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Rhinosinusitis treatment

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https://www.readbyqxmd.com/read/29350840/a-phase-3-trial-of-mometasone-furoate-sinus-implants-for-chronic-sinusitis-with-recurrent-nasal-polyps
#1
Robert C Kern, J Pablo Stolovitzky, Stacey L Silvers, Ameet Singh, Jivianne T Lee, David M Yen, Alfred M C Iloreta, Francis P J Langford, Boris Karanfilov, Keith E Matheny, James W Stambaugh, Anna K Gawlicka
BACKGROUND: Topical intranasal corticosteroid sprays (INCSs) are standard treatment for nasal polyps (NPs), but their efficacy is reduced by poor patient compliance and impaired access of drug to the sinus mucosa. A corticosteroid-eluting sinus implant was designed to address these limitations in patients with recurrent polyposis after sinus surgery by delivering 1350 μg of mometasone furoate (MF) directly to the ethmoid sinus mucosa over approximately 90 days. METHODS: A randomized, sham-controlled, double-blind trial was undertaken in 300 adults with refractory chronic rhinosinusitis with NPs (CRSwNP), who were candidates for repeat surgery...
January 19, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29350016/biomarkers-of-treatment-efficacy-in-patients-with-chronic-spontaneous-urticaria
#2
M Sánchez-Borges, A Capriles-Hulett, F Caballero-Fonseca, L González-Aveledo
Background. Currently there are no biomarkers useful to predict the future evolution and the therapeutic response in patients with chronic spontaneous urticaria (CSU). Objective. To review the available information on biomarkers that might be applied for the follow up of the response to guideline recommended therapies for CSU. Methods. A review of the medical literature on CSU potential clinical and laboratory biomarkers in PubMed and MEDLINE including the terms urticaria, chronic urticaria, chronic idiopathic urticaria, chronic spontaneous urticaria, antihistamines (AHs), omalizumab (OMA), cyclosporine (CyA), and treatment...
January 2018: European Annals of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/29341450/characterization-of-a-novel-papain-inducible-murine-model-of-eosinophilic-rhinosinusitis
#3
Anuj Tharakan, Alex Dobzanski, Nyall R London, Syed M Khalil, Nitya Surya, Andrew P Lane, Murugappan Ramanathan
BACKGROUND: Eosinophilic chronic rhinosinusitis (ECRS) is a disease characterized by eosinophilic inflammatory infiltrate and a local type 2 cytokine milieu. Current animal models fail to recapitulate many of the innate and adaptive immunologic hallmarks of the disease, thus hindering the development of effective therapeutics. In the present study, mice were exposed intranasally to the cysteine protease papain, which shares functional similarities with parasitic proteases and aeroallergens, to generate a rapidly inducible murine model of eosinophilic rhinosinusitis...
January 17, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29331025/multidimensional-endotypes-of-chronic-rhinosinusitis-and-their-association-with-treatment-outcomes
#4
Bo Liao, Jin-Xin Liu, Zhi-Yong Li, Zhen Zhen, Ping-Ping Cao, Yin Yao, Xiao-Bo Long, Heng Wang, Yan Wang, Robert Schleimer, Zheng Liu
BACKGROUND: The expression of chronic rhinosinusitis (CRS) is multidimensional. Disease heterogeneity in patients with CRS remains poorly understood. This study aimed to identify endotypes of CRS using cluster analysis by integrating multidimensional characteristics and to explore their association with treatment outcomes. METHODS: A total of 28 clinical variables and 39 mucosal cellular and molecular variables were analyzed using principal component analysis. Cluster analysis was performed on 246 prospectively recruited Chinese CRS patients with at least one-year post-operative follow-up...
January 13, 2018: Allergy
https://www.readbyqxmd.com/read/29323796/treatment-of-chronic-rhinosinusitis-with-dornase-alfa-in-patients-with-cystic-fibrosis-a-systematic-review
#5
Gopi B Shah, Linde De Keyzer, Joy A Russell, Ashleigh Halderman
BACKGROUND: A major component of sputum in cystic fibrosis (CF) patients is polymerized DNA, a byproduct of degraded neutrophils. Dornase alfa (dornase) selectively cleaves extracellular DNA and reduces the viscosity of sputum. It improves mucociliary clearance and pulmonary function. The benefit of dornase on CF-associated sinusitis is less clear. Therefore, the objective of this study was to systematically review the use of dornase on chronic rhinosinusitis (CRS) in CF patients. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement was followed for this systematic review...
January 11, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29316300/asthma-onset-pattern-and-patient-outcomes-in-a-chronic-rhinosinusitis-population
#6
Christopher Jones, Caroline P E Price, Ava R Weibman, Kevin C Welch, David B Conley, Stephanie Shintani-Smith, Whitney W Stevens, Anju T Peters, Leslie Grammer, Alcina K Lidder, Robert P Schleimer, Robert C Kern, Bruce K Tan
BACKGROUND: Chronic rhinosinusitis (CRS) is strongly associated with comorbid asthma. This study compares early-onset and late-onset asthma in a CRS population using patient-reported and clinical characteristics. METHODS: At enrollment into a clinical registry, CRS patients completed the 22-item Sino-Nasal Outcome Test (SNOT-22), Asthma Control Test (ACT), mini-Asthma Quality of Life Questionnaire (miniAQLQ), the 29-item Patient-Reported Outcomes Measurement Information System (PROMIS-29), and medication use questionnaires...
January 5, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29306959/-unknown-title
#7
C Hopkins, R Hettige, A Soni-Jaiswal, R Lakhani, S Carrie, A Cervin, R Douglas, W J Fokkens, R Harvey, P W Hellings, A Leunig, V J Lund, C Philpott, T Smith, D Y Wang, L Rudmik
STATEMENT OF PROBLEM: Evaluating the effectiveness of treatments in chronic rhinosinusitis (CRS) have been limited by both a paucity of high quality randomised trials, and the heterogeneity of outcomes in those that have been reported. Core outcome sets (COS) are an agreed, standardized set of outcomes that should be measured and reported by future trials as a minimum and will facilitate future meta-analysis of trial results in systematic reviews (SRs). We set out to develop a core outcome set for interventions for adults with CRS...
January 7, 2018: Rhinology
https://www.readbyqxmd.com/read/29306958/case-control-study-of-endoscopic-polypectomy-in-clinic-epic-versus-endoscopic-sinus-surgery-for-chronic-rhinosinusitis-with-polyps
#8
S J Kilty, A Lasso, L Mfuna-Endam, M Y Desrosiers
INTRODUCTION: Endoscopic Polypectomy In Clinic (EPIC) is a recently described deescalated form of endoscopic sinus surgery (ESS) performed in the outpatient clinic for patients with chronic rhinosinusitis with polyps (CRSwNP). The quality of life benefit of EPIC in comparison to ESS is not known. The purpose of this study was to determine if the disease specific quality of life measured with the SNOT-22 attained with EPIC is similar to that attained with ESS for patients with CRSwNP. METHODS: A multi-institutional observational case-control study was performed to evaluate quality of life improvement in patients treated with ESS and EPIC for CRSwNP with a 3 month follow-up...
January 7, 2018: Rhinology
https://www.readbyqxmd.com/read/29299516/clinical-efficacy-of-a-topical-lactic-acid-bacterial-microbiome-in-chronic-rhinosinusitis-a-randomized-controlled-trial
#9
Anders Mårtensson, Milad Abolhalaj, Malin Lindstedt, Anette Mårtensson, Tobias C Olofsson, Alejandra Vásquez, Lennart Greiff, Anders Cervin
Objective: A locally disturbed commensal microbiome might be an etiological factor in chronic rhinosinusitis (CRS) in general and in CRS without nasal polyps (CRSsNP) in particular. Lactic acid bacteria (LAB) have been suggested to restore commensal microbiomes. A honeybee LAB microbiome consisting of various lactobacilli and bifidobacteria have been found potent against CRS pathogens in vitro. Recently, we examined effects of single nasal administrations of this microbiome in healthy subjects and found it inert...
December 2017: Laryngoscope Investigative Otolaryngology
https://www.readbyqxmd.com/read/29298507/conservative-management-for-subperiosteal-orbital-abscess-in-adults-a-20-year-experience
#10
Haim Gavriel, Basel Jabarin, Ofer Israel, Ephraim Eviatar
OBJECTIVE: Orbital complications (OC) secondary to acute rhinosinusitis (ARS) in adults are less common than in children, with assumed worse outcome. MATERIALS AND METHODS: Adults with OC secondary to ARS between 1994 and 2014 were reviewed retrospectively. Parameters recorded included age, gender, clinical symptoms and signs, computed tomography (CT) scan findings, duration of hospitalization, treatment before and during admission, cultures, and outcome. RESULTS: Thirty-seven adults with a mean age of 34...
January 1, 2018: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/29289975/how-deep-is-the-inflammation-in-chronic-rhinosinusitis-sinus-wall-thickness-and-blood-eosinophilia
#11
K Y Lin, P Y Chen, T H Yeh
Various factors have been proposed to be related to refractory chronic rhinosinusitis (CRS). Treatment for refractory CRS is challenging for ear, nose, and throat (ENT) surgeons. The aim of the study was to determine the clinical features associated with the severity of CRS that may necessitate revision surgery by eliminating the bias of the surgeons technique using standardizing surgical procedures. Sinus wall thickness and blood eosinophilia, which may represent the depth of inflammation in CRS, are associated with the need for revision surgery...
December 31, 2017: Rhinology
https://www.readbyqxmd.com/read/29288573/omalizumab-treats-chronic-rhinosinusitis-with-nasal-polyps-and-asthma-together-a-real-life-study
#12
T Bidder, J Sahota, C Rennie, V J Lund, D S Robinson, H H Kariyawasam
INTRODUCTION: Chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma often coexist and thus treating both with one intervention is an attractive strategy. OBJECTIVE: To prospectively evaluate whether treatment with the monoclonal antibody against IgE Omalizumab for severe allergic asthma also effectively treats co-existent CRSwNP. METHODS: SNOT-22 and the ACQ-7 scores were recorded at 4 and 16 weeks of treatment in a cohort of patients with both CRSwNP and severe refractory allergic asthma treated with Omalizumab (n=13) according to UK guidelines for their severe asthma...
December 30, 2017: Rhinology
https://www.readbyqxmd.com/read/29286163/using-ifn-%C3%AE-antibodies-to-identify-the-pathogens-of-fungal-rhinosinusitis-a-novel-immunohistochemical-approach
#13
Yuyan Yan, Zuotao Zhao, Gehong Dong, Yiding Han, Dongmei Yang, Hongyan Yin, Yingshi Piao, Chunyan He, Cheng Tian, Hongfei Wan, Xue Li, Yulan Jin, Jugao Fang, Honggang Liu
Fungal rhinosinusitis (FRS) is commonly caused by various Aspergillus species (spp) and Mucorales fungi, and the treatment and prognosis of cases differ depending on the causative fungus. The present study describes a novel immunohistochemical method that has high sensitivity and specificity for distinguishing between these two types of fungi in patients with FRS. Three groups were included in the study. Group A included formalin‑fixed paraffin‑embedded blocks of 51 nasal tissue specimens of patients with FRS (27 Aspergillus spp and 24 Mucorales) that were continuously obtained from the Department of Pathology of Tongren Hospital in Beijing as the experimental group and 34 cultures (26 Aspergillus spp and 8 Mucorales) of FRS that were randomly selected from the bacterial laboratory of Tongren Hospital in Beijing to verify the staining results of the paraffin‑embedded blocks...
December 27, 2017: Molecular Medicine Reports
https://www.readbyqxmd.com/read/29280484/intranasal-tissue-necrosis-associated-with-opioid-abuse-case-report-and-systematic-review
#14
REVIEW
Danielle A Morrison, Sarah K Wise, John M DelGaudio, Naweed I Chowdhury, Joshua M Levy
OBJECTIVE: Opioid abuse is a common disorder affecting over 2 million Americans. Intranasal tissue necrosis is a previously described sequela of nasal opioid inhalation, with a similar presentation to invasive fungal rhinosinusitis (IFRS). The goal of this case report and systematic review is to evaluate the evidence supporting this uncommon disease, with qualitative analysis of the presentation, management and treatment outcomes. DATA SOURCES: MEDLINE, EMBASE, Google Scholar, Scopus, and Web of Science...
December 27, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29279055/chronic-rhinosinusitis-with-nasal-polyps-in-the-elderly-assessing-current-evidence
#15
Gino Marioni, Claudia Zanotti, Giuseppe Brescia
BACKGROUND: The recently reported prevalence of chronic rhinosinusitis (CRS) among people >60 years old was 4.7%, with CRS emerging as the sixth most common chronic condition in the elderly. There is still a dearth of studies that focused on older patients, however, regarding the characteristics of CRS with nasal polyps (CRSwNP). OBJECTIVE: The emerging role of CRSwNP endotyping to enable a tailored medical approach (for elderly patients also) was investigated...
January 1, 2018: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/29249643/chronic-nasal-dysfunction
#16
R Jankowski, D T Nguyen, A Russel, B Toussaint, P Gallet, C Rumeau
Chronic nasal dysfunction is a clinical concept in the diagnostic and therapeutic management of sinonasal diseases, based on the evo-devo theory of formation of the nose according to which the nose is not a single organ but rather an association of three organs: olfactory nose, respiratory nose and paranasal sinuses. In chronic nasal dysfunction theory, etiological diagnosis takes account of the possible pathophysiological independence of nasal symptoms, in accordance with the different origins and physiology of the three organs constituting the nose...
December 14, 2017: European Annals of Otorhinolaryngology, Head and Neck Diseases
https://www.readbyqxmd.com/read/29249187/an-update-on-the-management-of-aspirin-exacerbated-respiratory-disease
#17
Ji-Ho Lee, Chang-Gyu Jung, Hae-Sim Park
Clinical features of aspirin-exacerbated respiratory disease (AERD) consist of moderate to severe asthma associated with chronic rhinosinusitis (CRS), which are derived from overproduction of cysteinyl leukotrienes along with chronic type 2 mediated inflammation in the upper and lower airway mucosa. Area covered: This review provides recent up-to-date information regarding phenotypes of AERD and encompasses comprehensive diagnostic methods and treatment options. To confirm the diagnosis of AERD, provocation testing via nasal, inhalation or the oral route of aspirin remains the gold standard; in vitro diagnostic methods are still not available...
December 18, 2017: Expert Review of Respiratory Medicine
https://www.readbyqxmd.com/read/29244604/lateral-rhinostomy-for-treatment-of-severe-chronic-rhinosinusitis-in-two-rabbits
#18
Louden Wright, Christoph Mans
CASE DESCRIPTION 2 client-owned rabbits were evaluated for signs of chronic upper respiratory tract disease. CLINICAL FINDINGS Clinical signs had been present for 3 weeks and 4 years and included mucopurulent nasal discharge, right-sided maxillary swelling, recurrent dacryocystitis, and intermittent sneezing. One rabbit had been treated with nasolacrimal duct lavage and topical and systemic antimicrobial administration without resolution of clinical signs. Results of CT of the head in both cases indicated severe rhinosinusitis...
January 1, 2018: Journal of the American Veterinary Medical Association
https://www.readbyqxmd.com/read/29240296/bacteriophage-effectively-kills-multidrug-resistant-staphylococcus-aureus-clinical-isolates-from-chronic-rhinosinusitis-patients
#19
Guimin Zhang, Yin Zhao, Sathish Paramasivan, Katharina Richter, Sandra Morales, Peter-John Wormald, Sarah Vreugde
BACKGROUND: Bacteriophage (phage) therapy has been proposed as an alternative to antibiotics. Phages have been shown to kill antibiotic resistant Staphylococcus aureus strains; however, it is unknown whether stress-induced antibiotic tolerance affects S. aureus susceptibility to phages. Our objective was to determine the effectiveness of 2 phages currently in clinical development, against antibiotic-resistant and induced antibiotic-tolerant clinical S. aureus isolates. METHODS: Antibiotic tolerant S...
December 14, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29238574/role-of-guaifenesin-in-the-management-of-chronic-bronchitis-and-upper-respiratory-tract-infections
#20
REVIEW
Helmut H Albrecht, Peter V Dicpinigaitis, Eric P Guenin
Guaifenesin, a mucoactive drug, acts by loosening mucus in the airways and making coughs more productive. It is used for relief of wet cough and chest congestion due to the common cold, and remains the only legally marketed expectorant in the US (per OTC Monograph). An ingredient in numerous over-the-counter (OTC) cough/cold medications, guaifenesin has a secondary indication for use in stable chronic bronchitis (professional indication). Clinical pharmacology and patient studies support the clinical utility of guaifenesin in respiratory conditions where mucus hypersecretion is prevalent: acute upper respiratory tract infections (URTIs), stable chronic bronchitis, and possibly rhinosinusitis...
2017: Multidisciplinary Respiratory Medicine
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