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Chronic rhinosinusitis

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https://www.readbyqxmd.com/read/28337570/economics-of-chronic-rhinosinusitis
#1
REVIEW
Luke Rudmik
PURPOSE OF REVIEW: The objective of this article is to provide an updated review of the economic burden of chronic rhinosinusitis (CRS) and discuss how both medical and surgical interventions impact direct and indirect costs related to CRS. By understanding the economics of CRS, clinicians may improve the patient-centeredness of their care and help distinguish between low and high value interventions. RECENT FINDINGS: Direct costs related to CRS are primarily driven by outpatient physician visits, prescription medical therapy, and endoscopic sinus surgery (ESS)...
April 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28333393/laser-generated-shockwaves-enhance-antibacterial-activity-against-biofilms-in-vitro
#2
William Yao, Edward C Kuan, Nathan C Francis, Maie A St John, Warren S Grundfest, Zachary D Taylor
BACKGROUND AND OBJECTIVES: Bacterial biofilm formation within chronic wound beds, which provides an effective barrier against antibiotics, is a known cause of recalcitrant infections and a significant healthcare burden, often requiring repeated surgical debridements. Laser-generated shockwaves (LGS) is a novel, minimally invasive, and nonthermal modality for biofilm mechanical debridement which utilizes compressive stress waves, generated by photonic absorption in thin titanium films to mechanically disrupt the biofilm...
March 23, 2017: Lasers in Surgery and Medicine
https://www.readbyqxmd.com/read/28328160/co-morbidities-in-severe-asthma-clinical-impact-and-management
#3
REVIEW
Celeste Porsbjerg, Andrew Menzies-Gow
Patients with severe asthma represent a minority of the total asthma population, but carry a majority of the morbidity and healthcare costs. Achieving better asthma control in this group of patients is therefore of key importance. Systematic assessment of patients with possible severe asthma to identify treatment barriers and triggers of asthma symptoms, including co-morbidities, improves asthma control and reduces healthcare costs and is recommended by international guidelines on management of severe asthma...
March 22, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28322448/superior-turbinate-eosinophilia-correlates-with-olfactory-deficit-in-chronic-rhinosinusitis-patients
#4
Jennifer Lavin, Jin-Young Min, Alcina K Lidder, Julia He Huang, Atsushi Kato, Kent Lam, Eric Meen, Joan S Chmiel, James Norton, Lydia Suh, Mahboobeh Mahdavinia, Kathryn E Hulse, David B Conley, Rakesh K Chandra, Stephanie Shintani-Smith, Robert C Kern, Robert P Schleimer, Bruce K Tan
OBJECTIVE: To evaluate if molecular markers of eosinophilia in olfactory-enriched mucosa are associated with olfactory dysfunction. STUDY DESIGN: Cross-sectional study of tissue biopsies from 99 patients, and an additional 30 patients who underwent prospective olfactory testing prior to sinonasal procedures. METHODS: Tissue biopsies were processed for analysis of inflammatory markers using quantitative real time polymerase chain reaction (qRT-PCR)...
March 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28318535/organism-and-microbiome-analysis-techniques-and-implications-for-chronic-rhinosinusitis
#5
REVIEW
Ashleigh A Halderman, Andrew P Lane
Modern advances in DNA sequencing have allowed for the development of culture-independent techniques with application to infectious and inflammatory conditions, such as rhinosinusitis. Although paradigm-changing discoveries have resulted from molecular microbiologic methods for a number of diseases, insights provided into the role of bacteria in chronic rhinosinusitis have yet to be fully understood to the point of impacting clinical diagnosis and management. As culture-independent techniques continue to evolve and become more refined, it is likely that a better understanding will emerge of how the microbiome influences chronic rhinosinusitis pathogenesis and response to therapy...
March 16, 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/28318451/bacterial-lysate-for-the-prevention-of-chronic-rhinosinusitis-recurrence-in-children
#6
J Chen, Y Zhou, J Nie, Y Wang, L Zhang, Q Shi, H Tan, W Kong
BACKGROUND: Chronic rhinosinusitis is a common nasal disorder in children that is prone to recurrence. This study investigated the prevention of chronic rhinosinusitis recurrence with bacteria lysate in children. METHODS: Bacteria lysate was administered 10 days per month for 3 months to children with chronic rhinosinusitis, who had just entered a remission phase. Visual analogue score, nasal symptoms scores, rhinitis attack frequency and antibiotic use were assessed at three months and one year...
March 20, 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28318118/distinct-expression-of-nk2-homeobox-1-nkx2-1-and-goblet-cell-hyperplasia-in-nasal-polyps-with-different-endotypes
#7
Jintao Du, Luo Ba, Bo Li, Feng Liu, Xianting Hu, Jie Zhang, Yafeng Liu, Junming Xian, Sixi Liu, Huabin Li
BACKGROUND: Decreased expression of airway epithelial-specific transcription factor NK2 homeobox 1 (NKX2-1) was associated with allergic inflammation in asthma patients. However, the expression and role of NKX2-1 in nasal polyps (NPs) with different endotypes were undefined yet. METHODS: We examined the expression of key cytokines (interleukin [IL]-4 IL-5, IL-13, and IL-17A, etc.) and NKX2-1 in NPs with different endotypes and control tissues by immunohistochemistry staining, qualitative polymerase chain reaction (qPCR), enzyme-linked immunosorbent assay (ELISA), and Western blot analysis...
March 20, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28315920/-unknown-title
#8
J S Schwartz, S Al-Mot, M F Endam, S Al-Romaih, J Madrenas, M Desrosiers
BACKGROUND: Staphylococcus aureus is a frequently implicated pathogen in chronic rhinosinusitis (CRS). S. aureus may promote commensalism by downregulating pro-inflammatory T cell host responses via an IL-10 mediated pathway. This finding, coupled with the observation that S. aureus and CD8+ T cell numbers are inversely correlated in CRS mucosa, suggests that S. aureus may evade immune destruction via IL-10 induction. To support this hypothesis, we evaluated i) whether IL-10 levels differ in CRS compared to controls (CTL) using microarray and immunohistochemistry and ii) whether IL-10 levels correlate with S...
March 19, 2017: Rhinology
https://www.readbyqxmd.com/read/28306159/positioning-the-principles-of-precision-medicine-in-care-pathways-for-allergic-rhinitis-and-chronic-rhinosinusitis-an-euforea-aria-epos-airways-icp-statement
#9
P W Hellings, W J Fokkens, C Bachert, C A Akdis, T Bieber, I Agache, M Bernal-Sprekelsen, G W Canonica, P Gevaert, G Joos, V Lund, A Muraro, M Onerci, T Zuberbier, B Pugin, S F Seys, J Bousquet
Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions...
March 17, 2017: Allergy
https://www.readbyqxmd.com/read/28295361/smoking-an-independent-risk-factor-for-lost-productivity-in-chronic-rhinosinusitis
#10
Adam P Campbell, Lloyd P Hoehle, Katie M Phillips, David S Caradonna, Stacey T Gray, Ahmad R Sedaghat
OBJECTIVES/HYPOTHESIS: Chronic rhinosinusitis (CRS) is associated with a significant loss of patient productivity that costs billions of dollars every year. Smoking is associated with worsening sinonasal symptoms, but its effect on lost productivity in CRS patients has yet to be described. Therefore, we sought to determine the association between smoking and productivity in patients with CRS. STUDY DESIGN: Prospective cross-sectional cohort study of 140 patients with CRS...
March 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28293783/translation-and-validation-of-the-rhinosinusitis-disability-index-for-use-in-nigeria
#11
C N Asoegwu, C C Nwawolo, N U Okubadejo
The Rhinosinusitis Disability Index (RSDI) is a validated and reliable measure of severity of chronic rhinosinusitis. The objective of this study was to translate and validate the instrument for use in Nigeria. This is a methodological study. 71 patients with chronic rhinosinusitis attending two Otolaryngology clinics in Lagos, Nigeria. Using standardized methods and trained translators, the RSDI was translated to vernacular (Yoruba language) and back-translated to culturally appropriate English. Data analysis comprised of assessment of the item quality, content validity and internal consistency of the back-translated Rhinosinusitis Disability Index (bRSDI), and correlation to the original RSDI...
March 14, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28290230/cilia-and-ear
#12
Gioia Piatti, Maria Margherita De Santi, Sara Torretta, Lorenzo Pignataro, Daniela Soi, Umberto Ambrosetti
OBJECTIVE: To investigate the prevalence of otological complications derived from primary ciliary dyskinesia (PCD) in adulthood. METHODS: Twenty-three patients with diagnosed PCD underwent medical history aimed at recording the presence of ear, nose, and throat manifestations (ENT) and any surgical treatments. The ENT objectivity was annotated, and then patients were subjected to audiometric test, tympanometry, registration of otoacoustic emission, and vestibular evaluation...
April 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28286740/long-term-safety-of-topical-bacteriophage-application-to-the-frontal-sinus-region
#13
Amanda J Drilling, Mian L Ooi, Dijana Miljkovic, Craig James, Peter Speck, Sarah Vreugde, Jason Clark, Peter-John Wormald
Background:Staphylococcus aureus biofilms contribute negatively to a number of chronic conditions, including chronic rhinosinusitis (CRS). With the inherent tolerance of biofilm-bound bacteria to antibiotics and the global problem of bacterial antibiotic resistance, the need to develop novel therapeutics is paramount. Phage therapy has previously shown promise in treating sinonasal S. aureus biofilms. Methods: This study investigates the long term (20 days) safety of topical sinonasal flushes with bacteriophage suspensions...
2017: Frontiers in Cellular and Infection Microbiology
https://www.readbyqxmd.com/read/28286156/clinical-characteristics-of-patients-with-chronic-rhinosinusitis-with-nasal-polyps-asthma-and-aspirin-exacerbated-respiratory-disease
#14
Whitney W Stevens, Anju T Peters, Annemarie G Hirsch, Cara M Nordberg, Brian S Schwartz, Dione G Mercer, Mahboobeh Mahdavinia, Leslie C Grammer, Kathryn E Hulse, Robert C Kern, Pedro Avila, Robert P Schleimer
BACKGROUND: Aspirin-exacerbated respiratory disease (AERD) comprises the triad of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, and intolerance to inhibitors of the cyclooxygenase-1 (COX-1) enzyme. The prevalence of AERD remains unclear, and few studies have compared the clinical characteristics of patients with AERD to those with CRSwNP alone, asthma alone, or both CRSwNP and asthma. OBJECTIVE: To determine the prevalence of AERD within a tertiary care setting, and to identify unique clinical features that could distinguish these patients from those with both CRSwNP and asthma or with CRSwNP alone...
March 9, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28284780/a-structured-approach-to-specialist-referred-difficult-asthma-patients-improves-control-of-comorbidities-and-enhances-asthma-outcomes
#15
Tunn Ren Tay, Joy Lee, Naghmeh Radhakrishna, Fiona Hore-Lacy, Robert Stirling, Ryan Hoy, Eli Dabscheck, Robyn O'Hehir, Mark Hew
BACKGROUND: Systematic evaluation is advocated for difficult asthma, but how best to deliver such care is unclear and outcome data are scarce. OBJECTIVE: We describe our institution's structured approach to difficult asthma management and report on the outcomes of such an approach. METHODS: Eighty-two consecutive patients with difficult asthma referred to our clinic from respiratory specialists were evaluated in 3 key areas: diagnostic confirmation, comorbidity detection, and inflammatory phenotyping...
March 8, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28284535/depression-symptoms-and-lost-productivity-in-chronic-rhinosinusitis
#16
Adam P Campbell, Katie M Phillips, Lloyd P Hoehle, Allen L Feng, Regan W Bergmark, David S Caradonna, Stacey T Gray, Ahmad R Sedaghat
BACKGROUND: Chronic rhinosinusitis (CRS) is associated with significant losses of patient productivity that cost billions of dollars every year. The causative factors for decreases in productivity in patients with CRS have yet to be determined. OBJECTIVE: To determine which patterns of CRS symptoms drive lost productivity. METHODS: Prospective, cross-sectional cohort study of 107 patients with CRS. Sinonasal symptom severity was measured using the 22-item Sinonasal Outcomes Test, from which sleep, nasal, otologic or facial pain, and emotional function subdomain scores were calculated using principal component analysis...
March 2017: Annals of Allergy, Asthma & Immunology
https://www.readbyqxmd.com/read/28283855/the-role-of-human-parainfluenza-virus-infections-in-the-immunopathology-of-the-respiratory-tract
#17
REVIEW
Malgorzata Pawełczyk, Marek Leszek Kowalski
Viral infections are leading causes of both upper and lower airway acute illness in all age groups of healthy persons, and have also been implicated in the acute exacerbations of chronic respiratory disorders like asthma and COPD. Human rhinovirus, respiratory syncytial virus, influenza virus and coronavirus have been considered as the most important respiratory pathogens and relatively little attention has been paid to the role of parainfluenza viruses (hPIVs). Human parainfluenza viruses are single-stranded RNA viruses belonging to the paramyxovirus family that may evoke lower respiratory infections in infants, children and immunocompromised individuals...
March 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28281440/monoclonal-antibody-therapy-in-sinonasal-disease
#18
S E Chiarella, H Sy, A T Peters
Chronic rhinosinusitis (CRS) affects 12.5% of the U.S. POPULATION: CRS can be divided into CRS with nasal polyps (CRSwNP) and CRS without nasal polyps. Some individuals with CRSwNP do not respond to standard-of-care medical and surgical management. For these individuals, targeted biologic agentsare emerging as an important therapeutic alternative. In this review, we described the most-relevant studies that addressed the use of anti-immunoglobulin E (omalizumab), anti-interleukin 5 (mepolizumab and reslizumab), and anti-interleukin 4/interleukin 13 (dupilumab) monoclonal antibodies for the treatment of CRSwNP...
March 9, 2017: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28280847/neuronal-differentiation-capability-of-nasal-polyps-of-chronic-rhinosinusitis
#19
Michael Koennecke, Robert Böscke, Ann-Christin Pfannerstill, Stefan Reers, Martina Elsner, Benjamin Fell, Anja Richter, Karl-Ludwig Bruchhage, Sandra Schumann, Ralph Pries, Ludger Klimek, Barbara Wollenberg
Chronic rhinosinusitis with nasal polyps is considered a subgroup of chronic rhinosinusitis and a significant health problem, but the pathogenesis remains unclear to date. Therefore, we investigated the stemness to determine the role of stem cells in nasal polyps, with additional analysis of the neuronal differentiation potential of nasal polyp cells. We determined gene and protein expression profiles of stem cells in nasal polyp tissues, using whole genome microarray, quantitative real-time PCR (qPCR), immunohistochemistry, and flow cytometry...
March 9, 2017: Archivum Immunologiae et Therapiae Experimentalis
https://www.readbyqxmd.com/read/28279811/selective-expansion-of-human-regulatory-t-cells-in-nasal-polyps-and-not-adjacent-tissue-microenvironments-in-individual-patients-exposed-to-steroids
#20
Justin A Edward, Mrinmoy Sanyal, Wei Le, Ethan Soudry, Vijay R Ramakrishnan, Dawn T Bravo, Alan L Nguyen, David Zarabanda, Todd T Kingdom, Peter H Hwang, C Garrison Fathman, Jayakar V Nayak
Severe forms of chronic rhinosinusitis (CRS), a common upper airway inflammatory disorder, are associated with nasal polyps (NPs). NP disease is ameliorated by glucocorticoid (GC) treatment, whose cellular effects are poorly understood. We therefore assessed the influence of GC therapy on NPs in CRS patients, focusing on regulatory T (Treg) cells. Treg cell populations were analyzed by flow cytometry in NPs and control tissues from GC-treated CRS patients and controls. After GC exposure, selective expansion of Treg cells was seen within NPs, and not blood or adjacent ethmoid tissues...
March 6, 2017: Clinical Immunology: the Official Journal of the Clinical Immunology Society
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