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Rhinosinusitis treatment

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https://www.readbyqxmd.com/read/28333393/laser-generated-shockwaves-enhance-antibacterial-activity-against-biofilms-in-vitro
#1
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
#2
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/28306159/positioning-the-principles-of-precision-medicine-in-care-pathways-for-allergic-rhinitis-and-chronic-rhinosinusitis-an-euforea-aria-epos-airways-icp-statement
#3
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/28290230/cilia-and-ear
#4
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
#5
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/28284780/a-structured-approach-to-specialist-referred-difficult-asthma-patients-improves-control-of-comorbidities-and-enhances-asthma-outcomes
#6
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
#7
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/28281440/monoclonal-antibody-therapy-in-sinonasal-disease
#8
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/28279811/selective-expansion-of-human-regulatory-t-cells-in-nasal-polyps-and-not-adjacent-tissue-microenvironments-in-individual-patients-exposed-to-steroids
#9
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
https://www.readbyqxmd.com/read/28272838/mortality-risk-in-patients-with-chronic-rhinosinusitis-and-its-association-to-asthma
#10
Jeremiah A Alt, Andrew J Thomas, Karen Curtin, Jathine Wong, Luke Rudmik, Richard R Orlandi
BACKGROUND: Chronic rhinosinusitis (CRS) is a highly prevalent inflammatory condition, with significant effects on morbidity and quality of life. Given that other chronic inflammatory conditions have been associated with increased mortality risk, we sought to evaluate the relationship between mortality and CRS including the influence of asthma. Our objective was to determine if CRS, with or without asthma, is associated with altered risk of mortality. METHODS: Using a statewide population database, we retrospectively identified 27,005 patients diagnosed with CRS between 1996 and 2012, and 134,440 unaffected controls matched 5:1 on birth year and sex...
March 8, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28261021/immune-cell-responses-and-mucosal-barrier-disruptions-in-chronic-rhinosinusitis
#11
REVIEW
Roza Khalmuratova, Jong-Wan Park, Hyun-Woo Shin
Chronic rhinosinusitis (CRS) is one of the most common presentations of upper airway illness and severely affects patient quality of life. Its frequency is not surprising given levels of environmental exposure to microbes, pollutants, and allergens. Inflammatory cells, inflammatory cytokine and chemokine production, and airway remodeling have been detected in the sinonasal mucosae of CRS patients, although the precise pathophysiological mechanisms causing such persistent inflammation remain unclear. Given its high prevalence and considerable associated morbidity, continued research into CRS is necessary to increase our understanding of factors likely to contribute to its pathogenesis, and facilitate the development of novel therapeutic strategies to improve treatment...
February 2017: Immune Network
https://www.readbyqxmd.com/read/28260781/new-therapeutic-approach-to-treat-allergic-rhinitis-bronchial-asthma-considering-these-two-as-one-united-airway-disease
#12
M A Rahman, R Chakraborty, K R Ferdousi, A Alam, M K Chowdhury, B K Paul
The relationship between allergic rhinitis and asthma is now established, and most of the clinical, epidemiological and biological data recommend integrated management. This review discusses rhinosinusitis as a co-morbid condition, a precipitating or triggering condition, and an epiphenomenon as an integrated part of the disease. A better understanding and a more pragmatic method of diagnosis and management is needed using cost-effective long-term strategies. Allergic Rhinitis, though a non-life threatening disease, its pathogenesis reveals that Bronchial Asthma also develops by the same aetiopathogenesis...
January 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/28251318/isolated-sphenoid-sinus-fungus-ball-a-retrospective-study-conducted-at-a-tertiary-care-referral-center-in-korea
#13
Hyun-Sil Lim, Young Hoon Yoon, Jun Xu, Yong Min Kim, Ki-Sang Rha
Fungus ball (FB) is the most common form of extramucosal fungal rhinosinusitis involving one or more paranasal sinuses. The sphenoid sinus is an uncommon site of this disease. Here, we present our 20-year experience of managing isolated sphenoid sinus FB (SSFB). We retrospectively reviewed a series of 47 cases of isolated SSFB encountered between 1996 and 2015 with reference to the chronological incidence, demographics, clinical features, radiological findings, treatment modalities, and outcome. Recently, the number of patients with isolated SSFB has increased markedly...
March 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28248603/cochrane-corner-extracts-from-the-cochrane-library
#14
Richard Orlandi, Clair Hopkins, Carl Philpott, Richard M Rosenfeld
The Cochrane Corner is a section in the journal that highlights systematic reviews relevant to otolaryngology-head and neck surgery, with invited commentary to aid clinical decision making. This installment features a pair of related Cochrane Reviews on intranasal steroids for chronic rhinosinusitis, which identify low- to moderate-quality evidence for a beneficial effect on overall symptoms, nasal congestion, and rhinorrhea. There is no evidence, however, to suggest superiority of any particular steroid preparation or drug delivery system...
March 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28242868/risk-factors-of-chronic-rhinosinusitis-after-functional-endoscopic-sinus-surgery
#15
Feng Juan, Qukuerhan Ayiheng, Fan Yuqin, Zhang Hua, Yong Jun, Hu Bin
BACKGROUND Clinical data of 288 chronic rhinosinusitis patients were retrospectively analyzed to investigate the risk factors of clinical prognosis, aiming to provide clinical evidence for the diagnosis and treatment of chronic rhinosinusitis. MATERIAL AND METHODS A total of 288 patients diagnosed with chronic rhinosinusitis in the Department of Otolaryngology of the First Affiliated Hospital of Xinjiang Medical University were recruited. Among all participants, 177 were male and 111 were female, aged from 22 to 83 years, (52±14) years on average...
February 28, 2017: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
https://www.readbyqxmd.com/read/28231590/endotypes-in-chronic-rhinosinusitis-biomarkers-based-on-a-mechanistic-insight-for-targeted-treatment
#16
Martin Wagenmann, Kathrin Scheckenbach, Adam M Chaker
Chronic rhinosinusitis is an umbrella term for several phenotypes and mechanistically distinct inflammatory diseases of the nose and the paranasal sinuses affecting around 11% of the population in Europe and the USA. Approximately 20% of the patients present with uncontrolled disease despite adequate treatment, and revision surgery is common. While a clinical characterization alone does not improve treatment results, novel but expensive biologics have increasingly become available, but they require a better understanding of the mechanism...
2017: ORL; Journal for Oto-rhino-laryngology and its related Specialties
https://www.readbyqxmd.com/read/28231370/significance-of-imaging-in-the-diagnosis-of-olfactory-disorder
#17
Teemu Harju, Markus Rautiainen, Ilkka Kivekäs
The aim of this retrospective analysis was to examine olfactory disorders among the patients in the Ear, Nose, and Throat Clinic of Tampere University Hospital, Finland, from 2001 to 2011, and to evaluate the necessity of imaging in the examination of patients with olfactory disorders. Charts of 143 consecutive patients with a primary olfactory disorder were examined, and 69 patients who had undergone the necessary testing were included in the study. The most common causes of olfactory disorder were upper respiratory infection (23%), chronic rhinosinusitis (19%), head trauma (17%), and allergic or nonallergic rhinitis (6%)...
February 2017: Ear, Nose, & Throat Journal
https://www.readbyqxmd.com/read/28218486/determinants-and-outcomes-of-upfront-surgery-versus-medical-therapy-for-chronic-rhinosinusitis-in-cystic-fibrosis
#18
Noel Ayoub, Andrew Thamboo, Al-Rahim Habib, Jayakar V Nayak, Peter H Hwang
BACKGROUND: The indications for surgical management of chronic rhinosinusitis (CRS) in patients with cystic fibrosis (CF) are poorly defined. In this study we compare outcomes of medical versus surgical treatment and examine trends associated with the transition from medical to surgical therapy in CF patients. METHODS: One hundred thirty-six patients with CF referred to a tertiary rhinology practice were retrospectively divided into 3 cohorts: Medical, Upfront Surgery, or Crossover, if they converted from medical to surgical management...
February 20, 2017: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/28216249/position-statement-of-the-brazilian-academy-of-rhinology-on-the-use-of-antihistamines-antileukotrienes-and-oral-corticosteroids-in-the-treatment-of-inflammatory-sinonasal-diseases
#19
Olavo de Godoy Mion, João Ferreira de Mello, Daniel Lorena Dutra, Nilvano Alves de Andrade, Washington Luiz de Cerqueira Almeida, Wilma Teresinha Anselmo-Lima, Leonardo Lopes Balsalobre Filho, Jair de Carvalho E Castro, Roberto Eustáquio Dos Santos Guimarães, Marcus Miranda Lessa, Sérgio Fabrício Maniglia, Roberto Campos Meireles, Márcio Nakanishi, Shirley Shizue Nagata Pignatari, Renato Roithmann, Fabrizio Ricci Romano, Rodrigo de Paula Santos, Marco César Jorge Dos Santos, Edwin Tamashiro
INTRODUCTION: Inflammatory conditions of the nose and paranasal sinuses are very prevalent in the general population, resulting in marked loss of quality of life in affected patients, as well as significant work, leisure, and social activity losses. These patients require specific and specialized treatment. A wide range of oral medications are available. OBJECTIVE: The present document is aimed to clarify, for professionals treating patients with inflammatory sinonasal diseases, both specialists and general practitioners, specific oral therapies in noninfectious nasal inflammatory conditions...
January 21, 2017: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28215205/effectiveness-of-extensive-sinus-surgery-with-post-operative-medical-management-for-chronic-rhinosinusitis
#20
A J Wood, L Zhou, S Wilkinson, R G Douglas
OBJECTIVE: To prospectively assess treatment outcomes of chronic rhinosinusitis patients undergoing functional endoscopic sinus surgery and post-operative medical treatment over a prolonged follow-up period. METHODS: Patients undergoing functional endoscopic sinus surgery in the tertiary referral practice of a single surgeon were studied prospectively. Symptoms were scored by patients pre-operatively and over a minimum follow-up period of 12 months. RESULTS: The study comprised 200 non-consecutive patients...
February 20, 2017: Journal of Laryngology and Otology
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