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Rhinosinusitis treatment

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https://www.readbyqxmd.com/read/28434014/prospective-open-label-evaluation-of-long-term-low-dose-doxycycline-for-difficult-to-treat-chronic-rhinosinusitis-with-nasal-polyps
#1
A C Pinto Bezerra Soter, T F Bezerra, R Pezato, T R Teles Abdo, R M Pilan, F R Pinna, P Gevaert, T van Zele, C Bachert, R L Voegels
BACKGROUND: This study aimed to assess clinical outcomes of long-term low-dose oral doxycycline therapy in difficult-to-treat chronic rhinosinusitis with polyps (CRSwNP). METHODS: This was a prospective, open-label study of 60 patients with difficult-to-treat CRSwNP who had undergone endoscopic sinus surgery. Patients were divided into two groups: 28 received nasal steroids, saline irrigation, and doxycycline (200 mg on the first day, followed by 100 mg once daily) for 12 weeks, while 30 received only nasal steroids and saline irrigation...
April 23, 2017: Rhinology
https://www.readbyqxmd.com/read/28429305/the-role-of-macrolides-in-chronic-rhinosinusitis-crssnp-and-crswnp
#2
REVIEW
Gretchen M Oakley, Richard J Harvey, Valerie J Lund
PURPOSE OF REVIEW: We assess the literature on the pharmacokinetics, indications, important considerations, and effectiveness of long-term, low-dose macrolide antibiotics in chronic rhinosinusitis (CRS). RECENT FINDINGS: The key to effective implementation of macrolide therapy in CRS is appropriate patient selection. Macrolides have demonstrated the most benefit in Th1-mediated non-eosinophilic CRS when used for durations of at least 3 months. Macrolide antibiotics have demonstrated great benefit when used for their anti-inflammatory or immunomodulatory properties, which include the blockage of pro-inflammatory cytokines, such as interleukin (IL)-8 and tumor necrosis factor-α (TNF-α)...
May 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28429163/antimicrobial-susceptibility-of-bacterial-isolates-from-patients-presenting-with-ear-nose-and-throat-ent-infections-in-the-german-community-healthcare-setting
#3
B Olzowy, M Kresken, M Havel, D Hafner, B Körber-Irrgang
Empiric initial antibiotic therapy of bacterial infections is based primarily upon the susceptibility of the most common causative pathogens. The purpose of this study was to provide susceptibility data on six bacterial species known to cause ear, nose and throat (ENT) infections. A total of 1066 isolates collected during a nationwide laboratory-based surveillance study were analysed. All Streptococcus pyogenes isolates were penicillin (PEN)-susceptible, indicating that natural penicillins can still be recommended as the first-line treatment for group A streptococcal tonsillopharyngitis...
April 20, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/28398635/serum-periostin-relates-to-type-2-inflammation-and-lung-function-in-asthma-data-from-the-large-population-based-cohort-swedish-ga-2-len
#4
Anna James, Christer Janson, Andrei Malinovschi, Cecile Holweg, Kjell Alving, Junya Ono, Shoichiro Ohta, Alexandra Ek, Roelinde Middelveld, Barbro Dahlén, Bertil Forsberg, Kenji Izuhara, Sven-Erik Dahlén
BACKGROUND: Periostin has been suggested as a novel, phenotype-specific biomarker for asthma driven by type-2 inflammation. However, large studies examining relationships between circulating periostin and patient characteristics are lacking and the suitability of periostin as a biomarker in asthma remains unclear. AIM: To examine circulating periostin in healthy controls and subjects with asthma from the general population with different severity and treatment profiles, both with and without chronic rhinosinusitis (CRS), in relation to other biomarkers and clinical characteristics...
April 11, 2017: Allergy
https://www.readbyqxmd.com/read/28393053/the-effect-of-topical-tranexamic-acid-on-bleeding-reduction-during-functional-endoscopic-sinus-surgery
#5
Mohammad Hossein Baradaranfar, Mohammad Hossein Dadgarnia, Hossein Mahmoudi, Nasim Behniafard, Saeid Atighechi, Vahid Zand, Amin Baradaranfar, Sedighe Vaziribozorg
INTRODUCTION: Bleeding is a common concern during functional endoscopic sinus surgery (FESS) that can increase the risk of damage to adjacent vital elements by reducing the surgeon's field of view. This study aimed to explore the efficacy of topical tranexamic acid in reducing intraoperative bleeding. MATERIALS AND METHODS: This double-blind, randomized clinical trial was conducted in 60 patients with chronic rhinosinusitis with polyposis (CRSwP) who underwent FESS...
March 2017: Iranian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/28390807/xylitol-nasal-irrigation-in-the-treatment-of-chronic-rhinosinusitis
#6
Lin Lin, Xinyue Tang, Jinjin Wei, Fei Dai, Guangbin Sun
OBJECTIVE: To evaluate the efficacy of xylitol nasal irrigation (XNI) treatment on chronic rhinosinusitis (CRS) and to investigate the effect of XNI on nasal nitric oxide (NO) and inducible nitric oxide synthase (iNOS) mRNA in maxillary sinus. MATERIALS AND METHODS: Patients with CRS were enrolled and symptoms were assessed by Visual Analog Scale (VAS) and Sino-Nasal Outcome Test 22 (SNOT-22). Nasal NO and iNOS mRNA in the right maxillary sinus were also examined...
April 4, 2017: American Journal of Otolaryngology
https://www.readbyqxmd.com/read/28389843/impact-of-respiratory-virus-infections-in-exacerbation-of-acute-and-chronic-rhinosinusitis
#7
REVIEW
Kai Sen Tan, Yan Yan, Hsiao Hui Ong, Vincent T K Chow, Li Shi, De-Yun Wang
Rhinosinusitis (RS) is a symptomatic disease classification of many causes and is a major economic burden worldwide. It is widely accepted that RS is further classified into acute (ARS) and chronic (CRS) rhinosinusitis based on the duration of the symptoms, and that viral infection plays a large role in initiating or potentiating the disease. In this review, we examine the role of respiratory virus infection in the exacerbation of ARS and CRS. We explore the epidemiology of viral exacerbation of ARS and CRS and highlight key viruses that may cause exacerbation...
April 2017: Current Allergy and Asthma Reports
https://www.readbyqxmd.com/read/28389065/nattokinase-profibrinolytic-enzyme-effectively-shrinks-the-nasal-polyp-tissue-and-decreases-viscosity-of-mucus
#8
Tetsuji Takabayashi, Yoshimasa Imoto, Masafumi Sakashita, Yukinori Kato, Takahiro Tokunaga, Kanako Yoshida, Norihiko Narita, Tamotsu Ishizuka, Shigeharu Fujieda
BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) is often comorbid with asthma and resistant to therapeutic interventions. We recently reported that excessive fibrin deposition caused by impairment of fibrinolysis might play pivotal role in forming nasal polyp. Nattokinase (NK), a serine protease produced by Bacillus subtilis, has been reported to be a strong fibrinolytic enzyme. NK could be a promising drug candidate for use in the treatment of both CRSwNP and asthma. The objective of this study was to investigate the effects of NK on nasal polyp tissues from patients with CRSwNP...
April 4, 2017: Allergology International: Official Journal of the Japanese Society of Allergology
https://www.readbyqxmd.com/read/28387090/-how-to-approach-a-chronic-cough
#9
R Louis
Cough is the most common symptom for which patients seek medical attention. Chronic cough is defined when the symptom lasts for more than 8 weeks. It significantly alters quality of life. Chronic cough may be the dominant symptom which reveals a large number of diseases, not only respiratory. It is classic to distinguish chronic cough according to the chest X Ray results. In case of normal chest X ray, which is the most frequent condition, the diagnosis of tobacco-associated chronic bronchitis, drug induced cough, asthma, oesophageal reflux and rhinosinusitis should be considered...
February 2017: Revue Médicale de Liège
https://www.readbyqxmd.com/read/28374869/non-surgical-management-of-chronic-rhinosinusitis-with-nasal-polyps-based-on-clinical-cytological-grading-a-precision-medicine-based-approach
#10
M Gelardi, L Iannuzzi, M De Giosa, S Taliente, N De Candia, N Quaranta, E De Corso, V Seccia, G Ciprandi
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a common inflammatory disorder that strongly impacts patients' quality of life. CRSwNP is still a challenge for ENT specialists due to its unknown pathogenesis, difficult control and frequent relapse. We tested the hypothesis that a new standardised therapeutic approach based on individual clinical-cytological grading (CCG), may improve control of the disease and prevent the needing for surgery. We analysed 204 patients suffering from bilateral CRSwNP, 145 patients of whom regularly assumed therapy, respecting the planned check-up, and were considered cases; 59 patients were not assuming therapy as indicated and were considered as controls...
February 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28374868/the-value-of-nigella-sativa-in-the-treatment-of-experimentally-induced-rhinosinusitis
#11
O Yoruk, A Tatar, O N Keles, A Cakir
The aim of this study was to investigate the effect of Nigella sativa and cephalexin in the therapy of experimental bacterial rhinosinusitis. Bacterial rhinosinusitis was induced with Staphylococcus aureus. Rabbits were divided into five groups; control (n = 6), N. sativa 50 mg/ kg/d (n = 6), N. sativa 100 mg/kg/d (n = 6), N. sativa 200 mg/kg/d (n = 6), and cephalexin 20 mg/kg/d (n = 6) groups. N. sativa was given orally for 7 days. The same volume of normal saline (0.9% NaCl) was given as a vehicle to the control group for the same period...
February 2017: Acta Otorhinolaryngologica Italica
https://www.readbyqxmd.com/read/28366482/monoclonal-antibodies-for-the-treatment-of-nasal-polyps
#12
REVIEW
Thomas J Willson, Robert M Naclerio, Stella E Lee
Biologics are novel therapeutic medications developed for the targeted therapy for a variety of inflammatory conditions. The biologics currently investigated for the treatment of chronic rhinosinusitis (CRS) with nasal polyps modulate specific inflammatory pathways involved in the pathogenesis of disease. Investigations have focused on the most severe form of the disease, namely, CRS with nasal polyps. It is hoped that specific targeted therapies using these biologics can significantly modulate the immune system, offering both disease control and symptomatic relief...
May 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28366474/inflammatory-disorders-associated-with-allergy-overview-of-immunopathogenesis-and-implications-for-treatment
#13
REVIEW
Jonathan Corren
A number of chronic inflammatory diseases are associated with IgE-mediated immunologic hypersensitivity, including atopic dermatitis, chronic rhinosinusitis, and asthma. Pathogenetic studies of well-characterized patient groups has allowed investigators to more precisely define the molecular pathways involved in these diseases. Specific cytokines and chemokines, as well as other unique proteins, have now been identified in each of these common disorders and a number of medications are currently in development for inhibiting their actions...
May 2017: Immunology and Allergy Clinics of North America
https://www.readbyqxmd.com/read/28365802/biomarkers-in-the-evaluation-and-management-of-chronic-rhinosinusitis-with-nasal-polyposis
#14
REVIEW
Yao Yao, Shumin Xie, Chunguang Yang, Jianhui Zhang, Xuewen Wu, Hong Sun
Chronic rhinosinusitis with nasal polyposis (CRSwNP) is a group of multifactorial and heterogeneous disorders with a significant economic strain on society, likely made up of different endotypes, each with a unique pathomechanism. In addition to the traditional clinical measures, there is a recognized need for reliable biomarkers to provide predictive information regarding diagnosis, endotypes, treatment responses, and future risk of recurrence. Fueled by the advances in basic research, various biomarkers have been explored in recent years...
April 1, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28333393/laser-generated-shockwaves-enhance-antibacterial-activity-against-biofilms-in-vitro
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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