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https://www.readbyqxmd.com/read/27906696/medical-therapy-refractory-chronic-rhinosinusitis-and-productivity-costs
#1
Kristine A Smith, Luke Rudmik
PURPOSE OF REVIEW: The purpose of this review is to address the most recent advances in the medical therapy for chronic rhinosinusitis (CRS), define recalcitrant and refractory CRS, and discuss the productivity costs associated with CRS. RECENT FINDINGS: Recent studies evaluating anti-IL-4 receptor α antibodies and calcium channel blockers have demonstrated promising early results during management of CRS. Recent appropriateness criteria have been developed to assist clinicians with defining which patients have 'refractory' CRS and may be considered candidates for endoscopic sinus surgery...
November 30, 2016: Current Opinion in Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27906610/infectious-complications-after-cytoreductive-surgery-and-hyperthermic-intra-peritoneal-chemotherapy
#2
Naciye Cigdem Arslan, Selman Sokmen, Vildan Avkan-Oguz, Funda Obuz, Aras Emre Canda, Cem Terzi, Mehmet Fuzun
BACKGROUND: The aim of this study was to review the post-operative and infectious complications and determine the risk factors associated with infections in cytoreductive surgery (CRS) and hyperthermic intra-peritoneal chemotherapy (HIPEC). PATIENTS AND METHODS: Between October 2007 and December 2013, patients who underwent CRS and HIPEC with a curative intent were included in the study. The Centers for Disease Control and Prevention's National Nosocomial Infections Surveillance System definitions were used to identify post-operative nosocomial infections...
December 1, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27903594/chronic-rhinosinusitis-and-the-evolving-understanding-of-microbial-ecology-in-chronic-inflammatory-mucosal-disease
#3
REVIEW
Michael Hoggard, Brett Wagner Mackenzie, Ravi Jain, Michael W Taylor, Kristi Biswas, Richard G Douglas
Chronic rhinosinusitis (CRS) encompasses a heterogeneous group of debilitating chronic inflammatory sinonasal diseases. Despite considerable research, the etiology of CRS remains poorly understood, and debate on potential roles of microbial communities is unresolved. Modern culture-independent (molecular) techniques have vastly improved our understanding of the microbiology of the human body. Recent studies that better capture the full complexity of the microbial communities associated with CRS reintroduce the possible importance of the microbiota either as a direct driver of disease or as being potentially involved in its exacerbation...
January 2017: Clinical Microbiology Reviews
https://www.readbyqxmd.com/read/27903354/-the-characteristics-of-hiv-positive-men-who-have-sex-with-men-in-china-and-predictors-of-their-migration-2008-2015
#4
Q Q Qin, W Guo, L Y Wang, Z W Ding, C Cai, Y Cui, J P Sun
Objective: To characterize the migration patterns of men who have sex with men (MSM) living with HIV/AIDS in the period 2008-2015 and to characterize the determinants of their migration. Methods: All identified HIV/AIDS cases transmitted through self-reported homosexual contact reported to the National Case Reporting System(CRS) by the end of December 31, 2015 were included in this study. Data of basic demographic characteristics, household registration and address of the research objects were collected. Retrospective cohort study was used to analyze the migration characteristics of HIV/AIDS cases between 2008 and 2015...
November 6, 2016: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
https://www.readbyqxmd.com/read/27902866/bacterial-community-collapse-a-meta-analysis-of-the-sinonasal-microbiota-in-chronic-rhinosinusitis
#5
Brett Wagner Mackenzie, David W Waite, Michael Hoggard, Richard G Douglas, Michael W Taylor, Kristi Biswas
Chronic rhinosinusitis (CRS) is a common, debilitating condition characterized by long-term inflammation of the nasal cavity and paranasal sinuses. The role of the sinonasal bacteria in CRS is unclear. We conducted a meta-analysis combining and reanalyzing published bacterial 16S rRNA sequence data to explore differences in sinonasal bacterial community composition and predicted function between healthy and CRS affected subjects. The results identify the most abundant bacteria across all subjects as Staphylococcus, Propionibacterium, Corynebacterium, Streptococcus, and an unclassified lineage of Actinobacteria...
November 30, 2016: Environmental Microbiology
https://www.readbyqxmd.com/read/27898453/resolution-of-rectal-prolapse-by-vaginal-reconstruction
#6
Hemikaa Devakumar, Neeraja Chandrasekaran, Alexandriah Alas, Laura Martin, G Willy Davila, Eric Hurtado
BACKGROUND: Rectal prolapse is a disorder of the pelvic floor in which the layers of the rectal mucosa protrude outward through the anus. Surgical repair is the mainstay of treatment. Options include intra-abdominal procedures such as rectopexy and perineal procedures such as the Delorme and Altemeier perineal rectosigmoidectomy. Rectal and vaginal prolapse can often coexist. However, to our knowledge, there are no reported cases of rectal prolapse resolved by the repair of a compressive enterocele abutting the anterior rectal wall through a vaginal approach alone...
November 28, 2016: Female Pelvic Medicine & Reconstructive Surgery
https://www.readbyqxmd.com/read/27896512/cytoreduction-peritonectomy-procedures-combined-with-hyperthermic-intraperitoneal-chemotherapy-hipec-in-advanced-ovarian-cancer-retrospective-italian-multicenter-observational-study-of-511-cases
#7
Angelo Di Giorgio, Pierandrea De Iaco, Michele De Simone, Alfredo Garofalo, Giovanni Scambia, Antonio Daniele Pinna, Giorgio Maria Verdecchia, Luca Ansaloni, Antonio Macrì, Paolo Cappellini, Valerio Ceriani, Giorgio Giorda, Daniele Biacchi, Marco Vaira, Mario Valle, Paolo Sammartino
PURPOSE: The aim of this study was to help with the process of selecting patients with advanced ovarian cancer to undergo cytoreductive surgery (CRS) with hyperthermic intraperitoneal chemotherapy (HIPEC) by analyzing outcome data at distinct clinical time points reflecting the natural history of the disease. METHODS: In a retrospective Italian multicenter study investigating patients with advanced ovarian cancer who underwent CRS plus HIPEC between 1998 and 2014, we analyzed data for consecutive patients at eight treatment time points: primary debulking surgery (PDS); interval debulking surgery after partial response, after no response, and after a pathologic complete response to neoadjuvant chemotherapy; first recurrence with a progression-free interval >12, <12 months, or >12 months in patients who underwent further chemotherapy before CRS and HIPEC; and patients who underwent two or more CRS procedures and chemotherapy lines before CRS and HIPEC...
November 28, 2016: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/27895473/calf-raise-senior-a-new-test-for-assessment-of-plantar-flexor-muscle-strength-in-older-adults-protocol-validity-and-reliability
#8
Helô-Isa André, Filomena Carnide, Edgar Borja, Fátima Ramalho, Rita Santos-Rocha, António P Veloso
PURPOSE: This study aimed to develop a new field test protocol with a standardized measurement of strength and power in plantar flexor muscles targeted to functionally independent older adults, the calf-raise senior (CRS) test, and also evaluate its reliability and validity. PATIENTS AND METHODS: Forty-one subjects aged 65 years and older of both sexes participated in five different cross-sectional studies: 1) pilot (n=12); 2) inter- and intrarater agreement (n=12); 3) construct (n=41); 4) criterion validity (n=33); and 5) test-retest reliability (n=41)...
2016: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/27895276/rubella-immunity-in-pregnant-native-taiwanese-and-immigrants-from-asian-countries
#9
Yeong-Hwa Zen, Ching-Tang Shih, Wan-Ju Kung, Chien-Hung Lee, Ching-Chiang Lin
Vaccination is considered the most effective method to prevent rubella spread and congenital rubella syndrome (CRS). The aim of the present study was to investigate the rubella immunity among native and immigrant pregnant women in Taiwan. From 2000 to 2014, a total of 16,879 pregnant women who received routine prenatal examinations were recruited in this study. The rubella IgG antibodies were assayed using a microparticle enzyme immunoassay or chemiluminescent microparticle immunoassay. Subjects were categorized by nationality and subcategorized by specific periods of time for comparison...
November 28, 2016: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/27894328/effect-of-driving-pressure-on-mortality-in-ards-patients-during-lung-protective-mechanical-ventilation%C3%A2-in-two-randomized-controlled-trials
#10
Claude Guérin, Laurent Papazian, Jean Reignier, Louis Ayzac, Anderson Loundou, Jean-Marie Forel
BACKGROUND: Driving pressure (ΔPrs) across the respiratory system is suggested as the strongest predictor of hospital mortality in patients with acute respiratory distress syndrome (ARDS). We wonder whether this result is related to the range of tidal volume (VT). Therefore, we investigated ΔPrs in two trials in which strict lung-protective mechanical ventilation was applied in ARDS. Our working hypothesis was that ΔPrs is a risk factor for mortality just like compliance (Crs) or plateau pressure (Pplat,rs) of the respiratory system...
November 29, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27893686/association-between-cigarette-smoking-and-interleukin-17a-expression-in-nasal-tissues-of-patients-with-chronic-rhinosinusitis-and-asthma
#11
Chien-Chia Huang, Chun-Hua Wang, Chia-Hsiang Fu, Chi-Che Huang, Po-Hung Chang, Yi-Wei Chen, Chia-Chen Wu, Pei-Wen Wu, Ta-Jen Lee
Cigarette smoke plays a substantial role in the development of airway inflammatory diseases, including asthma and chronic rhinosinusitis (CRS). Interleukin (IL)-17A might contribute to cigarette smoke-related inflammation of the airway. This study aimed to investigate the association between cigarette smoking and IL-17A expression in the nasal tissues of patients with CRS and asthma.We prospectively recruited 24 patients (13 smokers, 11 nonsmokers) with CRS and asthma and 6 patients with asthma but without CRS (control group) in a tertiary medical center...
November 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27891335/a-comparative-evaluation-of-different-diagnostic-modalities-in-the-diagnosis-of-typhoid-fever-using-a-composite-reference-standard-a-tertiary-hospital-based-study-in-central-india
#12
Veena Maheshwari, Navinchandra Motiram Kaore, Vijay Kumar Ramnani, Sheil Sarda
INTRODUCTION: Enteric fever, caused by Salmonella spp. is a major cause of morbidity and mortality worldwide and endemic in many developing countries including India and other South-East Asian countries. Blood culture is regarded as the gold standard for diagnosis. Currently, the standard serological method is tube agglutination with moderate sensitivity and specificity. Dot blot assay detecting IgM and IgG antibodies to a specific 50kD Outer Membrane Protein (OMP) antigen of Salmonella spp...
October 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/27890349/clinical-features-and-outcomes-of-20-patients-with-abdominopelvic-desmoplastic-small-round-cell-tumor
#13
F A Angarita, S Hassan, A J Cannell, B C Dickson, R A Gladdy, C J Swallow, A Gupta, M E Blackstein, J A McCart
INTRODUCTION: Desmoplastic small round cell tumor (DSRCT) is a rare mesenchymal malignancy. We describe our experience with treating DSRCT at a large sarcoma referral center. METHODS: A retrospective chart review was performed on DSRCT patients referred to our institution (1998-2014). Pathology specimens were reviewed to confirm the diagnosis. Clinical and imaging were extracted and summarized with descriptive statistics. Univariate analysis was performed to evaluate the association between patient, tumor, and treatment variables and overall survival (OS)...
October 4, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27890084/comparison-of-molecular-and-conventional-methods-for-the-diagnosis-of-fasciola-hepatica-infection-in-the-field
#14
Maria Immaculata Arifin, Johan Höglund, Adam Novobilský
The liver fluke, Fasciola hepatica, is one of the major parasite threats to livestock industries world-wide. In sheep and cattle, F. hepatica infection is commonly diagnosed using a range of methods. Aside from conventional coprological and serological diagnostic methods, there are also several molecular methods available based on the detection of liver fluke DNA in faeces. In this study, the outcomes of faecal egg count (FEC), serology and coproantigen ELISA (cELISA) were compared with the performance of polymerase chain reaction (PCR) and loop-mediated isothermal amplification (LAMP) in diagnosis of F...
December 15, 2016: Veterinary Parasitology
https://www.readbyqxmd.com/read/27888915/biofilm-and-osteitis-in-refractory-chronic-rhinosinusitis
#15
REVIEW
Yi Chen Zhao, Peter-John Wormald
Our understanding of chronic rhinosinusitis (CRS) show biofilm and osteitis play a role in the disease's pathogenesis and refractory. Studies point to its role in pathogenesis and poor prognosis. Outside the research laboratory, biofilm detection remains difficult and specific treatment remains elusive. It is believed that osteitis is a nidus of inflammation and occurs more commonly in patients with refractory CRS. However, osteitis may be exacerbated by surgery and a marker of refractory disease, not a causative agent...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888914/bacterial-pathogens-and-the-microbiome
#16
REVIEW
Thad W Vickery, Vijay R Ramakrishnan
Bacterial pathogens and microbiome alterations can contribute to the initiation and propagation of mucosal inflammation in chronic rhinosinusitis (CRS). In this article, the authors review the clinical and research implications of key pathogens, discuss the role of the microbiome, and connect bacteria to mechanisms of mucosal immunity relevant in CRS.
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888910/genetic-and-immune-dysregulation-in-chronic-rhinosinusitis
#17
REVIEW
Ashleigh Halderman, Andrew P Lane
Chronic rhinosinusitis (CRS) is a prevalent condition that is heterogeneous in disease characteristics and multifactorial in cause. Although sinonasal mucosal inflammation in CRS is often either reversible or well-managed medically and surgically, a significant proportion of patients has a refractory form of CRS despite maximal therapy. Two of the several described factors thought to contribute to disease recalcitrance are genetic influences and dysfunction of the host immune system. Current evidence for a genetic basis of CRS is reviewed, as it pertains to putative abnormalities in innate and adaptive immune function...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888909/topical-therapies-for-refractory-chronic-rhinosinusitis
#18
REVIEW
Akshay Sanan, Mindy Rabinowitz, Marc Rosen, Gurston Nyquist
Topical therapy has become an important tool in the otolaryngologist's armamentarium for refractory chronic rhinosinusitis (CRS). Daily high-volume sinonasal saline irrigation and standard metered-dose topical nasal steroid therapy are supported by the most evidence. Nonstandard topical sinonasal steroid therapies are a potential option for refractory CRS. Current evidence recommends against the use of topical antifungal therapy and topical antibiotic therapy delivered using spray and nebulized techniques in routine cases of CRS...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888908/office-procedures-in-refractory-chronic-rhinosinusitis
#19
REVIEW
Andrew Thamboo, Zara M Patel
Office procedures in chronic rhinosinusitis (CRS) can be considered before and after medical management, as well as before and after surgical management. This article focuses specifically on refractory CRS, meaning those patients who have failed medical and surgical management already. The options available in the management of refractory CRS depend on the personnel, equipment, and instrumentation available in the office setting; surgeon experience; and patient suitability and tolerability. This article provides readers with possible procedural options that can be done in their clinics with indications, patient selection, potential complications, and postoperative considerations...
February 2017: Otolaryngologic Clinics of North America
https://www.readbyqxmd.com/read/27888907/classification-of-chronic-rhinosinusitis-working-toward-personalized-diagnosis
#20
REVIEW
Adam S DeConde, Timothy L Smith
An estimated 4.5% of total US health care dollars have been devoted to mitigating chronic rhinosinusitis. The most recalcitrant of these patients undergo surgery, which fails to improve symptoms in approximately 25% of patients. Recent advances in informational, microbiomic, and genomic analysis have introduced the first set of tools that patients, physicians, politicians, and payers can apply to better forecast which patients will respond favorably to endoscopic sinus surgery. This article summarizes the forces driving the application of personalized medicine to CRS and how new advances can be applied to clinical practice...
February 2017: Otolaryngologic Clinics of North America
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