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The management of posterior epistaxis in the United Kingdom, a national survey 英国后路鼻出血的处理,一项全国性调查
Pub Date : 2022-01-31 DOI: 10.4193/rhinol/21.056
A. Mowat, P. Meakin, S. Anastasiadou, R. Bidaye, S. Anari
Background: Posterior bleeds account for 5% of epistaxis. The patient cohort is often elderly and has significant co-morbidities. Such cases have been managed historically with urinary catheters, held in place with umbilical clips. Recently bespoke, double balloon, posterior packs have been utilised. The treatments remain in clinical equipoise with no gold standard or clear national guideline. Methodology: A ten question survey was sent out through www.surveymonkey.com. Attempts were made to contact all Trusts in the United Kingdom via the ENT on call service. A comparison of treatment costs was made. Results: 112 responses have been received. 54% of respondents reported a preference for bespoke posterior pack insertion, only 12% preferred catheters. Twice as many respondents have seen complications from urinary catheters: 14% vs 29%. The availability of posterior packs is inconsistent: 30% of respondents were not aware of the packs or reported them unavailable in their hospital. Conclusions: This survey provides the first comparison of the techniques in the United Kingdom. Bespoke packs have a lower complication rate and are preferred by ENT clinicians on the front line of patient care. We recommend that all UK trusts should stock posterior packs which should be used as first line treatment for cases of posterior epistaxis.
背景:鼻出血中后部出血占5%。患者队列通常是老年人,并且有显著的合并症。这类病例在历史上一直使用导尿管,用脐带夹固定。最近使用了定制的双气囊后装。这些治疗方法仍处于临床平衡状态,没有黄金标准或明确的国家指导方针。方法:通过www.surveymonkey.com发送了一份十个问题的调查。试图通过耳鼻喉科的电话服务联系英国的所有信托机构。对治疗费用进行了比较。结果:收到112份答复。54%的受访者表示更喜欢定制后包插入,只有12%的人更喜欢导管。两倍多的受访者看到导尿管并发症:14%对29%。后部包的可用性不一致:30%的受访者不知道这些包,或报告他们的医院没有这些包。结论:这项调查首次对英国的技术进行了比较。定制包并发症发生率较低,是耳鼻喉科一线临床医生的首选。我们建议所有英国信托机构都应储备后部鼻出血包,作为后部鼻出血病例的一线治疗。
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引用次数: 0
Translation and validation of the “Smell Diskettes” Olfaction Test into Arabic “嗅觉软盘”嗅觉测试的阿拉伯语翻译和验证
Pub Date : 2022-01-31 DOI: 10.4193/rhinol/21.041
N. Alotaibi, H. Alsheikh, A. Zahlan, F. Almana, S. Abduljawwad, O. Omar, A. Alshehri, A. Mohammed, S. Alsaleh
Objective: This study aims to translate and validate the 'Smell Diskettes' screening tool from English into Arabic. The significance of this study stems from the lack of reliable and rapid olfaction screening tests available to Arabic speaking patients and healthcare practitioners. Methods: This is a prospective cohort, multi-center study. A forward-backward translation of the olfaction screening test was done to translate the text into Arabic. Data was collected from two groups: a control group (n=125) of which 84 percent were females (n=105) and a mean age of 22.4 of subjectively normosmic individuals from Alfaisal University and a patients group (n=82) of which 35.4 percent females (n = 29) with a mean age of 38.2, all of whom were diagnosed with olfactory disturbances related to rhinological pathologies, from King Abdulaziz University Hospital (KAUH) in Riyadh, Saudi Arabia. One of the limitations we faced due to convenience sampling and COVID-19 pandemic restrictions was the inability to perform a “test-retest” on study subjects. Results: The study included 207 subjects, out of whom 82 (40 percent) were patients from the rhinology clinic at King Abdulaziz University Hospital (KAUH) and 125 (60 percent) were recruited as controls from Alfaisal University. The average olfaction scores for the control group and the patients’ group were 7/8 and 5/8, respectively. Conclusion: This study has determined that the Arabic-language version is a valid and useful instrument used in clinical practice and for research purposes. The development of this tool will allow more patients in Arabic-speaking countries to be screened for olfactory disturbances.
目的:本研究旨在将“气味磁盘”筛选工具从英语翻译成阿拉伯语并进行验证。这项研究的意义源于缺乏可靠和快速的嗅觉筛查测试,可用于阿拉伯语患者和保健从业人员。方法:这是一项前瞻性队列、多中心研究。对嗅觉筛选测试进行了前后翻译,将文本翻译成阿拉伯语。数据收集自两组:来自阿尔费萨尔大学的控制组(n=125),其中84%为女性(n=105),平均年龄为22.4岁;来自沙特阿拉伯利雅得的阿卜杜勒阿齐兹国王大学医院(KAUH)的患者组(n=82),其中35.4%为女性(n= 29),平均年龄为38.2岁,所有患者均被诊断患有与鼻病理相关的嗅觉障碍。由于采样方便和COVID-19大流行的限制,我们面临的限制之一是无法对研究对象进行“重新测试”。结果:该研究包括207名受试者,其中82名(40%)来自阿卜杜勒阿齐兹国王大学医院(KAUH)的鼻科诊所,125名(60%)来自阿尔费萨尔大学作为对照。对照组和患者组的平均嗅觉评分分别为7/8分和5/8分。结论:本研究确定阿拉伯语版本是临床实践和研究目的的有效和有用的工具。这一工具的开发将允许更多阿拉伯语国家的患者接受嗅觉障碍筛查。
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引用次数: 0
From SARS-CoV-2 infection to COVID-19 morbidity: an in silico projection of virion flow rates to the lower airway via nasopharyngeal fluid boluses 从SARS-CoV-2感染到COVID-19发病:通过鼻咽液丸向下气道的病毒粒子流速的计算机预测
Pub Date : 2022-01-27 DOI: 10.4193/rhinol/21.053
S. Basu, M. Akash, N. Hochberg, B. Senior, D. Joseph-McCarthy, A. Chakravarty
Background: While the nasopharynx is initially the dominant upper airway infection site for SARS-CoV-2, the physiologic mechanism launching the infection at the lower airway is still not well-understood. Based on the rapidity of infection progression to the lungs, it has been hypothesized that the nasopharynx may be acting as the primary seeding zone for subsequent contamination of the lower airway via aspiration of virus-laden boluses of nasopharyngeal fluids. Methodology: To examine the plausibility of the aspiration-driven mechanism, we have computationally tracked the inhalation process in three anatomic airway reconstructions and have quantified the nasopharyngeal liquid volume transmitted to the lower airspace during each aspiration. Results: Extending the numerical trends on aspiration volume to earlier records on aspiration frequencies indicates a total aspirated nasopharyngeal liquid volume of 0.3 – 0.76 ml/day. Subsequently, for mean sputum viral load, our modeling projects that the number of virions reaching the lower airway will range over 2.1×106 – 5.3×106 /day; for peak viral load, the corresponding number hovers between 7.1×108 – 1.8×109. Conclusions: The virion transmission findings fill in a key piece of the mechanistic puzzle on the systemic progression of SARS-CoV-2, and subjectively point to health conditions like dysphagia, with proclivity to increased aspiration, as some of the potential underlying risk factors for aggressive lung infections.
背景:虽然鼻咽部最初是SARS-CoV-2的主要上呼吸道感染部位,但下呼吸道感染的生理机制尚不清楚。根据感染向肺部进展的速度,有假设认为鼻咽部可能是通过吸入携带病毒的鼻咽部液体导致下气道污染的主要播种区。方法:为了检验吸入驱动机制的合理性,我们在三个解剖气道重建中计算跟踪了吸入过程,并量化了每次吸入时传递到下空域的鼻咽部液体体积。结果:将吸入量的数值趋势扩展到早期的吸入频率记录,表明鼻咽液总吸入量为0.3 - 0.76 ml/d。随后,对于平均痰病毒载量,我们的模型预测到达下气道的病毒粒子数量将在2.1×106 - 5.3×106 /天之间;对于峰值病毒载量,相应的数字在7.1×108 - 1.8×109之间徘徊。结论:病毒粒子传播的发现填补了SARS-CoV-2系统性进展机制之谜的关键部分,主观上指出了吞咽困难等健康状况,以及吸气增加的倾向,是侵袭性肺部感染的一些潜在潜在危险因素。
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引用次数: 4
Intranasal trigeminal sensitivity may be impaired after functional nasal surgery 鼻腔功能性手术后,鼻内三叉神经敏感性可能受损
Pub Date : 2022-01-27 DOI: 10.4193/rhinol/21.049
C. Migneault-Bouchard, F. Boselie, B. Landis, J. Frasnelli
Functional nasal surgery is frequently performed for sinonasal diseases not responding to medical treatment. Although surgery mostly turns out to be successful in such cases, a potential side effect of manipulating the nasal mucous membrane is impairment of intranasal trigeminal function. Not well known by specialists and clinically scarcely explored, this function provides sensory information from the nasal mucosa. It is responsible for the afferent part of protective nasal reflexes such as sneezing and coughing, but also provides the feeling of nasal airflow (1). Recent work suggests that patients with low intranasal trigeminal function are more prone to suffer from nasal obstruction and may be less satisfied with functional surgery (2-6). It has been suggested that intranasal trigeminal function decreases with mucosal changes, such as chronic inflammation and improves again once the inflammation has been treated (3). However, the influence of functional nasal surgery (i.e. surgery aimed at the improvement of nasal function) with consecutive mucosal micro-injuries on intranasal trigeminal function is not yet fully clear (2-4).
鼻腔功能性手术经常用于治疗对药物治疗没有反应的鼻腔疾病。尽管在这种情况下,手术大多是成功的,但操纵鼻粘膜的潜在副作用是损害鼻内三叉神经功能。这种功能不为专家所知,临床上也很少探索,它提供了来自鼻粘膜的感觉信息。它负责保护性鼻反射的传入部分,如打喷嚏和咳嗽,但也提供鼻腔气流的感觉(1)。最近的研究表明,鼻内三叉神经功能低下的患者更容易患鼻阻塞,可能对功能性手术不太满意(2-6)。有人认为,鼻内三叉神经功能随着粘膜变化(如慢性炎症)而降低,一旦炎症得到治疗,三叉神经功能就会再次改善(3)。然而,功能性鼻手术(即旨在改善鼻功能的手术)和连续的粘膜微损伤对鼻内三叉神经功能的影响尚不完全清楚(2-4)。
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引用次数: 1
A cost analysis of local anaesthetic nose and sinus surgery for the treatment of chronic rhinosinusitis 局部麻醉鼻窦手术治疗慢性鼻窦炎的成本分析
Pub Date : 2022-01-20 DOI: 10.4193/rhinol/21.050
W. Green, S. Carrie, Shahzad Ahmed, F. Goromonzi, James Stockle, E. Bell
Background: People with chronic rhinosinusitis may be referred for endoscopic sinus surgery (ESS), a procedure commonly performed under general anaesthesia, once maximal medical therapy has failed. A new pathway of care is emerging: Local Anaesthetic Nose & Sinus Surgery (LANSS). With LANSS the patient is not placed under general anaesthesia, but instead the procedure is performed under a local anaesthetic. Methodology: A decision analytic model was developed from the perspective of the UK National Health Service (NHS) to assess the potential cost impact of LANSS versus current standard care pathway for ESS. Results: Modelling indicated that the introduction of LANSS would generate substantial savings of around £84,500 per year if introduced to a typical NHS trust with a large otolaryngology department undertaking 300 ESS procedures per year. These savings are generated as a proportion of the ESS procedures no longer need to be completed in an operating theatre, which reduces operational costs (saving around £64,500 per year), plus the use of local anaesthetic instead of general anaesthetic and a reduction in the time a patient spends as an inpatient. Conclusions: The uptake of LANSS could generate cost-savings of around £84,500 per year to a typical NHS trust in the UK.
背景:慢性鼻窦炎患者可能需要进行内窥镜鼻窦手术(ESS),这是一种通常在全身麻醉下进行的手术,一旦最大的药物治疗失败。一种新的护理途径正在出现:局部麻醉鼻窦手术(LANSS)。使用LANSS时,患者不处于全身麻醉,而是在局部麻醉下进行手术。方法:从英国国民健康服务(NHS)的角度开发了一个决策分析模型,以评估LANSS与目前ESS标准护理途径的潜在成本影响。结果:建模表明,如果将LANSS引入典型的NHS信托,每年将产生大约84,500英镑的大量节省,其中大型耳鼻喉科每年承担300个ESS程序。这些节省是由于ESS手术的一部分不再需要在手术室完成,这降低了运营成本(每年节省约64,500英镑),加上使用局部麻醉而不是全身麻醉,减少了患者的住院时间。结论:LANSS的采用可以产生每年约84,500英镑的成本节约,以典型的NHS信托在英国。
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引用次数: 0
Office based inferior turbinate coblation treatment: a randomized controlled trial on effectiveness and tolerability of medicinal honey 办公室为基础的下鼻甲消融治疗:药用蜂蜜的有效性和耐受性的随机对照试验
Pub Date : 2022-01-20 DOI: 10.4193/rhinol/21.044
T. W. Aukema, M. Edens, A. B. Rinia
Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.
背景:当鼻阻塞的保守治疗失败时,通常采用手术治疗。下鼻甲肥大(ITH)是鼻阻塞的常见原因,可通过射频消融术进行治疗。这项技术可以在局部麻醉(办公室麻醉;OBC)下进行,如果合适的话,还可以结合下鼻甲(IT)的侧化(骨折外)。软膏以医用蜂蜜为基础,具有伤口愈合特性。方法:单中心、单盲随机对照试验。55名受试者接受了双侧OBC的IT治疗。受试者被随机分配到术后护理,使用生理盐水冲洗(NSI)或NSI联合蜂蜜软膏(NSI+STB)。受试者每周通过VAS评分主观报告总体鼻腔负担、结痂、疼痛、嗅觉丧失,通过NL-NOSE量表主观报告鼻腔阻塞。结果:NSI组和NSI+STB组之间没有显著差异,尽管后者表现出较少的疼痛。就整个研究组而言,平均鼻负荷评分和鼻阻塞分别从63.4显著降低到16.0和65.3显著降低到22.0。术后3-4周,鼻腔结痂、疼痛和嗅觉丧失基本消失,症状轻微。伴随的偏侧显示出更快解决鼻塞的趋势。结论:OBC是一种安全、耐受性好、有效的治疗ITH引起的鼻梗阻的方法。关于多个终点,我们没有发现任何证据表明蜂蜜软膏在NSI的基础上对术后护理有有益效果,除了明显减少结痂和疼痛。
{"title":"Office based inferior turbinate coblation treatment: a randomized controlled trial on effectiveness and tolerability of medicinal honey","authors":"T. W. Aukema, M. Edens, A. B. Rinia","doi":"10.4193/rhinol/21.044","DOIUrl":"https://doi.org/10.4193/rhinol/21.044","url":null,"abstract":"Background: When conservative treatment for nasal obstruction fails, surgery is often applied. Inferior Turbinate Hypertrophy (ITH) is a common cause of nasal obstruction, which can be treated by means of radiofrequency coblation. This technique can be administered under local anesthesia (office based coblation; OBC) and if expedient combined with a lateralization (out-fracture) of the inferior turbinate (IT). Ointment based on medical grade honey, is known to have wound healing characteristics. Methodology: Single center, single blinded randomized controlled trial. Fifty-five subjects received bilateral OBC of the IT. Subjects were randomized to postoperative care with either nasal saline irrigations (NSI) or NSI combined with ointment based on honey (NSI+STB). Subjects weekly reported subjectively overall nasal burden, -crusting, -pain, loss of smell by means of VAS-scores and nasal obstruction by means of the NL-NOSE scale. Results: No significant differences between the NSI and NSI+STB groups, though the latter showed less pain. Concerning the study group as a whole, mean nasal burden score and nasal obstruction significantly decreased from 63.4 to 16.0 and 65.3 to 22.0, respectively. Nasal crusting, -pain, and loss of smell largely resolved 3-4 weeks postoperatively and were only mild. Concomitant lateralization showed a tendency to quicker resolution of the nasal obstruction. Conclusions: OBC is a safe, well tolerated and effective treatment for nasal obstruction caused by ITH. Concerning multiple end-points, we found no evidence of a beneficial effect of ointment based on honey as addition to NSI in postoperative care, except a clear tendency in less crusting and pain.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41386957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
A longitudinal study of olfactory dysfunction and parosmia in mild COVID-19 cases. 轻症COVID-19患者嗅觉功能障碍和嗅觉缺失的纵向研究
Pub Date : 2022-01-01
Aurelia S Monk, Daniel R Bacon, Princess Onuorah, Alexander Murr, Christopher A Wiesen, Jonathan Oakes, Brian D Thorp, Charles S Ebert, David Wohl, Brent A Senior, Adam J Kimple

Background: COVID-19-related olfactory dysfunction (OD) can persist long after patients recover from acute infection, yet few studies have investigated the long-term progression of this complication. Moreover, existing studies are focused on hyposmia/anosmia but parosmia is becoming an increasingly recognized long-term symptom.

Methods: We completed a longitudinal study about OD in individuals with mild cases of COVID-19. Participants completed a questionnaire and Brief Smell Identification Test (BSIT) one week, one month and one year after diagnosis. At one-year, participants completed an additional survey about parosmia.

Results: We obtained questionnaires and psychophysical olfactory testing information from participants at one week (n=45), one month (n=38), and one year (n=33) post COVID-19 diagnosis. At one-year, 15.2% of participants had persistent OD and 66.7% of participants reported experiencing parosmia at some point following COVID-19 diagnosis. The mean onset of parosmia was 1.3 weeks (SD: 1.9 weeks) after diagnosis, although two patients reported delayed onset (>4 weeks after diagnosis). Eight patients (24.2%) reported ongoing parosmia one year after diagnosis. Of the patients whose parosmia resolved, the mean duration of symptoms was 7.2 weeks (SD: 7.3 weeks).

Conclusion: Decreased sense of smell associated with COVID-19 infection has received significant recognition in both the media and in the medical literature. Symptoms of OD and parosmia were common in our patients with COVID-19. Hyposmia, anosmia, and parosmia, all decrease quality of life, necessitating continued research to understand the pathogenesis, course of symptoms, and possible treatment for these complications.

背景:与covid -19相关的嗅觉功能障碍(OD)在患者从急性感染中恢复后可持续很长时间,但很少有研究调查这种并发症的长期进展。此外,现有的研究主要集中在嗅觉减退/嗅觉缺失,但嗅觉缺失正逐渐成为一种公认的长期症状。方法:我们完成了一项关于COVID-19轻度病例个体OD的纵向研究。在诊断后一周、一个月和一年,参与者完成了问卷调查和简短气味识别测试(BSIT)。在一年的时间里,参与者完成了一项关于失忆的额外调查。结果:我们在新冠肺炎确诊后1周(n=45)、1个月(n=38)和1年(n=33)对参与者进行问卷调查和心理物理嗅觉测试信息。在一年的时间里,15.2%的参与者持续吸毒过量,66.7%的参与者报告在COVID-19诊断后的某个时候出现了嗅觉缺失。虽然有2例患者报告延迟发病(诊断后>4周),但平均发病时间为诊断后1.3周(SD: 1.9周)。8名患者(24.2%)在诊断一年后报告持续的畸形。在失语症消退的患者中,平均症状持续时间为7.2周(SD: 7.3周)。结论:嗅觉下降与COVID-19感染相关已得到媒体和医学文献的广泛认可。在我们的COVID-19患者中,吸毒过量和嗅觉缺失的症状很常见。嗅觉减退、嗅觉缺失和嗅觉缺失都会降低生活质量,因此需要继续研究以了解这些并发症的发病机制、症状过程和可能的治疗方法。
{"title":"A longitudinal study of olfactory dysfunction and parosmia in mild COVID-19 cases.","authors":"Aurelia S Monk,&nbsp;Daniel R Bacon,&nbsp;Princess Onuorah,&nbsp;Alexander Murr,&nbsp;Christopher A Wiesen,&nbsp;Jonathan Oakes,&nbsp;Brian D Thorp,&nbsp;Charles S Ebert,&nbsp;David Wohl,&nbsp;Brent A Senior,&nbsp;Adam J Kimple","doi":"","DOIUrl":"","url":null,"abstract":"<p><strong>Background: </strong>COVID-19-related olfactory dysfunction (OD) can persist long after patients recover from acute infection, yet few studies have investigated the long-term progression of this complication. Moreover, existing studies are focused on hyposmia/anosmia but parosmia is becoming an increasingly recognized long-term symptom.</p><p><strong>Methods: </strong>We completed a longitudinal study about OD in individuals with mild cases of COVID-19. Participants completed a questionnaire and Brief Smell Identification Test (BSIT) one week, one month and one year after diagnosis. At one-year, participants completed an additional survey about parosmia.</p><p><strong>Results: </strong>We obtained questionnaires and psychophysical olfactory testing information from participants at one week (n=45), one month (n=38), and one year (n=33) post COVID-19 diagnosis. At one-year, 15.2% of participants had persistent OD and 66.7% of participants reported experiencing parosmia at some point following COVID-19 diagnosis. The mean onset of parosmia was 1.3 weeks (SD: 1.9 weeks) after diagnosis, although two patients reported delayed onset (>4 weeks after diagnosis). Eight patients (24.2%) reported ongoing parosmia one year after diagnosis. Of the patients whose parosmia resolved, the mean duration of symptoms was 7.2 weeks (SD: 7.3 weeks).</p><p><strong>Conclusion: </strong>Decreased sense of smell associated with COVID-19 infection has received significant recognition in both the media and in the medical literature. Symptoms of OD and parosmia were common in our patients with COVID-19. Hyposmia, anosmia, and parosmia, all decrease quality of life, necessitating continued research to understand the pathogenesis, course of symptoms, and possible treatment for these complications.</p>","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":"5 ","pages":"168-172"},"PeriodicalIF":0.0,"publicationDate":"2022-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10065456/pdf/nihms-1881106.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9283062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Nasal epithelium: new insights and differences of the cytokine profile between normal subjects and subjects with allergic rhinitis 鼻上皮:正常人和变应性鼻炎患者之间细胞因子谱的新见解和差异
Pub Date : 2021-12-10 DOI: 10.4193/rhinol/21.047
S. Stamataki, N. G. Papadopoulos, J. Lakoumentas, A. Georgountzou, P. Maggina, P. Xepapadaki, E. Andreakos, E. Prokopakis, E. Legaki, S. Taka
Background: The role of the nasal epithelium in the induction of a proper cytokine response in normal subjects and subjects with allergic rhinitis is still not completely elucidated. Methodology: We aimed to compare nasal epithelial immune responses in allergic rhinitis patients of different ages compared to healthy volunteers. Primary nasal epithelial cells from 47 subjects (33 normal and 17 with allergic rhinitis) were collected and cultured. Their unstimulated supernatants were analysed for 21 cytokines and chemokines. Statistical analysis was performed with the R statistical software and the RStudio interface. Results: Differences of the spontaneous release of epithelial cytokines and chemokines were noticed between the two study groups. The levels of GMCSF, MIP1A, MIP1B, IL28A, TNFA, CCL5 were significantly lower in the allergic rhinitis group compared to healthy volunteers’ group, independent of age. Most differences were noticed in the younger allergic rhinitis group (0-12 years old). Conclusions: Despite the cross-sectional nature of the study and the limited number of subjects, allergic rhinitis appears to be associated with dysfunction of cytokine and chemokine spontaneous release from nasal epithelial cells which may represent an abnormal innate immunity maturation pattern.
背景:鼻上皮在正常受试者和变应性鼻炎受试者中诱导适当细胞因子反应的作用仍未完全阐明。方法:我们的目的是比较不同年龄变应性鼻炎患者与健康志愿者的鼻上皮免疫反应。采集47例(正常人33例,变应性鼻炎17例)鼻上皮细胞进行原代培养。分析未受刺激的上清液中21种细胞因子和趋化因子。采用R统计软件和RStudio界面进行统计分析。结果:两组间上皮细胞因子和趋化因子的自发释放存在差异。与健康志愿者组相比,变应性鼻炎组GMCSF、MIP1A、MIP1B、IL28A、TNFA、CCL5水平显著降低,且与年龄无关。最明显的差异出现在年龄较小的变应性鼻炎组(0-12岁)。结论:尽管该研究是横断面性质的,受试者数量有限,变应性鼻炎似乎与细胞因子和趋化因子自发释放功能障碍有关,这可能代表了一种异常的先天免疫成熟模式。
{"title":"Nasal epithelium: new insights and differences of the cytokine profile between normal subjects and subjects with allergic rhinitis","authors":"S. Stamataki, N. G. Papadopoulos, J. Lakoumentas, A. Georgountzou, P. Maggina, P. Xepapadaki, E. Andreakos, E. Prokopakis, E. Legaki, S. Taka","doi":"10.4193/rhinol/21.047","DOIUrl":"https://doi.org/10.4193/rhinol/21.047","url":null,"abstract":"Background: The role of the nasal epithelium in the induction of a proper cytokine response in normal subjects and subjects with allergic rhinitis is still not completely elucidated. Methodology: We aimed to compare nasal epithelial immune responses in allergic rhinitis patients of different ages compared to healthy volunteers. Primary nasal epithelial cells from 47 subjects (33 normal and 17 with allergic rhinitis) were collected and cultured. Their unstimulated supernatants were analysed for 21 cytokines and chemokines. Statistical analysis was performed with the R statistical software and the RStudio interface. Results: Differences of the spontaneous release of epithelial cytokines and chemokines were noticed between the two study groups. The levels of GMCSF, MIP1A, MIP1B, IL28A, TNFA, CCL5 were significantly lower in the allergic rhinitis group compared to healthy volunteers’ group, independent of age. Most differences were noticed in the younger allergic rhinitis group (0-12 years old). Conclusions: Despite the cross-sectional nature of the study and the limited number of subjects, allergic rhinitis appears to be associated with dysfunction of cytokine and chemokine spontaneous release from nasal epithelial cells which may represent an abnormal innate immunity maturation pattern.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48852130","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 1
Skull base low-grade non-intestinal adenocarcinoma in a paediatric patient 小儿颅底低级别非肠腺癌1例
Pub Date : 2021-12-06 DOI: 10.4193/rhinol/21.046
K. Miu, Chrysostomos Tornari, P. Surda
Background: Non-intestinal adenocarcinomas of the sinonasal tract are uncommon neoplasms in adults, and particularly rare in the paediatric population. Case presentation: A 10-year-old male presented to the Paediatric Otolaryngology clinic with symptoms of recurrent epistaxis, persistent clear nasal discharge, and a left-sided polypoidal swelling causing nasal obstruction. An endoscopic biopsy of the polyp under general anaesthesia found a mass arising from the anterior olfactory cleft, and the histology report described the mass as a low-grade non-intestinal adenocarcinoma. CT and MRI of the sinuses post-biopsy demonstrated no bony structure infiltration. The patient underwent a further endoscopic operation for definitive excision of the nasal mass, and the histology findings confirmed a complete resection of the tumour. Conclusion: This case demonstrates the first case of a primary low-grade non-intestinal adenocarcinoma originating from the olfactory cleft.
背景:鼻腔非肠道腺癌在成人中是不常见的肿瘤,在儿科人群中尤其罕见。病例介绍:一名10岁男性在儿科耳鼻喉科诊所就诊,症状为反复鼻出血、持续性清晰鼻腔分泌物和左侧息肉状肿胀导致鼻阻塞。在全身麻醉下对息肉进行的内镜活检发现一个由前嗅裂引起的肿块,组织学报告将该肿块描述为低度非肠腺癌。活检后鼻窦的CT和MRI显示没有骨结构浸润。患者接受了进一步的鼻内镜手术,最终切除了鼻腔肿块,组织学检查结果证实肿瘤完全切除。结论:本病例为首例原发性低度非肠腺癌,起源于嗅裂。
{"title":"Skull base low-grade non-intestinal adenocarcinoma in a paediatric patient","authors":"K. Miu, Chrysostomos Tornari, P. Surda","doi":"10.4193/rhinol/21.046","DOIUrl":"https://doi.org/10.4193/rhinol/21.046","url":null,"abstract":"Background: Non-intestinal adenocarcinomas of the sinonasal tract are uncommon neoplasms in adults, and particularly rare in the paediatric population. Case presentation: A 10-year-old male presented to the Paediatric Otolaryngology clinic with symptoms of recurrent epistaxis, persistent clear nasal discharge, and a left-sided polypoidal swelling causing nasal obstruction. An endoscopic biopsy of the polyp under general anaesthesia found a mass arising from the anterior olfactory cleft, and the histology report described the mass as a low-grade non-intestinal adenocarcinoma. CT and MRI of the sinuses post-biopsy demonstrated no bony structure infiltration. The patient underwent a further endoscopic operation for definitive excision of the nasal mass, and the histology findings confirmed a complete resection of the tumour. Conclusion: This case demonstrates the first case of a primary low-grade non-intestinal adenocarcinoma originating from the olfactory cleft.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-12-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49047428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Association between smell and taste dysfunction and obesity and metabolic syndrome in older adults 老年人嗅觉和味觉功能障碍与肥胖和代谢综合征的关系
Pub Date : 2021-11-22 DOI: 10.4193/rhinol/21.023
S. Dobrow, J. Qazi, S. Payne, J. Mattos
Background: Obesity and metabolic syndrome (MS) are prevalent and associated with negative health outcomes in the elderly. There is a need to identify risk factors for these diseases in this population. Methodology: The 2013-14 National Health and Nutrition Examination Survey was used in this study. Adults aged 60 or under were categorized into normosmia, hyposmia, anosmia, and combined anosmia + hyposmia using the Pocket Sniff Test. Taste was evaluated using quinine and NaCl solutions. Multivariate logistic regression models were used to characterize associations between smell and taste status and obesity and MS. Results: In univariate obesity analysis, normosmia, combined anosmia + hyposmia, and 0.32M NaCl taste dysfunction were significant. 0.32M NaCl taste dysfunction remained significant in multivariate analysis. MS was significantly associated with only tongue tip quinine dysfunction in univariate and multivariate analyses. Conclusions: Salty taste dysfunction was found to be negatively associated with obesity while bitter taste dysfunction was found to be positively associated with MS.
背景:肥胖和代谢综合征(MS)在老年人中普遍存在,并与负面健康结果相关。有必要确定这一人群中这些疾病的危险因素。方法:采用2013-14年全国健康与营养检查调查。60岁及以下的成年人被分为正常嗅觉障碍、低嗅觉障碍、嗅觉障碍和嗅觉障碍+低嗅觉障碍。用奎宁和NaCl溶液评价其口感。多变量logistic回归模型用于表征嗅觉和味觉状态与肥胖和ms之间的关系。结果:在单变量肥胖分析中,正常嗅觉缺失、合并嗅觉缺失+低嗅觉缺失和0.32M NaCl味觉功能障碍显著。多因素分析表明,0.32M NaCl对味觉功能障碍的影响仍然显著。在单因素和多因素分析中,MS仅与舌尖奎宁功能障碍显著相关。结论:咸味功能障碍与肥胖呈负相关,苦味功能障碍与多发性硬化症呈正相关。
{"title":"Association between smell and taste dysfunction and obesity and metabolic syndrome in older adults","authors":"S. Dobrow, J. Qazi, S. Payne, J. Mattos","doi":"10.4193/rhinol/21.023","DOIUrl":"https://doi.org/10.4193/rhinol/21.023","url":null,"abstract":"Background: Obesity and metabolic syndrome (MS) are prevalent and associated with negative health outcomes in the elderly. There is a need to identify risk factors for these diseases in this population. Methodology: The 2013-14 National Health and Nutrition Examination Survey was used in this study. Adults aged 60 or under were categorized into normosmia, hyposmia, anosmia, and combined anosmia + hyposmia using the Pocket Sniff Test. Taste was evaluated using quinine and NaCl solutions. Multivariate logistic regression models were used to characterize associations between smell and taste status and obesity and MS. Results: In univariate obesity analysis, normosmia, combined anosmia + hyposmia, and 0.32M NaCl taste dysfunction were significant. 0.32M NaCl taste dysfunction remained significant in multivariate analysis. MS was significantly associated with only tongue tip quinine dysfunction in univariate and multivariate analyses. Conclusions: Salty taste dysfunction was found to be negatively associated with obesity while bitter taste dysfunction was found to be positively associated with MS.","PeriodicalId":74737,"journal":{"name":"Rhinology online","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-11-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48748441","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
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Rhinology online
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