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Rhinosinusitis treatment

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https://www.readbyqxmd.com/read/28196638/japanese-guidelines-for-adult-asthma-2017
#1
REVIEW
Masakazu Ichinose, Hisatoshi Sugiura, Hiroyuki Nagase, Masao Yamaguchi, Hiromasa Inoue, Hironori Sagara, Jun Tamaoki, Yuji Tohda, Mitsuru Munakata, Kohei Yamauchi, Ken Ohta
Adult bronchial asthma is characterized by chronic airway inflammation, and presents clinically with variable airway narrowing (wheezes and dyspnea) and cough. Long-standing asthma induces airway remodeling, leading to intractable asthma. The number of patients with asthma has increased; however, the number of patients who die of asthma has decreased (1.2 per 100,000 patients in 2015). The goal of asthma treatment is to enable patients with asthma to attain normal pulmonary function and lead a normal life, without any symptoms...
February 11, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28194802/safe-treatment-of-ethmoid-sinusitis-utilizing-minimally-invasive-ethmoid-punch-sinusotomy-eps-in-chronic-rhinosinusitis-without-polyposis-crssnp-patients
#2
Nathalia Velasquez, Andrew Thamboo, Waleed M Abuzeid, Jayakar V Nayak
OBJECTIVES/HYPOTHESIS: Current rhinologic practice is devoid of minimally invasive procedures dedicated to the treatment of ethmoid sinusitis to improve ventilation and topical drug delivery. We have recently described a handheld spiral punch to create minimally invasive ethmoid punch sinusotomy (EPS) sites into the ethmoid bulla and basal lamella, which significantly increased irrigant access to the ethmoid sinuses in cadaver models. Here, we conducted a clinical feasibility study to determine the initial safety evaluation of EPS in chronic rhinosinusitis without polyposis (CRSsNP) patients with active ethmoid disease...
February 14, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28185668/effect-of-nebulized-budesonide-on-decreasing-the-recurrence-of-allergic-fungal-rhinosinusitis
#3
Qi Dai, Chen Duan, Quan Liu, Hongmeng Yu
OBJECTIVE: The aim of this study was to evaluate the clinical efficacy and the effects on decreasing the recurrence of AFRS (allergic fungal rhinosinusitis) of a budesonide inhalation suspension delivered via transnasal nebulization to patients following endoscopic sinus surgery. SUBJECTS AND METHODS: Thirty-five patients were recruited into this study. Final diagnoses were reached using Bent and Kuhn's criteria. The eligible patients were randomly divided into two groups: the budesonide transnasal nebulization group (group A) and the topical nasal steroids group (group B)...
February 1, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28182331/establishing-utility-values-for-the-22-item-sino-nasal-outcome-test-snot-22-using-a-crosswalk-to-the-euroqol-five-dimensional-questionnaire-three-level-version-eq-5d-3l
#4
R Trafford Crump, Ernest Lai, Guiping Liu, Arif Janjua, Jason M Sutherland
BACKGROUND: Chronic rhinosinusitis (CRS) is a common condition for which there are numerous medical and surgical treatments. The 22-item Sino-Nasal Outcome Test (SNOT-22) is a patient-reported outcome measure often used with patients diagnosed with CRS. However, there are no utility values associated with the SNOT-22, limiting its use in comparative effectiveness research. The purpose of this study was to establish utilities for the SNOT-22 by mapping responses to utility values associated with the EuroQol-5-dimensional questionnaire-3-level version (EQ-5D-3L)...
February 9, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28177596/evaluating-metrics-of-responsiveness-using-patient-reported-outcome-measures-in-chronic-rhinosinusitis
#5
Alcina K Lidder, Kara Y Detwiller, Caroline P E Price, Robert C Kern, David B Conley, Stephanie Shintani-Smith, Kevin C Welch, Rakesh K Chandra, Anju T Peters, Leslie C Grammer, Li-Xing Man, Robert P Schleimer, Bruce K Tan
BACKGROUND: Responsiveness, or sensitivity to clinical change, is important when selecting patient-reported outcome measures (PROMs) for research and clinical applications. This study compares responsiveness of PROMs used in chronic rhinosinusitis (CRS) to inform the future development of a highly responsive instrument that accurately portrays CRS patients' symptom experiences. METHODS: Adult CRS patients initiating medical therapy (MT; n = 143) or undergoing endoscopic sinus surgery after failing MT (ESS; n = 123) completed the 22-item Sino-Nasal Outcome Test (SNOT-22), European Position Statement on Rhinosinusitis (EPOS) visual analog scale (VAS), and 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29) at baseline and 3 months after treatment...
February 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28166559/should-we-prescribe-antibiotics-to-this-patient-with-persistent-upper-respiratory-symptoms-grand-rounds-discussion-from-beth-israel-deaconess-medical-center
#6
Howard Libman, Diane M Brockmeyer, Howard S Gold
The American College of Physicians (ACP) and the Centers for Disease Control and Prevention (CDC) recently published advice for high-value care on the appropriate use of antibiotics for acute respiratory tract infections. They conducted a narrative literature review of evidence for antibiotic use in this setting that included recent clinical guidelines from professional societies supplemented by randomized, controlled trials; meta-analyses; and systematic reviews. They concluded that clinicians should reserve antibiotic treatment for acute rhinosinusitis in patients with persistent symptoms for more than 10 days, high fever and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or worsening symptoms after a typical viral illness that lasted 5 days and had initially improved ("double-sickening")...
February 7, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28164779/hyaluronic-acid-for-post-sinus-surgery-care-systematic-review-and-meta-analysis
#7
REVIEW
E Fong, M Garcia, C M Woods, E Ooi
BACKGROUND: Wound healing after endoscopic sinus surgery may result in adhesion formation. Hyaluronic acid may prevent synechiae development. A systematic review was performed to evaluate the current evidence on the clinical efficacy of hyaluronic acid applied to the nasal cavity after sinus surgery. METHODS: Studies using hyaluronic acid as an adjunct treatment following endoscopic sinus surgery for chronic rhinosinusitis were identified. The primary outcome was adhesion formation rates...
January 2017: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/28151588/safety-of-long-term-intranasal-budesonide-delivered-via-the-mucosal-atomization-device-for-chronic-rhinosinusitis
#8
Jamil Manji, Gurkaran Singh, Christopher Okpaleke, Anali Dadgostar, Fahad Al-Asousi, Ameen Amanian, Luis Macias-Valle, Andres Finkelstein, Mark Tacey, Andrew Thamboo, Amin Javer
BACKGROUND: Although short-term use (≤2 months) of atomized topical nasal steroids has been shown to be safe and effective, the long-term safety has yet to be demonstrated. The aim of this study was to determine the impact of long-term topical budesonide treatment via the mucosal atomization device (MAD) on the hypothalamic-pituitary-adrenal axis (HPAA) and intraocular pressure (IOP). METHODS: A cross-sectional study of patients with chronic rhinosinusitis (CRS), with or without nasal polyposis, managed with daily nasal budesonide via MAD was conducted at a tertiary rhinology center...
February 2, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28151586/nuclear-erythroid-2-related-factor-2-activation-inhibits-house-dust-mite-induced-sinonasal-epithelial-cell-barrier-dysfunction
#9
Nyall R London, Anuj Tharakan, Andrew P Lane, Shyam Biswal, Murugappan Ramanathan
BACKGROUND: Dysregulated sinonasal epithelial cell (SNEC) barrier function has been proposed to contribute to the pathogenesis of sinonasal inflammatory conditions such as allergic rhinitis (AR) and chronic rhinosinusitis (CRS). Allergens such as house dust mite (HDM) have been reported to disrupt SNEC barrier integrity. We have recently identified nuclear erythroid 2-related factor 2 (Nrf2) activation via sulforaphane (SFN) stimulation to stabilize SNEC barrier function. The purpose of this study was to explore whether Nrf2 activation could ameliorate HDM-induced SNEC barrier dysfunction...
February 2, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28143692/the-journal-of-allergy-and-clinical-immunology-in-practice-2016-year-in-review
#10
REVIEW
Michael Schatz, Scott H Sicherer, Robert S Zeiger
As editors, we concluded that it would be helpful to our readers to write a Year in Review article that highlights the Review, Original, and Clinical Communication articles published in 2016 in The Journal of Allergy and Clinical Immunology: In Practice. We summarized articles on the topics of asthma, rhinitis/rhinosinusitis, food allergy, anaphylaxis, drug allergy, urticarial/angioedema, eosinophilic disorders, and immunodeficiency. Within each topic, epidemiologic findings are presented, relevant aspects of prevention are described, and diagnostic and therapeutic advances are enumerated...
January 28, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28137718/bacterial-meningitis-a-rare-complication-of-an-unrecognised-nasal-foreign-body-in-a-child
#11
Jana van der Veen, Simon Thorne
We present an interesting case of a 7-year-old child who developed severe bacterial meningitis requiring admission to paediatric ICU. Initial investigations failed to identify the reason for this otherwise healthy child to develop this life-threatening condition. The child recovered fully with no long-term sequelae. Further on-going unilateral purulent rhinorrhoea lead to ENT referral. CT head from a previous admission showed mucosal thickening and fluid within paranasal sinuses. Reluctance to expose the child to further radiation meant that no formal scan of sinuses was organised and the child was diagnosed with chronic rhinosinusitis...
January 30, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28126352/preclinical-evaluation-of-luffa-operculata-cogn-and-its-main-active-principle-in-the-treatment-of-bacterial-rhinosinusitis
#12
Leonardo Silva, Henrique Olival Costa, Flávia Coelho de Souza, Elaine Monteiro Cardoso Lopes, Suely Mitoi Ykko Ueda
INTRODUCTION: The prevalence of rhinosinusitis is quite high. Despite the widespread use of antibiotics for rhinosinusitis, there are other forms of treatment, including phytotherapy. One of the most widely used herbal medicines for treatment of rhinosinusitis is Luffa operculata. OBJECTIVE: This study aimed to evaluate the efficacy of topical nasal solution of the aqueous extract of L. operculata, determining the toxicity to its use and identifying the active principles presented in the aqueous extract...
December 26, 2016: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28124653/practice-patterns-in-pediatric-chronic-rhinosinusitis-a-survey-of-the-american-rhinologic-society
#13
Daniel M Beswick, Hassan Ramadan, Fuad M Baroody, Peter H Hwang
BACKGROUND: The management of pediatric chronic rhinosinusitis (PCRS) is evolving. OBJECTIVE: To assess current practice patterns of members of the American Rhinologic Society (ARS) in managing PCRS. METHODS: A 27-item Web-based survey on treatment of PCRS was electronically distributed to the ARS membership. RESULTS: The survey was completed by 67 members, 40% of whom had completed a rhinology fellowship. The most frequently used medical therapies as part of initial treatment for PCRS were nasal saline solution irrigation, (90%), topical nasal steroids (93%), oral antibiotics (52%), and oral steroids (20%)...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124652/culture-directed-topical-antibiotic-treatment-for-chronic-rhinosinusitis
#14
Victoria S Lee, Greg E Davis
BACKGROUND: Topical antibiotics, delivered optimally as high-volume culture-directed sinus irrigations, are being increasingly used for recalcitrant chronic rhinosinusitis (CRS). Their impact on subjective and objective outcome measures, however, is still unclear. OBJECTIVE: To assess if the use of topical antibiotics in recalcitrant CRS is associated with improved 20-Item Sino-Nasal Outcome Test and Lund-Kennedy endoscopic scores, and to determine the negative posttreatment culture "control" rate...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124651/aspirin-exacerbated-respiratory-disease-prevalence-diagnosis-treatment-and-considerations-for-the-future
#15
Joshua L Kennedy, Ashley N Stoner, Larry Borish
Aspirin-exacerbated respiratory disease (AERD) is a late onset condition characterized by the Samter triad (aspirin sensitivity [as well as sensitivity to any nonselective cyclooxygenase inhibitor], nasal polyps, asthma) and additional features, including eosinophilic chronic rhinosinusitis, hypereosinophilia, anosmia, frequent absence of atopy, and, intolerance to ingestion of red wine and other alcoholic beverages. The diagnosis is rare, and, because of this, it is also often missed by physicians. However, it is highly overexpressed in patients with severe asthma (and severe chronic rhinosinusitis with nasal polyps), which makes its recognition essential...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28124646/failure-of-itraconazole-to-prevent-t-helper-type-2-cell-immune-deviation-implications-for-chronic-rhinosinusitis
#16
Joshua L Kennedy, John W Steinke, Lixia Liu, Julie Negri, Larry Borish, Spencer C Payne
BACKGROUND: T-helper (Th) type 2 cell inflammation is the hallmark of several disease processes, including asthma, atopic dermatitis, and some forms of chronic rhinosinusitis. Itraconazole has been used as both an antifungal and an anti-inflammatory agent, with some success in many of these diseases, in part, by altering Th2 cytokine expression by T cells. It is not known whether this merely reflects inhibition of established Th2-like cells or the inhibition of differentiation of naive T cells into Th2-like cells...
November 1, 2016: American Journal of Rhinology & Allergy
https://www.readbyqxmd.com/read/28117652/topical-treatment-of-mycotic-rhinitis-rhinosinusitis-in-dogs-with-meticulous-debridement-and-1-clotrimazole-cream-64-cases-2007-2014
#17
Katarina Hazuchova, Reto Neiger, Christiane Stengel
OBJECTIVE To evaluate outcomes for dogs with mycotic rhinitis-rhinosinusitis (MRR) treated by meticulous debridement and topical application of 1% clotrimazole cream and investigate potential prognostic factors that could help predict whether 1 or multiple treatments would be needed for clinical resolution of the condition. DESIGN Retrospective case series. ANIMALS 64 dogs. PROCEDURES Medical records were reviewed to identify dogs treated for MRR by meticulous debridement and topical application of 1% clotrimazole cream...
February 1, 2017: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/28116488/antibiofilm-effects-of-topical-corticosteroids-and-intranasal-saline-in-patients-with-chronic-rhinosinusitis-with-nasal-polyps-depend-on-bacterial-species-and-their-biofilm-forming-capacity
#18
Ivana Cirkovic, Bojan Pavlovic, Dragana D Bozic, Ana Jotic, Ljubica Bakic, Jovica Milovanovic
Microbial biofilms have been implicated in the pathogenesis of chronic rhinosinusitis with nasal polyposis (CRSwNP). Intranasal application of corticosteroids and saline is a reliable option for their management. The aim of our study was to evaluate in vitro antibiofilm effects of corticosteroids and isotonic and hypertonic nasal saline in CRSwNP patients. The sinus mucosal specimens were harvested from the ethmoid cavity of 48 patients with CRSwNP and further subjected to hematoxylin-eosin staining and microbiology analysis...
January 23, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28114954/endoscopic-sinus-surgery-in-adult-patients-with-chronic-rhinosinusitis-with-nasal-polyps-polypess-study-protocol-for-a-randomised-controlled-trial
#19
Evelijn S Lourijsen, Corianne A J M de Borgie, Marleen Vleming, Wytske J Fokkens
BACKGROUND: Chronic rhinosinusitis with nasal polyps is a chronic disease frequently seen in otorhinolaryngological practice. Along with its chronic disease burden it creates high societal costs. Therapy consists of long-term use of medication and, if insufficient, endoscopic sinus surgery. No consensus exists on the right timing and extent of disease that warrants surgery. Furthermore, there is lack of clinical knowledge about the benefit of surgery over medication only. The current trial evaluates the clinical effectiveness and cost-effectiveness of endoscopic sinus surgery in addition to drug treatment versus medication exclusively in the adult patient group with nasal polyps...
January 23, 2017: Trials
https://www.readbyqxmd.com/read/28092201/evaluation-of-a-steroid-releasing-sinus-implant-for-the-treatment-of-patients-undergoing-frontal-sinus-surgery-for-chronic-rhinosinusitis
#20
Sean Bury, Ameet Singh
Management of the frontal sinus places great demands on the otolaryngologist. Given that the fronto-ethmoidal region is susceptible to recurrent inflammation, scarring, and stenosis, maintaining long-term patency of the frontal sinus is a difficult challenge. Oral and topical anti-inflammatory therapy, post-operative stenting, and 'home-brew' drug elution have been used for the treatment of the frontal sinus with mixed success. Recently an implant has been approved for post-operative placement into the frontal recess...
February 2017: Expert Review of Medical Devices
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