greenberg
The treatment of heart failure with reduced ejection (HFrEF) is changing rapidly. Advances over the past several decades have focused on blocking the adverse effects of neurohormonal activation. This approach has resulted in marked improvement in outcomes in the HFrEF population. Despite these advances, however, mortality and morbidity remain high and HFrEF patients have poor quality of life. New approaches to therapy now offer additional benefits. Combined neprilysin inhibition and angiotensin receptor blockade using sacubitril-valsartan (LCZ696) has been shown to be superior to an angiotensin-converting enzyme inhibitor in HFrEF patients...
2016: Reviews in Cardiovascular Medicine
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
Ozge Turhan, Asli Bostanci, Irem Hicran Ozbudak, Murat Turhan
Chronic invasive nongranulomatous fungal rhinosinusitis is a well-described but uncommon type of fungal rhinosinusitis (FRS). While the prevalence of chronic FRS is 0.11% in healthy individuals, only 1.3% of them are in nongranulomatous invasive nature. The majority of the cases in the literature have been reported from developing countries mostly located in the tropical regions, as typically occurring in the background of diabetes mellitus or corticosteroid treatment. The current paper reports four consecutive cases, who were diagnosed within a short period of six months at a single center of a country located outside the tropical climate zone...
2016: Case Reports in Otolaryngology
Edvard Janev, Enis Redzep
BACKGROUND: Draining cutaneous sinus tract in chin area may be caused by chronic periapical dental infections. Misdiagnosis of these lesions usually leads to destructive invasive treatment of the sinus tract that is not correct and curative. CASE REPORT: A 31-year-old male patient referred to us with a chronically draining lesion on his chin. The lesion previously was misdiagnosed by medical doctors and had undergone two times surgery with a focus on the skin lesion and had received antibiotic therapy for a prolonged period of time...
September 15, 2016: Open Access Macedonian Journal of Medical Sciences
Desiderio Passali, Giacomo Gabelli, Giulio Cesare Passali, Roberto Magnato, Stefan Platzgummer, Lorenzo Salerni, Salvatore Lo Cunsolo, Alexandra Joos, Luisa Maria Bellussi
Allergic rhinitis is a common nasal disorder with a high impact on quality of life, high social costs in therapies, and a natural development towards asthma. Pharmacological therapy is based on several genres of medications, of which intranasal corticosteroids are currently the most widespread. Thermal water treatment has traditionally been used as adjunctive treatment for chronic rhinitis and sinusitis. The present study was carried out to assess the clinical efficacy of nasal inhalation of radioactive oligomineral water vapours from the Merano hot spring and to compare it with the clinical efficacy of mometasone furoate nasal spray...
2016: International Journal of Otolaryngology
B Marcus
OBJECTIVE: Cryopreserved amniotic suspension allograft (CASA) is a regenerative tissue suspension containing amniotic membrane and amniotic fluid components used for soft-tissue repair, replacement, and reconstruction. The aim of this case series is to examine its effects in different wound types. METHOD: In a retrospective series CASA was applied to chronic non-healing wounds. All patients were treated at a single center between June 2013 and December 2014. The criterion for application of CASA was lack of progress toward wound healing despite standard treatments and adjuvant therapies...
October 2016: Journal of Wound Care
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
Hyun Jung Gu, Young Jin Kim, Hee Joo Lee, Sung Hwa Dong, Sung Wan Kim, Hee Jae Huh, Chang-Seok Ki
Human Lasiodiplodia theobromae infection has not been reported frequently. We report the first case of invasive L. theobromae nasal and neck infection. A 66-year-old male visited our hospital with anemia and general weakness. He showed pancytopenia, and his bone marrow examination revealed markedly decreased hematopoietic cells. The patient was presumed to have iatrogenic aplastic anemia due to mushroom toxicity. He began treatment for multiple organ infections with broad-spectrum antibiotics and antifungal agents...
September 20, 2016: Mycopathologia
Anni Koskinen, Petri Mattila, Jyri Myller, Matti Penttilä, Juha Silvola, Ismo Alastalo, Heini Huhtala, Maija Hytönen, Sanna Toppila-Salmi
CONCLUSION: In terms of operation time, anesthesia method, and low complication rate, ESS and balloon sinuplasty seemed comparable. The advantages of balloon sinuplasty were shown to be shortness of sick leave, possibility to be performed as an in-office procedure, and lower adhesion formation. BACKGROUND: Endoscopic sinus surgery (ESS) has been considered as a treatment of choice for persistent chronic rhinosinusitis (CRS). During the last decade balloon sinuplasty has been introduced as an alternative technique to dilate the ostium...
September 20, 2016: Acta Oto-laryngologica
Yutaro Yamashita, Hiroaki Nagae, Ichiro Hashimoto
Pilonidal sinus is a cystic disease that occurs most often in the sacrococcygeal region. Surgical excision and coverage with a skin flap require postoperative bed rest. Most affected patients are young adults who find it difficult to obtain adequate postoperative bed rest owing to their work. The purpose of this study is to review the effectiveness of our ambulatory surgery procedure for pilonidal sinus, which involves tract excision and open treatment followed by at-home irrigation. We reviewed the 9 cases of chronic pilonidal sinus treated at our out-patient clinic by ambulatory surgery consisting of open excision without skin closure...
2016: Journal of Medical Investigation: JMI
Eduard Shantsila, Gregory Yh Lip
BACKGROUND: Morbidity in patients with chronic heart failure is high, and this predisposes them to thrombotic complications, including stroke and thromboembolism, which in turn contribute to high mortality. Oral anticoagulants (e.g. warfarin) and antiplatelet agents (e.g. aspirin) are the principle oral antithrombotic agents. Many heart failure patients with sinus rhythm take aspirin because coronary artery disease is the leading cause of heart failure. Oral anticoagulants have become a standard in the management of heart failure with atrial fibrillation...
September 15, 2016: Cochrane Database of Systematic Reviews
Antonio Juan, Laura Alonso, Teresa Olivé, Alexandra Navarro, Elena Sulleiro, José Sánchez de Toledo, Cristina Díaz de Heredia
Acanthamoeba infections are rare and mostly occur in immunocompromised patients. Most of the reported cases after stem-cell transplantation have been diagnosed postmortem. We present the case of a 3-year-old boy with chronic graft versus host disease post-hematopoietic transplantation who was successfully treated for Acanthamoeba.
September 12, 2016: Pediatric Infectious Disease Journal
W Zhou, Q Liu, W D Zhao, H P Yu, X C Sun, J J Wang, Z F Liu, H Y Li, C Q Zheng, S Y Wang, D H Wang
OBJECTIVE: To evaluate the survival outcomes of invasive fungal rhinosinusitis by analyzing the clinical features. METHODS: A retrospective analysis was performed for cases of invasive fungal sinusitis proved by histological analysis between March 2006 and November 2015. All relevant factors including interval from the onset of symptoms to initiation of diagnosis, clinical characteristics, features of CT and MRI, treatment and prognosis were collected. A total of 18 patients (10 males; 8 females) were identified...
August 7, 2016: Zhonghua Er Bi Yan Hou Tou Jing Wai Ke za Zhi, Chinese Journal of Otorhinolaryngology Head and Neck Surgery
Diana Carolina Moncada, Melisa Montes, Verónica Molina, Jorge Byron Velásquez, Carlos Ignacio Gómez
Entomophtoramycosis is a type of subcutaneous mycosis which includes both basidiobolomycosis and conidiobolomycosis; the latter is caused by Conidiobolus coronatus, a saprophytic fungus which lives in tropical soils. This mycosis characteristically affects the paranasal sinuses and oropharynx, with the potential to deform the face in patients without apparent immunodeficiency. It has a chronic course of infection with a tendency to form granulomas visible using histology. We present the case of a 28 year-old male agricultural worker, with a clinical profile of 6 months' evolution of rhinofacial tumefaction, nasal obstruction and post-nasal drip who was diagnosed with conidiobolomycosis by means of tissue culture after multiple biopsies of the facial area...
2016: Biomédica: Revista del Instituto Nacional de Salud
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