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The effect of open-label placebo on allergic rhinitis symptoms: A systematic review and meta-analysis of randomized controlled trials. 开放标签安慰剂对过敏性鼻炎症状的影响:随机对照试验的系统回顾和荟萃分析。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-30 DOI: 10.1002/alr.23444
Ebraheem Albazee, Abdullah M Alharran, Mooza M Alzayed

Key points: The evidence regarding the open-label placebo effect on allergic rhinitis symptoms remains uncertain. Open-label placebo significantly reduced the frequency of symptoms in allergic rhinitis patients with similar safety profiles; however, there was no effect on the severity of symptoms and impairment due to symptoms. The statistically significant impact on symptom frequency can be considered not clinically significant.

要点:有关开放标签安慰剂对过敏性鼻炎症状影响的证据仍不确定。在安全性相似的情况下,开放标签安慰剂能明显降低过敏性鼻炎患者的症状频率;但对症状的严重程度和症状造成的损害没有影响。从统计学角度看,对症状频率的影响并无临床意义。
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引用次数: 0
Functional and radiological sinonasal outcomes of CFTR modulators for sinus disease in cystic fibrosis: A meta-analysis CFTR调节剂治疗囊性纤维化鼻窦疾病的功能和鼻窦放射学结果:荟萃分析
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-30 DOI: 10.1002/alr.23439
Tristan Tham MD, Felisha A. Li BA, Jacob R. Schneider BS, Matthew I. Saleem MD, Michael T. Werner MD, PhD, Mark B. Chaskes MD, Charles C. L. Tong MD, Judd H. Fastenberg MD

Background

Cystic fibrosis transmembrane conductance regulator (CFTR) modulators improve pulmonary outcomes in cystic fibrosis (CF) by stabilizing the CFTR protein on respiratory epithelial surfaces. To determine the efficacy of CFTR modulators on sinonasal outcomes in patients with CF, we performed a meta-analysis of clinical trials to date that include functional and radiographic evidence of sinus disease.

Methods

English full-text articles were searched in PubMed, Embase, and Scopus databases. Two reviewers screened articles and a third reviewer resolved disagreements. Articles were included if they reported functional or radiological sinonasal outcomes in patients with CF before and after CFTR modulator therapies. Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines were followed, and the risk of bias in non-randomized studies of interventions tool was used for quality assessment. The generic inverse variance method with random effects model was used for meta-analysis. Standardized mean difference (SMD) and mean difference (MD) were used as effect measurements.

Results

Seven prospective and two retrospective studies representing 248 patients were included in this analysis. There was a significant improvement in sinonasal outcome test-22 scores on elexacaftor‒tezacaftor‒ivacaftor (MD = 12.80, [95% confidence interval, CI: 10.46‒15.13], p < 0.001, n = 222), with no heterogeneity detected (I2 = 0%, p = 0.820). There was also a significant improvement in Lund‒Mackay scores (SMD = 1.25, [95% CI: 0.58‒1.91], p < 0.001, n = 88), with heterogeneity detected (I2 = 67%, p = 0.030).

Conclusions

CFTR modulators improve functional and radiologic sinonasal outcomes. Given the utility of CFTR modulators, the treatment paradigm for CF-related chronic rhinosinusitis promises to evolve.

背景:囊性纤维化跨膜传导调节剂(CFTR)调节剂通过稳定呼吸道上皮细胞表面的CFTR蛋白,改善囊性纤维化(CF)患者的肺部预后。为了确定CFTR调节剂对CF患者鼻窦疾病的疗效,我们对迄今为止包含鼻窦疾病功能和影像学证据的临床试验进行了荟萃分析:在 PubMed、Embase 和 Scopus 数据库中检索英文全文文章。两名审稿人对文章进行筛选,第三名审稿人负责解决分歧。如果文章报道了CFTR调节剂治疗前后CF患者鼻窦的功能性或放射学结果,则将其纳入研究。研究遵循《系统综述和Meta分析首选报告项目》指南,并使用非随机干预研究偏倚风险工具进行质量评估。荟萃分析采用随机效应模型的通用逆方差法。采用标准化平均差(SMD)和平均差(MD)作为效应测量指标:本次分析共纳入了七项前瞻性研究和两项回顾性研究,代表了 248 名患者。elexacaftor-tezacaftor-ivacaftor 的鼻窦结果测试-22 评分有明显改善(MD = 12.80,[95% 置信区间,CI:10.46-15.13],P 2 = 0%,P = 0.820)。Lund-Mackay 评分也有明显改善(SMD = 1.25,[95% CI:0.58-1.91],P 2 = 67%,P = 0.030):结论:CFTR调节剂可改善鼻窦功能和放射学结果。鉴于 CFTR 调节剂的效用,CF 相关慢性鼻炎的治疗模式有望得到发展。
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引用次数: 0
EDS-FLU efficacy in patients with chronic rhinosinusitis with or without prior sinus surgery in ReOpen1 and ReOpen2 randomized controlled trials. 在 ReOpen1 和 ReOpen2 随机对照试验中,EDS-FLU 对接受过或未接受过鼻窦手术的慢性鼻窦炎患者的疗效。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-26 DOI: 10.1002/alr.23434
Sarah K Wise, Nithin D Adappa, Rakesh K Chandra, Greg E Davis, Mahboobeh Mahdavinia, Ramy Mahmoud, John Messina, James N Palmer, Zara M Patel, Anju T Peters, Rodney J Schlosser, Raj Sindwani, Zachary M Soler, Andrew A White

Background: The inability of topical medications to reach sinus cavities is a potential reason for lack of efficacy in chronic rhinosinusitis (CRS). One purpose of endoscopic sinus surgery (ESS) is to enable delivery of medications into the sinus cavities. The exhalation delivery system with fluticasone (EDS-FLU; XHANCE) creates unique biomechanics that enable deposition of intranasal corticosteroid into sinuses and sinus drainage pathways but may have differing efficacy in operated versus unoperated sinuses. Two 24-week randomized trials (ReOpen1/2) evaluated EDS-FLU versus EDS-placebo in patients with CRS, stratified by surgical status.

Methods: Surgery-naive (n = 332) and prior-surgery (n = 215) patient groups were analyzed as pooled data from ReOpen1/2. Outcome measures (least-squares mean change from baseline) included combined symptom score (CSS) and congestion score at weeks 4, 8, and 12 and average of percentages of opacified volume (APOV) of ethmoid/maxillary sinuses on CT and Sinonasal Outcome Test 22 (SNOT-22) total score at week 24.

Results: Baseline scores suggested moderate-severe disease: mean CSS = 5.8; APOV = 67.2%. EDS-FLU produced significant improvement versus placebo (p < 0.05): CSS (surgery-naive, -0.68 vs. -1.42; prior ESS, -0.70 vs. -1.87); congestion (surgery-naive, -0.24 vs. -0.59; prior ESS, -0.24 vs. -0.69); and SNOT-22 (surgery-naive, -7.56 vs. -18.30; prior ESS, -10.72 vs. -18.74). Similar results were observed for APOV (p < 0.05). No statistically significant difference was observed between surgery subgroups with either EDS-FLU dose.

Conclusion: EDS-FLU improved symptoms, sinus opacification, and quality of life in patients with CRS with or without prior ESS, suggesting a role for EDS-FLU in both populations.

背景:外用药物无法进入鼻窦腔是慢性鼻窦炎(CRS)疗效不佳的一个潜在原因。内窥镜鼻窦手术(ESS)的目的之一就是将药物送入鼻窦腔。氟替卡松呼气给药系统(EDS-FLU;XHANCE)具有独特的生物力学原理,能将鼻内皮质类固醇沉积到鼻窦和鼻窦引流通路中,但在手术与未手术鼻窦中的疗效可能不同。两项为期 24 周的随机试验(ReOpen1/2)评估了 EDS-FLU 与 EDS-placebo 对 CRS 患者的疗效,并根据手术状态进行了分层:对ReOpen1/2试验中未接受过手术(n = 332)和接受过手术(n = 215)的患者组进行数据汇总分析。结果测量指标(与基线相比的最小二乘平均变化)包括第 4、8 和 12 周的综合症状评分 (CSS) 和充血评分,以及第 24 周的 CT 检出的乙状窦/上颌窦不通畅体积百分比平均值 (APOV) 和第 22 周的鼻窦结果测试 (SNOT-22) 总分:基线评分显示病情为中重度:平均 CSS = 5.8;APOV = 67.2%。与安慰剂相比,EDS-FLU 有明显改善(PEDS-FLU可改善曾患或未患过ESS的CRS患者的症状、窦不通透性和生活质量,这表明EDS-FLU在这两种人群中都能发挥作用。
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引用次数: 0
Comparative analysis of traditional machine learning and automated machine learning: advancing inverted papilloma versus associated squamous cell carcinoma diagnosis. 传统机器学习与自动机器学习的比较分析:推进倒置乳头状瘤与相关鳞状细胞癌的诊断。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-26 DOI: 10.1002/alr.23438
Farideh Hosseinzadeh, S Saeed Mohammadi, James N Palmer, Michael A Kohanski, Nithin D Adappa, Michael T Chang, Peter H Hwang, Jayakar V Nayak, Zara M Patel

Key points: Inverted papilloma conversion to squamous cell carcinoma is not always easy to predict. AutoML requires much less technical knowledge and skill to use than traditional ML. AutoML surpassed the traditional ML algorithm in differentiating IP from IP-SCC.

要点:倒置乳头状瘤转化为鳞状细胞癌并不总是那么容易预测。与传统的 ML 相比,使用 AutoML 所需的技术知识和技能要少得多。AutoML 在区分 IP 与 IP-SCC 方面超过了传统的 ML 算法。
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引用次数: 0
Letter to the editor regarding “The association between olfactory subdomains and frailty: A prospective case‒control study investigation” 致编辑的信,内容涉及 "嗅觉子域与虚弱之间的关联:前瞻性病例对照研究调查"。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-26 DOI: 10.1002/alr.23432
Le Xu MD, WenJie Zheng MD, JiaLin Feng MD, QinYi Zhou MD, Jun Chen PhD
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引用次数: 0
The impact of cadaveric donor transplant on the development of chronic rhinosinusitis and recalcitrant disease. 尸体供体移植对慢性鼻炎和顽固性疾病发展的影响。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-24 DOI: 10.1002/alr.23429
Estephania Candelo, Anyull D Bohorquez-Caballero, Karol Avila-Castano, Hani Wadei, Angela M Donaldson

Key points: The study found a higher incidence of chronic rhinosinusitis (CRS) and recalcitrant CRS in cadaveric organ transplant recipients compared to those receiving living donor transplants. Recipients of cadaveric transplants were 1.32 times more likely to develop CRS and 1.68 times more likely to develop medically recalcitrant CRS. Living kidney transplants significantly reduced the risk of developing CRS (OR = 0.12) and recalcitrant CRS (OR = 0.11), highlighting a potentially protective effect against these conditions. In contrast, cadaveric liver transplants were associated with an increased risk of CRS and medically recalcitrant CRS. Kaplan-Meier survival analysis indicated a significant difference in time to CRS onset between cadaveric and living donor transplants. Median time to CRS onset was longer for living donor recipients (21.1 months) compared to cadaveric recipients (15.6 months). This study underscores the need for transplant teams and otolaryngologist to consider donor type during transplant follow-up due to differing risks of CRS development.

要点研究发现,与接受活体器官移植的受者相比,尸体器官移植受者的慢性鼻炎(CRS)和顽固性CRS发病率更高。尸体器官移植受者患 CRS 的几率是活体器官移植受者的 1.32 倍,患药物难治性 CRS 的几率是活体器官移植受者的 1.68 倍。活体肾移植大大降低了罹患CRS(OR = 0.12)和顽固性CRS(OR = 0.11)的风险,凸显了对这些疾病的潜在保护作用。相比之下,尸体肝移植与CRS和医学上顽固的CRS风险增加有关。Kaplan-Meier生存分析表明,尸体移植和活体移植的CRS发病时间存在显著差异。活体器官移植受者发生 CRS 的中位时间(21.1 个月)长于尸体器官移植受者(15.6 个月)。这项研究强调,由于 CRS 发生的风险不同,移植团队和耳鼻喉科医生在移植随访过程中需要考虑供体类型。
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引用次数: 0
Letter to the editor regarding “Intralesional cidofovir injections for the treatment of multifocal exophytic sinonasal papilloma”: The utility of topical cidofovir 致编辑的信,内容涉及 "局部注射西多福韦治疗多灶性鼻窦外生乳头状瘤":局部西多福韦的效用。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-23 DOI: 10.1002/alr.23437
Briana R. Halle MD, Edward C. Kuan MD, Melissa Shive MD, MPH
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引用次数: 0
Interpretability of operative and pathological reports for radiotherapy planning of sinonasal carcinomas: An ancillary study of the GORTEC 2016-02 SANTAL trial. 鼻窦癌放疗计划中手术和病理报告的可读性:GORTEC 2016-02 SANTAL试验的辅助研究。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-20 DOI: 10.1002/alr.23433
Coline Labarre, Florent Carsuzaa, Maxime Fieux, Benjamin Verillaud, Antoine Moya Plana, Ludovic de Gabory, Vincent Patron, Francois-Régis Ferrand, Juliette Thariat

Key points: Interpretation of surgical mapping is essential for postoperative radiotherapy planning. Operative and pathological reports lack comprehensive information on margins quality and tissue block mapping. Standardizing reports is essential to reduce uncertainties, aiming for less morbid poRT.

要点:解读手术图谱对术后放疗计划至关重要。手术和病理报告缺乏关于边缘质量和组织块映射的全面信息。标准化报告对减少不确定性至关重要,其目的是降低放疗的发病率。
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引用次数: 0
Reply to: Confounders in the association between olfactory subdomains and frailty 回复:嗅觉亚域与虚弱之间关系的干扰因素。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-20 DOI: 10.1002/alr.23430
Michael Z Cheng MD, Varun Vohra BS, Hang Wang MS, Akhil Katuri BS, Jackie Langdon MS, Qian-Li Xue PhD, Nicholas R Rowan MD
{"title":"Reply to: Confounders in the association between olfactory subdomains and frailty","authors":"Michael Z Cheng MD,&nbsp;Varun Vohra BS,&nbsp;Hang Wang MS,&nbsp;Akhil Katuri BS,&nbsp;Jackie Langdon MS,&nbsp;Qian-Li Xue PhD,&nbsp;Nicholas R Rowan MD","doi":"10.1002/alr.23430","DOIUrl":"10.1002/alr.23430","url":null,"abstract":"","PeriodicalId":13716,"journal":{"name":"International Forum of Allergy & Rhinology","volume":"14 9","pages":"1541-1542"},"PeriodicalIF":7.2,"publicationDate":"2024-08-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142004173","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Reply to: “Intralesional cidofovir injections for the treatment of multifocal exophytic sinonasal papilloma”: The utility of topical cidofovir 答复"局部注射西多福韦治疗多灶性鼻窦外生乳头状瘤":局部西多福韦的效用。
IF 7.2 2区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-08-20 DOI: 10.1002/alr.23436
Florian Chatelet MD, MPH, Alessandro Vinciguerra, Morgane Marc, Benjamin Verillaud, Philippe Herman
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引用次数: 0
期刊
International Forum of Allergy & Rhinology
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