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Rhinosinusitis treatment

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https://www.readbyqxmd.com/read/28630938/sleep-dysfunction-and-its-association-to-chronic-rhinosinusitis-updated-review
#1
Quinn Orb, Richard R Orlandi, Jeremiah A Alt
BACKGROUND: Poor sleep has significant effects on health contributing to increased morbidity and mortality. The direct and indirect costs of sleep dysfunction total well in to the billions of dollars annually in the US. Chronic rhinosinusitis (CRS) affects up to 16% of the US population and has been linked to poor sleep quality with up to three quarters of patients with CRS reporting poor sleep quality. There is a growing body of literature evaluating the relationship between sleep and CRS...
April 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/28625008/the-role-of-local-allergy-in-the-nasal-inflammation
#2
REVIEW
Ke-Jia Cheng, Min-Li Zhou, Ying-Ying Xu, Shui-Hong Zhou
Local allergic inflammation (LAI) is recognized recently. 'entopy' was used to define LAI, which was positively correlated with allergen provocation testing, local sIgE up-regulation, inflammatory mediator secretion, and a lack of systemic allergy. The study of LAI is in its infancy and focuses mainly on the respiratory system. It is closely related to nasal inflammation and plays important roles in patients with nonallergic rhinitis (NAR), nonallergic chronic sinusitis with nasal polyps (CRSwNP), and nonallergic fungal rhinosinusitis (NAFRS)...
June 17, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28623534/acquired-immunity-in-chronic-rhinosinusitis
#3
REVIEW
Bruce K Tan, Jin-Young Min, Kathryn E Hulse
Chronic rhinosinusitis (CRS) is a prevalent disease that is associated with significant costs and quality of life impairments. Currently, patients are classified into subgroups based on clinical characteristics, most often the presence or absence of nasal polyps. However, despite medical and surgical treatment, many of these patients continue to have symptoms. Recent efforts have focused on gaining a more complete understanding of the inflammatory mechanisms that drive pathogenesis in CRS, and it is becoming clear that the inflammatory processes in CRS are quite complex...
July 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28607894/impact-of-co-existing-vascular-headache-on-symptom-relief-after-endoscopic-sinus-surgery
#4
Shilpa Chandrashekarappa, Sandeep Shetty, T Shivaram Shetty, Amjad Khan, Parijat Joshi
Vascular headache and chronic rhinosinusitis (CRS) are diseases that share similar symptoms and demographics, including headache, facial pain and nasal symptoms. Contribution of chronic sinusitis as a cause of chronic headache is controversial, as there are scarce studies to know incidence of vascular headache in patients with CRS. To evaluate incidence of vascular headache in patients with CRS. Using descriptive study design, group of 100 patients with symptoms of CRS with headache were included in study. Patients underwent surgical management and 3% managed medically...
June 2017: Indian Journal of Otolaryngology and Head and Neck Surgery
https://www.readbyqxmd.com/read/28604115/a-randomized-controlled-trial-comparing-a-xyloglucan-based-nasal-spray-with-saline-in-adults-with-symptoms-of-rhinosinusitis
#5
Alessandro Allegrini, Daniele Pavone, Fulvio Carluccio
BACKGROUND: This study assessed the efficacy, safety and tolerability of a xyloglucan-based nasal spray in the treatment of symptoms of rhinosinusitis. METHODOLOGY: In this randomized, double-blind study, 40 patients with itching, nasal congestion or continuous sneezing and a Total Nasal Symptom Score (TNSS) of ≥8 were randomized to 2 weeks' treatment with a xyloglucan-based nasal spray ('xyloglucan') or a physiological saline nasal spray ('saline'). Assessments included the TNSS, rhinosinusitis severity index, nocturnal awakenings, use of rescue medication, safety and tolerability...
June 10, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28592581/the-stop-ab-trial-protocol-efficacy-and-safety-of-discontinuing-patient-antibiotic-treatment-when-physicians-no-longer-consider-it-necessary
#6
Carl Llor, Ana Moragas, Carolina Bayona, Josep M Cots, José M Molero, Joana Ribas, Julio Francisco Fóthy, Isabel Gutiérrez, Coro Sánchez, Jesús Ortega, Javier Arranz, Jenifer Botanes, Purificación Robles
INTRODUCTION: Since 2011, the Spanish Society of Family Medicine has recommended general practitioners (GPs) to ask their patients to stop taking antibiotics when they suspect a viral infection. However, this practice is seldom used because uncertainty about diagnosis, and fear of consequences of discontinuing antibiotic therapy, as well as perceived pressure to continue prescribing antibiotics and potential conflict with patients are more of a concern for GPs than antibiotic resistance...
June 6, 2017: BMJ Open
https://www.readbyqxmd.com/read/28587510/effects-of-fluticasone-furoate-nasal-spray-on-parameters-of-eosinophilic-inflammation-in-patients-with-nasal-polyposis-and-perennial-allergic-rhinitis
#7
Cveta Špadijer Mirković, Aleksandar Perić, Biserka Vukomanović Đurđević, Danilo Vojvodić
OBJECTIVES: Regulated on activation normal T cell expressed and secreted (RANTES) and eotaxin-2 have been postulated to be responsible for eosinophilia in chronically inflamed nasal mucosa. This study evaluated mucosal production of RANTES and eotaxin-2 in patients with perennial allergic rhinitis (PAR) and nonallergic and allergic form of chronic rhinosinusitis with nasal polyps (CRSwNP) before and after nasal corticosteroid treatment. METHODS: Twenty patients with PAR, 20 nonallergic and 20 allergic CRSwNP patients, and 20 healthy controls were included...
June 1, 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/28583227/differential-diagnosis-and-proper-treatment-of-acute-rhinosinusitis-guidance-based-on-historical-data-analysis
#8
Gregor Cevc
BACKGROUND: The time course of rhinovirus positive and negative rhinosinusitis has not been quantified yet, which aggravates proper selection and justification of the optimum treatment for this illness. Such quantitative information would facilitate an early and proper identification of the disease and its differentiation from acute bacterial rhinosinusitis, and could diminish harmful overuse of antibiotics, arguably driven by patients' want for attention and the treating physicians' inability to offer an adequate verbal comfort in its stead...
June 1, 2017: Allergy & Rhinology
https://www.readbyqxmd.com/read/28575786/clinical-features-of-igg4-related-rhinosinusitis
#9
Machiko Hanaoka, Terumi Kammisawa, Satomi Koizumi, Sawako Kuruma, Kazuro Chiba, Masataka Kikuyama, Satoshi Shirakura, Taro Sugimoto, Tsunekazu Hishima
PURPOSE: IgG4-related disease is a systemic disease that affects various organs of the body. Aim of this study is to elucidate the clinical characteristics of IgG4-related rhinosinusitis. MATERIAL AND METHODS: Clinical features, laboratory findings, radiological and endoscopic findings, associated disease, treatment and prognosis were retrospectively examined in 10 patients with IgG4-related rhinosinusitis. RESULTS: The age was 59.1±11.3 years old and male-to-female ratio was 1:1...
May 30, 2017: Advances in Medical Sciences
https://www.readbyqxmd.com/read/28572918/multi-morbidities-of-allergic-rhinitis-in-adults-european-academy-of-allergy-and-clinical-immunology-task-force-report
#10
REVIEW
C Cingi, P Gevaert, R Mösges, C Rondon, V Hox, M Rudenko, N B Muluk, G Scadding, F Manole, C Hupin, W J Fokkens, C Akdis, C Bachert, P Demoly, J Mullol, A Muraro, N Papadopoulos, R Pawankar, P Rombaux, E Toskala, L Kalogjera, E Prokopakis, P W Hellings, J Bousquet
This report has been prepared by the European Academy of Allergy and Clinical Immunology Task Force on Allergic Rhinitis (AR) comorbidities. The aim of this multidisciplinary European consensus document is to highlight the role of multimorbidities in the definition, classification, mechanisms, recommendations for diagnosis and treatment of AR, and to define the needs in this neglected area by a literature review. AR is a systemic allergic disease and is generally associated with numerous multi-morbid disorders, including asthma, eczema, food allergies, eosinophilic oesophagitis (EoE), conjunctivitis, chronic middle ear effusions, rhinosinusitis, adenoid hypertrophy, olfaction disorders, obstructive sleep apnea, disordered sleep and consequent behavioural and educational effects...
2017: Clinical and Translational Allergy
https://www.readbyqxmd.com/read/28571174/comparison-of-steroid-and-itraconazole-for-prevention-of-recurrence-in-allergic-fungal-rhinosinusitis-a-randomized-controlled-trial
#11
Moirangthem Rojita, Swagatika Samal, Pradeep Pradhan, V P Venkatachalam
INTRODUCTION: Allergic Fungal Rhinosinusitis (AFRS) is due to the continuous exposure of fungal antigens to an atopic individual. Medical treatment following the surgery is the standard protocol often practiced for the treatment of AFRS. Steroid (systemic/topical) has been considered as the standard medical treatment for the control of the disease in AFRS although most of the patients show recurrence with long term follow up. Instead, antifungals (itraconazole) can be tried to decrease the recurrence rate which acts by inhibiting the fungal growth in the postoperative period...
April 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28565763/effects-of-glucocorticoid-on-the-expression-and-regulation-of-aquaporin-5-in-the-paranasal-sinus-of-rats-with-chronic-rhinosinusitis
#12
Chen-Jie Yu, Xin-Yan Cui, Ling Lu, Jun Yang, Bin Chen, Cheng-Wen Zhu, Xia Gao
Aquaporins (AQPs) are water-specific membrane channel proteins that regulate water homeostasis for cells and organisms. AQP5 serves an important role in the maintenance of mucosal water homeostasis, and potentially contributes to mucosal edema and inflammation formation in chronic rhinosinusitis (CRS). The aim of the present study was to explore the expression pattern of AQP5 and the effect of glucocorticoids on AQP5 expression in rats with CRS. The rats were randomly divided into three equal groups, as follows: CRS, dexamethasone (dexa) treatment and control groups...
May 2017: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28558147/safety-and-efficacy-of-a-bioabsorbable-fluticasone-propionate-eluting-sinus-dressing-in-postoperative-management-of-endoscopic-sinus-surgery-a-randomized-clinical-trial
#13
Gwijde F J P M Adriaensen, Keng-Hua Lim, Wytske J Fokkens
BACKGROUND: Postoperative wound healing after endoscopic sinus surgery (ESS) in patients with chronic rhinosinusitis (CRS) is an important factor in procedural success. Local steroids and separation of opposing mucosa are commonly implemented to optimize healing. A bioabsorbable, fluticasone propionate (FP)-eluting implant, SinuBand FP, was assessed for its safety and efficacy when used in patients with CRS and nasal polyps, who were indicated for ESS including bilateral anterior and posterior ethmoidectomy...
May 30, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28558139/safety-and-tolerability-of-surfactant-nasal-irrigation
#14
Justin H Turner, Jeffanie Wu, Cindy A Dorminy, Rakesh K Chandra
BACKGROUND: Abnormal mucus composition and bacterial biofilms are thought to contribute to the pathophysiology of rhinosinusitis. Addition of a mucoactive surfactant to saline irrigation solution has been hypothesized to address these factors. We evaluated the safety and tolerability of a reformulated surfactant in a sample of normal subjects. METHODS: A total of 33 volunteers were randomly assigned to receive either surfactant solution or buffered saline at baseline in a controlled crossover study design...
May 30, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28556611/defining-the-minimal-clinically-important-difference-for-olfactory-outcomes-in-the-surgical-treatment-of-chronic-rhinosinusitis
#15
Joshua M Levy, Jess C Mace, Todd E Bodner, Jeremiah A Alt, Timothy L Smith
BACKGROUND: Olfactory dysfunction is a common and defining symptom of chronic rhinosinusitis (CRS). Many measures of olfactory dysfunction in CRS are limited by scoring criteria defined within general populations with interpretations of statistical significance to infer clinically meaningful improvement. In this investigation we define a minimal clinically important difference (MCID) for the Brief Smell Identification Test (BSIT) in CRS patients electing endoscopic sinus surgery (ESS)...
May 26, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28552099/bacteriology-and-treatment-of-infections-in-the-upper-and-lower-airways-in-patients-with-primary-ciliary-dyskinesia-adressing-the-paranasal-sinuses
#16
Mikkel Christian Alanin
The respiratory tract is lined with motile cilia that transport respiratory mucus. Primary ciliary dyskinesia (PCD) is a chronic genetic disease caused by mutations in genes responsible for ciliary structure and function. Non-functional airway cilia impair the mucociliary clearance (MCC), causing mucostasis, lung infections and destruction, chronic rhinosinusitis (CRS) and hearing impairment. It is of paramount importance to postpone chronic lung infection mainly with Gram-negative bacteria (GNB) in patients with an impaired MCC...
May 2017: Danish Medical Journal
https://www.readbyqxmd.com/read/28542675/analgesic-effects-of-intravenous-acetaminophen-vs-placebo-for-endoscopic-sinus-surgery-and-postoperative-pain-a-randomized-clinical-trial
#17
Matthew A Tyler, Kent Lam, Faramarz Ashoori, Chunyan Cai, Joshua J Kain, Samer Fakhri, Martin J Citardi, Davide Cattano, Amber Luong
Importance: Intravenous acetaminophen is a commonly prescribed analgesic for the prevention and treatment of postsurgical pain. Its efficacy in the context of endoscopic sinus surgery (ESS) has yielded mixed results. Objective: To compare the efficacy of perioperative intravenous acetaminophen (IVAPAP) with that of placebo in improving early postoperative pain after endoscopic sinus surgery (ESS). Design, Setting, and Participants: A prospective, randomized clinical trial including 62 patients undergoing ESS for chronic rhinosinusitis in a single tertiary referral hospital...
May 25, 2017: JAMA Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/28530264/cyclamen-europaeum-improves-the-effect-of-oral-antibiotics-on-exacerbations-and-recurrences-of-chronic-rhinosinusitis-a-real-life-observational-study-chronos
#18
A S Lopatin, O A Ivanchenko, S S Soshnikov, J Mullol
Chronic rhinosinusitis (CRS) is an inflammatory disease of the nose and paranasal sinuses affecting 11% of the European population. Cyclamen europaeum plant extract (CE) has demonstrated efficacy in treating acute rhinosinusitis, but its role in CRS exacerbations remains unknown. In this real-life, prospective, epidemiological, observational study, a total of 317 patients with exacerbations of CRS without nasal polyps (CRSsNP) of moderate severity were treated using three different options: oral antibiotics, CE extract nasal spray, or the combination of oral antibiotic with CE extract...
May 22, 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28526836/characterisation-of-antibiotic-prescriptions-for-acute-respiratory-tract-infections-in-danish-general-practice-a-retrospective-registry-based-cohort-study
#19
Rune Aabenhus, Malene Plejdrup Hansen, Laura Trolle Saust, Lars Bjerrum
Inappropriate use of antibiotics is contributing to the increasing rates of antimicrobial resistance. Several Danish guidelines on antibiotic prescribing for acute respiratory tract infections in general practice have been issued to promote rational prescribing of antibiotics, however it is unclear if these recommendations are followed. We aimed to characterise the pattern of antibiotic prescriptions for patients diagnosed with acute respiratory tract infections, by means of electronic prescriptions, labeled with clinical indications, from Danish general practice...
May 19, 2017: NPJ Primary Care Respiratory Medicine
https://www.readbyqxmd.com/read/28526278/biotherapeutics-in-chronic-rhinosinusitis-with-and-without-nasal-polyps
#20
Claus Bachert, Philippe Gevaert, Peter Hellings
In western countries, 85% of chronic rhinosinusitis with nasal polyp disease reveals a type 2 inflammatory pattern with expression of IL-4, -5, and -13 as well as increased concentrations of IgE, whereas chronic rhinosinusitis without nasal polyps merely expresses these biomarkers. The degree of type 2 inflammation furthermore is associated with disease severity, asthma comorbidity, and recurrence of disease after surgery. Therefore, these biomarkers also form the targets for innovative therapeutic approaches such as monoclonal antibodies directed against IgE, IL-5, and IL-4 receptor alpha, blocking the activity of IL-4 and -13...
May 16, 2017: Journal of Allergy and Clinical Immunology in Practice
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