首页 > 最新文献

American Journal of Rhinology & Allergy最新文献

英文 中文
The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019. 2016 年至 2019 年当代垂体护理中门诊的时间负担。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-27 DOI: 10.1177/19458924241242198
Rose C Dimitroyannis, Thomas F Cyberski, Neil S Kondamuri, Sean P Polster, Paramita Das, Peleg M Horowitz, Christopher R Roxbury

Background: The concept of "time toxicity" has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.

Objective: To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.

Methods: A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.

Results: In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (P < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (P < 0.001).

Conclusions: E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.

背景:时间毒性 "这一概念的出现是为了解决在医疗保健系统中花费的时间所产生的影响;然而,在耳鼻喉科领域却很少有人研究过这一现象:目的:验证使用评估与管理(E/M)当前程序术语代码作为评估时间负担的方法,并试用这一工具来描述 2016 年至 2019 年期间与垂体腺瘤诊断相关的门诊时间毒性:一项门诊就诊的回顾性队列研究量化了记录就诊时长的时间戳与相关E/M代码就诊时长之间的差异。通过查询 IBM MarketScan 数据库,确定了 2016 年诊断为垂体腺瘤的患者,并分析了他们在 2016 年至 2019 年期间的新报销单和返还报销单。采用单因素方差分析和双样本 t 检验来研究索赔数量、诊室时间和年度就诊时间:在验证研究中,通过 E/M 代码估算的就诊时间与实际就诊时间存在统计学差异(P P 结论:E/M 代码低估了就诊时间:E/M 代码低估了门诊就诊时间;因此,垂体瘤患者经历的时间毒性可能大于报告的时间毒性。需要进一步研究开发更多的时间毒性评估工具,提高垂体腺瘤患者的护理效率。
{"title":"The Time Burden of Office Visits in Contemporary Pituitary Care, 2016 to 2019.","authors":"Rose C Dimitroyannis, Thomas F Cyberski, Neil S Kondamuri, Sean P Polster, Paramita Das, Peleg M Horowitz, Christopher R Roxbury","doi":"10.1177/19458924241242198","DOIUrl":"10.1177/19458924241242198","url":null,"abstract":"<p><strong>Background: </strong>The concept of \"time toxicity\" has emerged to address the impact of time spent in the healthcare system; however, little work has examined the phenomenon in the field of otolaryngology.</p><p><strong>Objective: </strong>To validate the use of Evaluation and Management (E/M) current procedural terminology codes as a method to assess time burden and to pilot this tool to characterize the time toxicity of office visits associated with a diagnosis of pituitary adenoma between 2016 and 2019.</p><p><strong>Methods: </strong>A retrospective cohort study of outpatient office visits quantified differences between timestamps documenting visit length and their associated E/M code visit length. The IBM MarketScan database was queried to identify patients with a diagnosis of pituitary adenoma in 2016 and to analyze their new and return claims between 2016 and 2019. One-way ANOVA and two-sample t-tests were used to examine claim quantity, time in office, and yearly visit time.</p><p><strong>Results: </strong>In the validation study, estimated visit time via E/M codes and actual visit time were statistically different (<i>P</i> < 0.01), with E/M codes underestimating actual time spent in 79.0% of visits. In the MarketScan analysis, in 2016, 2099 patients received a primary diagnosis of pituitary adenoma. There were 8490 additional-related claims for this cohort from 2016 to 2019. The plurality of new office visits were with endocrinologists (n = 857; 29.3%). Total time spent in office decreased yearly, from a mean of 113 min (2016) to 69 min (2019) (<i>P</i> < 0.001).</p><p><strong>Conclusions: </strong>E/M codes underestimate the length of outpatient visits; therefore, time toxicity experienced by pituitary patients may be greater than reported. Further studies are needed to develop additional assessment tools for time toxicity and promote increased efficiency of care for patients with pituitary adenomas.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"203-210"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140304420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Effects of Endoscopic Sinus Surgery on Olfactory Bulb Volume among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis. 内窥镜鼻窦手术对慢性鼻窦炎患者嗅球体积的影响:系统回顾与元分析》。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-07-01 Epub Date: 2024-03-28 DOI: 10.1177/19458924241241874
Xincen Jiang, Tianhao Huang, Feifan Chang, Yu Song, Dawei Wu

Background: Endoscopic sinus surgery (ESS) could significantly improve olfactory function among patients with chronic rhinosinusitis (CRS). This study aimed to perform a meta-analysis to evaluate the effect of ESS on the olfactory bulb volume (OBV) among patients with CRS.

Methods: A systemic search of PubMed, Medline, Embase, Web of Science, and other databases was conducted to identify studies assessing OBV changes in patients with CRS after ESS utilizing magnetic resonance imaging.

Results: A total of four studies with 168 participants were included. Comparing the changes in OBV of patients with CRS before and after surgery within 3-6 months, the ESS significantly improved the overall OBV (P = 0.005, I2 = 66%), with the left OBV increased by 5.57mm3 (P = 0.84, I2 = 0%), and the right OBV increased by 8.63mm3 (P = 0.09, I2 = 53%). A difference in OBV persists between healthy controls and patients with CRS 3-6 months after ESS. The overall OBV of patients with CRS after ESS was significantly smaller than controls (mean difference = -3.84, P = 0.04), with a mean difference of 4.13mm3 on the left side (P = 0.72, I2 = 0%), and a mean difference of 3.22mm3 on the right side (P = 0.0001, I2 = 89%).

Conclusions: ESS significantly increases the OBV among patients with CRS.

背景:内窥镜鼻窦手术(ESS)可显著改善慢性鼻窦炎(CRS)患者的嗅觉功能。本研究旨在进行一项荟萃分析,评估ESS对CRS患者嗅球体积(OBV)的影响:方法:对PubMed、Medline、Embase、Web of Science和其他数据库进行了系统检索,以确定利用磁共振成像评估ESS后CRS患者嗅球体积变化的研究:结果:共纳入了四项研究,168 名参与者。比较CRS患者手术前后3-6个月内的OBV变化,ESS显著改善了整体OBV(P = 0.005,I2 = 66%),左侧OBV增加了5.57mm3(P = 0.84,I2 = 0%),右侧OBV增加了8.63mm3(P = 0.09,I2 = 53%)。健康对照组和 CRS 患者在 ESS 3-6 个月后的 OBV 仍存在差异。ESS后CRS患者的总体OBV明显小于对照组(平均差异=-3.84,P=0.04),左侧平均差异为4.13mm3(P=0.72,I2=0%),右侧平均差异为3.22mm3(P=0.0001,I2=89%):结论:ESS可明显增加CRS患者的OBV。
{"title":"Effects of Endoscopic Sinus Surgery on Olfactory Bulb Volume among Patients with Chronic Rhinosinusitis: A Systematic Review and Meta-Analysis.","authors":"Xincen Jiang, Tianhao Huang, Feifan Chang, Yu Song, Dawei Wu","doi":"10.1177/19458924241241874","DOIUrl":"10.1177/19458924241241874","url":null,"abstract":"<p><strong>Background: </strong>Endoscopic sinus surgery (ESS) could significantly improve olfactory function among patients with chronic rhinosinusitis (CRS). This study aimed to perform a meta-analysis to evaluate the effect of ESS on the olfactory bulb volume (OBV) among patients with CRS.</p><p><strong>Methods: </strong>A systemic search of PubMed, Medline, Embase, Web of Science, and other databases was conducted to identify studies assessing OBV changes in patients with CRS after ESS utilizing magnetic resonance imaging.</p><p><strong>Results: </strong>A total of four studies with 168 participants were included. Comparing the changes in OBV of patients with CRS before and after surgery within 3-6 months, the ESS significantly improved the overall OBV (<i>P</i> = 0.005, I<sup>2 </sup>= 66%), with the left OBV increased by 5.57mm<sup>3</sup> (<i>P</i> = 0.84, I<sup>2 </sup>= 0%), and the right OBV increased by 8.63mm<sup>3</sup> (<i>P</i> = 0.09, I<sup>2 </sup>= 53%). A difference in OBV persists between healthy controls and patients with CRS 3-6 months after ESS. The overall OBV of patients with CRS after ESS was significantly smaller than controls (mean difference = -3.84, <i>P</i> = 0.04), with a mean difference of 4.13mm<sup>3</sup> on the left side (<i>P</i> = 0.72, I<sup>2 </sup>= 0%), and a mean difference of 3.22mm<sup>3</sup> on the right side (<i>P</i> = 0.0001, I<sup>2 </sup>= 89%).</p><p><strong>Conclusions: </strong>ESS significantly increases the OBV among patients with CRS.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"251-257"},"PeriodicalIF":2.6,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140317622","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Early Endonasal Dacryocystorhinostomy for Acute Dacryocystitis: A Systematic Review and Meta-Analysis. 急性泪囊炎的早期鼻腔内泪囊鼻腔造口术:系统综述与元分析》。
IF 2.5 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI: 10.1177/19458924241237009
Jia Li, Jihong Wang, Changling Sun

Objective: The aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).

Methods: A comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger's test.

Results: Six studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, P = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = -4.92, 95% CI: -5.46 to 4-.37, P < .00001) and complete resolution of symptoms (MD = -17.70, 95% CI: -23.88 to -11.52, P < .00001).

Conclusion: Primary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.

目的:本荟萃分析旨在比较早期鼻内泪囊鼻腔吻合术(DCR)与延迟 DCR 治疗急性泪囊炎(AD)的效果:截至 2023 年 11 月 11 日,对 PubMed、Embase、Web of Science 和 Cochrane Library 数据库进行了全面的电子检索。使用Review Manager 5.4进行数据综合,并为每项结果指标生成森林图。使用漏斗图和Egger检验评估潜在的发表偏倚:荟萃分析共纳入了六项研究,涉及288名患者。总体而言,早期鼻内DCR的成功率与延迟DCR组相当(几率比[OR] = 1.52,95%置信区间[CI]:0.81-2.85,P = .19)。此外,与延迟 DCR 组相比,早期鼻内 DCR 显著缩短了内侧角肿胀消退的时间(平均差 [MD] = -4.92,95% 置信区间 [CI]:-5.46 至 4-.37,P P 结论:与传统的延迟 DCR 相比,原发性早期鼻内 DCR 似乎是治疗 AD 的一种有前途的好方法,疗效相当,症状缓解更快。
{"title":"Early Endonasal Dacryocystorhinostomy for Acute Dacryocystitis: A Systematic Review and Meta-Analysis.","authors":"Jia Li, Jihong Wang, Changling Sun","doi":"10.1177/19458924241237009","DOIUrl":"10.1177/19458924241237009","url":null,"abstract":"<p><strong>Objective: </strong>The aim of this meta-analysis is to compare the outcomes of early endonasal dacryocystorhinostomy (DCR) with delayed DCR in the treatment of acute dacryocystitis (AD).</p><p><strong>Methods: </strong>A comprehensive electronic search of PubMed, Embase, Web of Science, and the Cochrane Library databases was conducted up to November 11, 2023. Data synthesis was performed using Review Manager 5.4, and forest plots were generated for each outcome measure. Potential publication bias was assessed using funnel plots and Egger's test.</p><p><strong>Results: </strong>Six studies involving 288 patients were included in the meta-analysis. Overall, the success rate of early endonasal DCR was comparable to that in the delayed DCR group (odds ratio [OR] = 1.52, 95% confidence interval [CI]: 0.81-2.85, <i>P</i> = .19). Furthermore, in comparison with the delayed DCR group, early endonasal DCR significantly reduced the time for medial canthus swelling resolution (mean differences [MD] = -4.92, 95% CI: -5.46 to 4-.37, <i>P</i> < .00001) and complete resolution of symptoms (MD = -17.70, 95% CI: -23.88 to -11.52, <i>P</i> < .00001).</p><p><strong>Conclusion: </strong>Primary early endonasal DCR seems to be a promising and favorable approach for managing AD with comparable efficacy and faster relief of symptoms compared to conventional delayed DCR.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"185-191"},"PeriodicalIF":2.5,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Corrigendum to "HNE Induces the Hyperexpression of MUC5AC in Chronic Rhinosinusitis with Nasal Polyps by Activating the TRAF6/Autophagy Regulatory Axis". HNE通过激活TRAF6/自噬调控轴诱导慢性鼻炎伴鼻息肉患者的MUC5AC过度表达》勘误表
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2023-01-05 DOI: 10.1177/19458924221150105
{"title":"Corrigendum to \"HNE Induces the Hyperexpression of MUC5AC in Chronic Rhinosinusitis with Nasal Polyps by Activating the TRAF6/Autophagy Regulatory Axis\".","authors":"","doi":"10.1177/19458924221150105","DOIUrl":"10.1177/19458924221150105","url":null,"abstract":"","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"194"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10489771","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
The Surprising Effect of Priming on SNOT-22 Results. 引物对 SNOT-22 结果的惊人影响
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-08 DOI: 10.1177/19458924241229160
Ibtisam Mohammad, Taylor Stack, Meghan Norris, Sulgi Kim, Meredith Lamb, Brian D Thorp, Christine Klatt-Cromwell, Charles S Ebert, Adam J Kimple, Brent A Senior

Background: Priming is a psychological phenomenon where subconscious cues in the environment impact our behavioral responses in certain situations. Well studied in the worlds of business, marketing, and even politics, it is unclear how the priming phenomenon impacts patient perception of their own disease state nor how they report that perception using tools like the Sinonasal Outcomes Test (SNOT-22), used to measure that perception in chronic rhinosinusitis.

Objective: To determine the impact of positive or negative priming on self-reported patient perception of their chronic rhinosinusitis disease using the SNOT-22 disease-specific quality of life instrument.

Methods: Single-blind, randomized, prospective cohort pilot study of 206 consecutive adult patients with a clinical diagnosis of chronic rhinosinusitis presenting to a university rhinology clinic. Patients were randomized to receive "positive priming" (103) or "negative priming" (103) by reading a passage about the positive or negative aspects of chronic sinusitis and its treatment respectively. Patients were then asked to fill out the SNOT-22 and results between the two groups were compared.

Results: The negative priming group had a higher median SNOT-22 score of 49 [IQR = 39] compared to the positive priming groups' score of 22 [IQR = 27], p < 0.0001), a difference of nearly three times the minimal clinical impactful difference (MCID). This effect was consistent regardless of age or sex of the patient. Subgroup analysis revealed a greater impact when priming was performed by the senior male attending regardless of patient age or sex (p < 0.001), while priming performed by the younger female research fellow had greater impact on older patients (>59 years, p = 0.001) and female patients (p = 0.003).

Conclusions: Priming impacts how patient's perceive their chronic rhinosinusitis as determined by the SNOT-22. It is imperative that the rhinologist understand this when using this instrument in research applications and in clinical decision-making for patients.

背景介绍诱导是一种心理现象,环境中的潜意识暗示会影响我们在特定情况下的行为反应。这种现象在商业、市场营销甚至政治领域都得到了深入研究,但目前还不清楚诱导现象如何影响患者对自身疾病状态的感知,也不清楚他们如何使用窦鼻结果测试(SNOT-22)等工具报告这种感知,该工具用于测量慢性鼻炎患者对自身疾病状态的感知:利用 SNOT-22 疾病特异性生活质量工具,确定积极或消极引导对患者自我报告的慢性鼻炎疾病认知的影响:单盲、随机、前瞻性队列试点研究:对 206 名连续到某大学鼻科诊所就诊、临床诊断为慢性鼻炎的成年患者进行研究。患者被随机分配接受 "积极引导"(103)或 "消极引导"(103),分别阅读一段关于慢性鼻窦炎及其治疗的积极或消极方面的文章。然后要求患者填写 SNOT-22,并对两组结果进行比较:结果:消极引导组的 SNOT-22 中位得分为 49 [IQR = 39],高于积极引导组的 22 [IQR = 27](P 59 岁,P = 0.001)和女性患者(P = 0.003):根据 SNOT-22 的测定,诱导会影响患者对其慢性鼻炎的看法。鼻科医生在研究和临床决策中使用该工具时必须了解这一点。
{"title":"The Surprising Effect of Priming on SNOT-22 Results.","authors":"Ibtisam Mohammad, Taylor Stack, Meghan Norris, Sulgi Kim, Meredith Lamb, Brian D Thorp, Christine Klatt-Cromwell, Charles S Ebert, Adam J Kimple, Brent A Senior","doi":"10.1177/19458924241229160","DOIUrl":"10.1177/19458924241229160","url":null,"abstract":"<p><strong>Background: </strong>Priming is a psychological phenomenon where subconscious cues in the environment impact our behavioral responses in certain situations. Well studied in the worlds of business, marketing, and even politics, it is unclear how the priming phenomenon impacts patient perception of their own disease state nor how they report that perception using tools like the Sinonasal Outcomes Test (SNOT-22), used to measure that perception in chronic rhinosinusitis.</p><p><strong>Objective: </strong>To determine the impact of positive or negative priming on self-reported patient perception of their chronic rhinosinusitis disease using the SNOT-22 disease-specific quality of life instrument.</p><p><strong>Methods: </strong>Single-blind, randomized, prospective cohort pilot study of 206 consecutive adult patients with a clinical diagnosis of chronic rhinosinusitis presenting to a university rhinology clinic. Patients were randomized to receive \"positive priming\" (103) or \"negative priming\" (103) by reading a passage about the positive or negative aspects of chronic sinusitis and its treatment respectively. Patients were then asked to fill out the SNOT-22 and results between the two groups were compared.</p><p><strong>Results: </strong>The negative priming group had a higher median SNOT-22 score of 49 [IQR = 39] compared to the positive priming groups' score of 22 [IQR = 27], p < 0.0001), a difference of nearly three times the minimal clinical impactful difference (MCID). This effect was consistent regardless of age or sex of the patient. Subgroup analysis revealed a greater impact when priming was performed by the senior male attending regardless of patient age or sex (p < 0.001), while priming performed by the younger female research fellow had greater impact on older patients (>59 years, p = 0.001) and female patients (p = 0.003).</p><p><strong>Conclusions: </strong>Priming impacts how patient's perceive their chronic rhinosinusitis as determined by the SNOT-22. It is imperative that the rhinologist understand this when using this instrument in research applications and in clinical decision-making for patients.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"153-158"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11000435/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139705830","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Corrigendum to "A Meta-Analysis of Probiotics for the Treatment of Allergic Airway Diseases in Children and Adolescents". 更正“益生菌治疗儿童和青少年过敏性呼吸道疾病的荟萃分析”。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2023-10-06 DOI: 10.1177/19458924231205963
{"title":"Corrigendum to \"A Meta-Analysis of Probiotics for the Treatment of Allergic Airway Diseases in Children and Adolescents\".","authors":"","doi":"10.1177/19458924231205963","DOIUrl":"10.1177/19458924231205963","url":null,"abstract":"","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"195"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41091437","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Endoscopic and Radiologic Central Compartment Disease as Predictors of Perennial Inhalant Allergen Sensitization in Chronic Rhinosinusitis. 作为慢性鼻窦炎患者常年吸入过敏原致敏的预测因素的内窥镜和放射学中央区病变
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-05 DOI: 10.1177/19458924241237915
Linus Lau, Terese Low, Yew Kwang Ong, Xu Xinni

Background: Central compartment atopic disease (CCAD) is a recently described variant of chronic rhinosinusitis (CRS) strongly associated with atopy. The association between central compartment disease (CCD) and inhalant allergy is not well established in South-East Asia, where perennial allergic rhinitis is common.

Objectives: The primary objective was to evaluate endoscopic and radiologic CCD as predictors of perennial allergen sensitization in primary CRS. The secondary objective was to compare clinical characteristics of CCAD with other CRS subtypes (CRSwNP and CRSsNP).

Methods: A retrospective study of consecutive patients with primary CRS who underwent endoscopic sinus surgery at our institution was performed. Allergen sensitization was confirmed by skin or serum testing. Endoscopy records and computed tomography scans of paranasal sinuses were reviewed for CCD. The diagnostic accuracy of endoscopic and radiologic CCD in predicting atopy was calculated.

Results: There were 104 patients (43 CCAD, 30 CRSwNP and 31 CRSsNP). Endoscopic CCD was significantly associated with aeroallergen sensitization (odds ratio (OR) 3.99, 95% confidence interval (CI) 1.65-9.67, P = 0.002). Endoscopic CCD predicted atopy with 57% sensitivity, 72% specificity, 69% positive predictive value and positive likelihood ratio of 2.05. Radiologic CCD was not associated with aeroallergen sensitization (OR 0.728, 95%CI 0.292-1.82, P = 0.496). There were more CCAD patients who reported hyposmia (86% vs 42%, P < 0.001) and had anosmia on olfactory testing than CRSsNP (65% vs 14%, P = 0.015). The prevalence of atopy was significantly higher in CCAD than CRSwNP and CRSsNP (70% vs 37% and 42%, P = 0.015 and P = 0.05, respectively). Median serum total immunoglobulin E was higher in CCAD (283 IU/ml) and CRSwNP (127 IU/ml) than CRSsNP (27 IU/ml, P = 0.006 and P = 0.042, respectively).

Conclusions: Endoscopic CCD was a better predictor of inhalant allergy than radiologic CCD in primary CRS, in a locale of perennial allergic rhinitis.

背景:中央区特应性疾病(CCAD)是最近描述的慢性鼻炎(CRS)的一种变异型,与特应性鼻炎密切相关。在东南亚,常年性过敏性鼻炎很常见,但中心隔室疾病(CCD)与吸入剂过敏之间的关联尚未得到很好的证实:主要目的是评估内窥镜和放射学 CCD 对原发性 CRS 常年过敏原致敏的预测作用。次要目的是比较 CCAD 与其他 CRS 亚型(CRSwNP 和 CRSsNP)的临床特征:方法:我们对在本院接受内窥镜鼻窦手术的连续原发性 CRS 患者进行了回顾性研究。过敏原致敏通过皮肤或血清检测确认。对内窥镜检查记录和副鼻窦计算机断层扫描进行了复查,以确定是否存在 CCD。计算了内窥镜和放射学 CCD 在预测过敏症方面的诊断准确性:共有 104 名患者(43 名 CCAD、30 名 CRSwNP 和 31 名 CRSsNP)。内镜 CCD 与过敏原致敏明显相关(比值比 (OR) 3.99,95% 置信区间 (CI)1.65-9.67,P = 0.002)。内窥镜 CCD 预测过敏症的敏感性为 57%,特异性为 72%,阳性预测值为 69%,阳性似然比为 2.05。放射学 CCD 与过敏原致敏无关(OR 0.728,95%CI 0.292-1.82,P = 0.496)。有更多的 CCAD 患者报告了嗅觉减退(86% 对 42%,P = 0.015)。CCAD患者的特应性发病率明显高于CRSwNP和CRSsNP(分别为70% vs 37% 和42%,P = 0.015和P = 0.05)。CCAD(283 IU/ml)和CRSwNP(127 IU/ml)的血清总免疫球蛋白E中位数高于CRSsNP(27 IU/ml,分别为P = 0.006和P = 0.042):结论:在常年发生过敏性鼻炎的地区,内窥镜 CCD 比放射学 CCD 更能预测原发性 CRS 的吸入剂过敏。
{"title":"Endoscopic and Radiologic Central Compartment Disease as Predictors of Perennial Inhalant Allergen Sensitization in Chronic Rhinosinusitis.","authors":"Linus Lau, Terese Low, Yew Kwang Ong, Xu Xinni","doi":"10.1177/19458924241237915","DOIUrl":"10.1177/19458924241237915","url":null,"abstract":"<p><strong>Background: </strong>Central compartment atopic disease (CCAD) is a recently described variant of chronic rhinosinusitis (CRS) strongly associated with atopy. The association between central compartment disease (CCD) and inhalant allergy is not well established in South-East Asia, where perennial allergic rhinitis is common.</p><p><strong>Objectives: </strong>The primary objective was to evaluate endoscopic and radiologic CCD as predictors of perennial allergen sensitization in primary CRS. The secondary objective was to compare clinical characteristics of CCAD with other CRS subtypes (CRSwNP and CRSsNP).</p><p><strong>Methods: </strong>A retrospective study of consecutive patients with primary CRS who underwent endoscopic sinus surgery at our institution was performed. Allergen sensitization was confirmed by skin or serum testing. Endoscopy records and computed tomography scans of paranasal sinuses were reviewed for CCD. The diagnostic accuracy of endoscopic and radiologic CCD in predicting atopy was calculated.</p><p><strong>Results: </strong>There were 104 patients (43 CCAD, 30 CRSwNP and 31 CRSsNP). Endoscopic CCD was significantly associated with aeroallergen sensitization (odds ratio (OR) 3.99, 95% confidence interval (CI) 1.65-9.67, <i>P</i> = 0.002). Endoscopic CCD predicted atopy with 57% sensitivity, 72% specificity, 69% positive predictive value and positive likelihood ratio of 2.05. Radiologic CCD was not associated with aeroallergen sensitization (OR 0.728, 95%CI 0.292-1.82, <i>P</i> = 0.496). There were more CCAD patients who reported hyposmia (86% vs 42%, <i>P</i> < 0.001) and had anosmia on olfactory testing than CRSsNP (65% vs 14%, <i>P</i> = 0.015). The prevalence of atopy was significantly higher in CCAD than CRSwNP and CRSsNP (70% vs 37% and 42%, <i>P</i> = 0.015 and <i>P</i> = 0.05, respectively). Median serum total immunoglobulin E was higher in CCAD (283 IU/ml) and CRSwNP (127 IU/ml) than CRSsNP (27 IU/ml, <i>P</i> = 0.006 and <i>P</i> = 0.042, respectively).</p><p><strong>Conclusions: </strong>Endoscopic CCD was a better predictor of inhalant allergy than radiologic CCD in primary CRS, in a locale of perennial allergic rhinitis.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"178-184"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140038572","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Biofilm-producing Bacteria and Quality of Life after Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyposis. 慢性鼻窦炎伴鼻息肉患者内窥镜鼻窦手术后的生物膜细菌和生活质量
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-07 DOI: 10.1177/19458924241236233
Jovica Milovanović, Dragana D Božić, Bojan Pavlović, Ana Jotić, Snežana Brkić, Ivana Ćirković

Background: Chronic rhinosinusitis (CRS) is one of the most common health disorders in humans and has a major impact on health-related quality of life (HRQoL). Of the many factors contributing to the etiology of CRS, less is known about the correlation between CRS and bacterial biofilms and their impact on HRQoL.

Objective: The aim of this prospective study was to investigate the relationship between biofilm-producing bacteria and patients' objective findings and HRQoL.

Methods: Forty-eight patients with CRSwNP were enrolled in a 12-month prospective study. The Lund-Mackay (LM) CT and endoscopic Lund-Kennedy (LK) scores were obtained before endoscopic sinus surgery (ESS), and patients completed the HRQoL instruments: the 22-item Sinonasal Outcome Test (SNOT-22), the 36-item Short Questionnaire (SF-36), and the visual analog scale (VAS). A sinus culture was obtained at ESS, bacteria were isolated, and in vitro quantification of the biofilm was performed. The LK score and HRQoL were determined postoperatively at months 1, 3, 6, and 12.

Results: The most common bacterial isolates in patients with CRSwNP were Staphylococcus aureus (28%), coagulase-negative staphylococci (52%), and Pseudomonas aeruginosa (8%). Preoperatively, the highest LM and LK scores were found in patients with strong biofilm producers. Postoperative LK scores were significantly reduced in all patients. Postoperative VAS scores were significantly reduced from month 1 to month 12 postoperatively. Patients with strong biofilm producers had significantly worse nasal blockage, secretion, headache, facial pressure and pain, and loss of smell preoperatively, compared to patients with low biofilm producers. The most significant reduction in preoperative scores SNOT-22 and SF-36 (excluding physical functioning) was seen in patients with S. aureus and P. aeruginosa.

Conclusions: Patients with strong biofilm producers had higher LK and LM scores preoperatively, and greater improvement in LK and HRQoL scores postoperatively. Microbiologic surveillance of all CRS patients is recommended.

背景:慢性鼻炎(CRS)是人类最常见的健康疾病之一,对健康相关生活质量(HRQoL)有重大影响。在导致 CRS 病因的众多因素中,人们对 CRS 与细菌生物膜之间的相关性及其对 HRQoL 的影响知之甚少:这项前瞻性研究旨在调查产生生物膜的细菌与患者客观检查结果和 HRQoL 之间的关系:这项为期 12 个月的前瞻性研究共招募了 48 名 CRSwNP 患者。在进行内窥镜鼻窦手术(ESS)前,患者进行了伦德-马凯(LM)CT和内窥镜伦德-肯尼迪(LK)评分,并完成了 HRQoL 工具:22 项鼻窦结果测试(SNOT-22)、36 项简短问卷(SF-36)和视觉模拟量表(VAS)。在 ESS 采集鼻窦培养物,分离细菌,并对生物膜进行体外定量。术后第 1、3、6 和 12 个月测定 LK 评分和 HRQoL:结果:CRSwNP 患者最常见的细菌分离物是金黄色葡萄球菌(28%)、凝固酶阴性葡萄球菌(52%)和铜绿假单胞菌(8%)。术前,生物膜产生较多的患者的 LM 和 LK 评分最高。术后所有患者的 LK 评分都明显降低。术后 VAS 评分从术后第 1 个月到第 12 个月都明显降低。与生物膜产生量少的患者相比,生物膜产生量多的患者术前的鼻塞、分泌物、头痛、面部压痛和嗅觉减退等症状明显更严重。金黄色葡萄球菌和铜绿假单胞菌患者的术前评分 SNOT-22 和 SF-36(不包括身体功能)下降最为明显:结论:生物膜产生较多的患者术前 LK 和 LM 评分较高,术后 LK 和 HRQoL 评分改善幅度较大。建议对所有 CRS 患者进行微生物监测。
{"title":"Biofilm-producing Bacteria and Quality of Life after Endoscopic Sinus Surgery in Patients with Chronic Rhinosinusitis with Nasal Polyposis.","authors":"Jovica Milovanović, Dragana D Božić, Bojan Pavlović, Ana Jotić, Snežana Brkić, Ivana Ćirković","doi":"10.1177/19458924241236233","DOIUrl":"10.1177/19458924241236233","url":null,"abstract":"<p><strong>Background: </strong>Chronic rhinosinusitis (CRS) is one of the most common health disorders in humans and has a major impact on health-related quality of life (HRQoL). Of the many factors contributing to the etiology of CRS, less is known about the correlation between CRS and bacterial biofilms and their impact on HRQoL.</p><p><strong>Objective: </strong>The aim of this prospective study was to investigate the relationship between biofilm-producing bacteria and patients' objective findings and HRQoL.</p><p><strong>Methods: </strong>Forty-eight patients with CRSwNP were enrolled in a 12-month prospective study. The Lund-Mackay (LM) CT and endoscopic Lund-Kennedy (LK) scores were obtained before endoscopic sinus surgery (ESS), and patients completed the HRQoL instruments: the 22-item Sinonasal Outcome Test (SNOT-22), the 36-item Short Questionnaire (SF-36), and the visual analog scale (VAS). A sinus culture was obtained at ESS, bacteria were isolated, and <i>in vitro</i> quantification of the biofilm was performed. The LK score and HRQoL were determined postoperatively at months 1, 3, 6, and 12.</p><p><strong>Results: </strong>The most common bacterial isolates in patients with CRSwNP were <i>Staphylococcus aureus</i> (28%), coagulase-negative staphylococci (52%), and <i>Pseudomonas aeruginosa</i> (8%). Preoperatively, the highest LM and LK scores were found in patients with strong biofilm producers<i>.</i> Postoperative LK scores were significantly reduced in all patients. Postoperative VAS scores were significantly reduced from month 1 to month 12 postoperatively. Patients with strong biofilm producers had significantly worse nasal blockage, secretion, headache, facial pressure and pain, and loss of smell preoperatively, compared to patients with low biofilm producers. The most significant reduction in preoperative scores SNOT-22 and SF-36 (excluding physical functioning) was seen in patients with <i>S. aureus</i> and <i>P. aeruginosa.</i></p><p><strong>Conclusions: </strong>Patients with strong biofilm producers had higher LK and LM scores preoperatively, and greater improvement in LK and HRQoL scores postoperatively. Microbiologic surveillance of all CRS patients is recommended.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"159-168"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058482","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Expression of NMU and NMUR1 in tryptase-positive mast cells and PBLs in allergic rhinitis patients' nasal mucosa. 过敏性鼻炎患者鼻粘膜中色氨酸酶阳性肥大细胞和碱性粒细胞中 NMU 和 NMUR1 的表达。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-02-20 DOI: 10.1177/19458924241228764
Wei Zhao, Yunfang An, Fengli Cheng, Changqing Zhao

Background: The neuropeptide U (NMU) has been proven to elicit the release of mediators from mast cells (MCs) through its receptor NMUR1 in allergic inflammatory models. However, little is known about the correlations between NMU and MCs in human allergic rhinitis (AR).

Objective: The objective of this study is to investigate the expressions of NMU and NMUR1 in the tryptase  +  MCs and the peripheral blood leukocytes (PBLs) in human nasal mucosa with AR.

Methods: Specimens of nasal mucosa from patients with AR (n  =  10) and control patients without AR (n  =  8) were collected and soaked in frozen tissue liquid solution (OCT) in tum. Cryostat sections were prepared for immunofluorescence staining. Tryptase was used as a marker to detect mast cells and other tryptase  +  immune cells. The expression of NMU and NMUR1 was respectively determined by double staining using a confocal microscope.

Results: Neither NMU nor NMUR1 were detected in the tryptase  +  mast cells in the human nasal mucosa. To our surprise, both NMU and NMUR1 were co-expressed with tryptase in the PBLs within peripheral blood vessels in AR and controls.

Conclusion: Our findings showed that NMU could not influence human nasal tryptase  +  mast cells directly through NMUR1 in AR. The co-expression of both NMU and NMUR1 with tryptase in the PBLs provided new insight into the potential roles of NMU and tryptase in the circulation PBLs, and the infiltrated PBLs may promote nasal allergic inflammation by producing tryptase and NMU.

背景:神经肽U(NMU)已被证实可在过敏性炎症模型中通过其受体NMUR1诱导肥大细胞(MC)释放介质。然而,人们对人类过敏性鼻炎(AR)中 NMU 与肥大细胞之间的相关性知之甚少:本研究旨在探讨 NMU 和 NMUR1 在患有 AR 的人类鼻粘膜胰蛋白酶 + MCs 和外周血白细胞(PBLs)中的表达情况:收集 AR 患者(10 人)和无 AR 对照组患者(8 人)的鼻黏膜标本,并将其浸泡在肿瘤冷冻组织液(OCT)中。制备冷冻切片用于免疫荧光染色。胰蛋白酶被用作检测肥大细胞和其他胰蛋白酶+免疫细胞的标记物。使用共聚焦显微镜进行双重染色,分别测定NMU和NMUR1的表达:结果:在人鼻粘膜的胰蛋白酶+肥大细胞中均未检测到NMU和NMUR1。令我们惊讶的是,在 AR 和对照组的外周血管中,NMU 和 NMUR1 均与胰蛋白酶共同表达:我们的研究结果表明,NMU 不能直接通过 NMUR1 影响 AR 患者的鼻腔胰蛋白酶+肥大细胞。NMU和NMUR1与胰蛋白酶在PBLs中的共表达为NMU和胰蛋白酶在循环PBLs中的潜在作用提供了新的见解,浸润的PBLs可能通过产生胰蛋白酶和NMU促进鼻过敏性炎症。
{"title":"Expression of NMU and NMUR1 in tryptase-positive mast cells and PBLs in allergic rhinitis patients' nasal mucosa.","authors":"Wei Zhao, Yunfang An, Fengli Cheng, Changqing Zhao","doi":"10.1177/19458924241228764","DOIUrl":"10.1177/19458924241228764","url":null,"abstract":"<p><strong>Background: </strong>The neuropeptide U (NMU) has been proven to elicit the release of mediators from mast cells (MCs) through its receptor NMUR1 in allergic inflammatory models. However, little is known about the correlations between NMU and MCs in human allergic rhinitis (AR).</p><p><strong>Objective: </strong>The objective of this study is to investigate the expressions of NMU and NMUR1 in the tryptase  +  MCs and the peripheral blood leukocytes (PBLs) in human nasal mucosa with AR.</p><p><strong>Methods: </strong>Specimens of nasal mucosa from patients with AR (n  =  10) and control patients without AR (n  =  8) were collected and soaked in frozen tissue liquid solution (OCT) in tum. Cryostat sections were prepared for immunofluorescence staining. Tryptase was used as a marker to detect mast cells and other tryptase  +  immune cells. The expression of NMU and NMUR1 was respectively determined by double staining using a confocal microscope.</p><p><strong>Results: </strong>Neither NMU nor NMUR1 were detected in the tryptase  +  mast cells in the human nasal mucosa. To our surprise, both NMU and NMUR1 were co-expressed with tryptase in the PBLs within peripheral blood vessels in AR and controls.</p><p><strong>Conclusion: </strong>Our findings showed that NMU could not influence human nasal tryptase  +  mast cells directly through NMUR1 in AR. The co-expression of both NMU and NMUR1 with tryptase in the PBLs provided new insight into the potential roles of NMU and tryptase in the circulation PBLs, and the infiltrated PBLs may promote nasal allergic inflammation by producing tryptase and NMU.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"146-152"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139911815","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"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
Quantification of Budesonide Retained in the Sinonasal Cavity After High-Volume Saline Irrigation in Post-Operative Chronic Rhinosinusitis. 慢性鼻窦炎术后大容量生理盐水冲洗后保留在鼻窦腔内的布地奈德定量。
IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Pub Date : 2024-05-01 Epub Date: 2024-03-08 DOI: 10.1177/19458924241237839
Paige A Shipman, Bhuvanesh Yathavan, Amarbir S Gill, Chelsea E Pollard, Venkata Yellepeddi, Hamidreza Ghandehari, Jeremiah A Alt, Abigail Pulsipher, Kristine A Smith

Background: Budesonide high-volume saline irrigations (HVSIs) are routinely used to treat chronic rhinosinusitis (CRS) due to improved sinonasal delivery and efficacy compared to intranasal corticosteroid sprays. The off-label use of budesonide is assumed to be safe, with several studies suggesting the systemically absorbed dose of budesonide HVSI is low. However, the actual budesonide dose retained in the sinonasal cavity following HVSI is unknown. The objective of this study was to quantify the retained dose of budesonide after HVSI.

Methods: Adult patients diagnosed with CRS who had undergone endoscopic sinus surgery (ESS) and were prescribed budesonide HVSI were enrolled into a prospective, observational cohort study. Patients performed budesonide HVSI (0.5 mg dose) under supervision in an outpatient clinic, and irrigation effluent was collected. High-performance liquid chromatography was employed to determine the dose of budesonide retained after HVSI.

Results: Twenty-four patients met inclusion criteria. The average corrected retained dose of budesonide across the cohort was 0.171 ± 0.087 mg (37.9% of administered budesonide). Increased time from ESS significantly impacted the measured retained dose, with those 3 months post-ESS retaining 27.4% of administered budesonide (P = .0004).

Conclusion: The retained dose of budesonide in patients with CRS after HVSI was found to be significantly higher than previously estimated and decreased with time post-ESS. Given that budesonide HVSI is a cornerstone of care in CRS, defining the retained dose and the potential systemic implications is critical to understanding the safety of budesonide HVSI.

背景:布地奈德高容量生理盐水冲洗(HVSI)与鼻内皮质类固醇喷雾剂相比,能改善鼻窦给药和疗效,因此被常规用于治疗慢性鼻窦炎(CRS)。一些研究表明,布地奈德 HVSI 的全身吸收剂量较低,因此认为标签外使用布地奈德是安全的。然而,布地奈德HVSI后保留在鼻窦腔内的实际剂量尚不清楚。本研究旨在量化布地奈德在 HVSI 后的保留剂量:方法: 一项前瞻性观察性队列研究将已接受内窥镜鼻窦手术(ESS)并开具布地奈德HVSI处方的CRS成人患者纳入研究。患者在门诊指导下进行布地奈德高压吸引术(0.5 毫克剂量),并收集灌洗流出物。采用高效液相色谱法确定布地奈德HVSI后的保留剂量:结果:24 名患者符合纳入标准。整个队列中布地奈德的平均校正保留剂量为 0.171 ± 0.087 毫克(占布地奈德给药量的 37.9%)。ESS后3个月的患者保留了27.4%的布地奈德剂量(P = .0004):结论:HVSI 后 CRS 患者的布地奈德保留剂量明显高于之前的估计值,并且随着 ESS 后时间的延长而减少。鉴于布地奈德 HVSI 是治疗 CRS 的基石,确定保留剂量和潜在的全身影响对于了解布地奈德 HVSI 的安全性至关重要。
{"title":"Quantification of Budesonide Retained in the Sinonasal Cavity After High-Volume Saline Irrigation in Post-Operative Chronic Rhinosinusitis.","authors":"Paige A Shipman, Bhuvanesh Yathavan, Amarbir S Gill, Chelsea E Pollard, Venkata Yellepeddi, Hamidreza Ghandehari, Jeremiah A Alt, Abigail Pulsipher, Kristine A Smith","doi":"10.1177/19458924241237839","DOIUrl":"10.1177/19458924241237839","url":null,"abstract":"<p><strong>Background: </strong>Budesonide high-volume saline irrigations (HVSIs) are routinely used to treat chronic rhinosinusitis (CRS) due to improved sinonasal delivery and efficacy compared to intranasal corticosteroid sprays. The off-label use of budesonide is assumed to be safe, with several studies suggesting the systemically absorbed dose of budesonide HVSI is low. However, the actual budesonide dose retained in the sinonasal cavity following HVSI is unknown. The objective of this study was to quantify the retained dose of budesonide after HVSI.</p><p><strong>Methods: </strong>Adult patients diagnosed with CRS who had undergone endoscopic sinus surgery (ESS) and were prescribed budesonide HVSI were enrolled into a prospective, observational cohort study. Patients performed budesonide HVSI (0.5 mg dose) under supervision in an outpatient clinic, and irrigation effluent was collected. High-performance liquid chromatography was employed to determine the dose of budesonide retained after HVSI.</p><p><strong>Results: </strong>Twenty-four patients met inclusion criteria. The average corrected retained dose of budesonide across the cohort was 0.171 ± 0.087 mg (37.9% of administered budesonide). Increased time from ESS significantly impacted the measured retained dose, with those 3 months post-ESS retaining 27.4% of administered budesonide (<i>P</i> = .0004).</p><p><strong>Conclusion: </strong>The retained dose of budesonide in patients with CRS after HVSI was found to be significantly higher than previously estimated and decreased with time post-ESS. Given that budesonide HVSI is a cornerstone of care in CRS, defining the retained dose and the potential systemic implications is critical to understanding the safety of budesonide HVSI.</p>","PeriodicalId":7650,"journal":{"name":"American Journal of Rhinology & Allergy","volume":" ","pages":"169-177"},"PeriodicalIF":2.6,"publicationDate":"2024-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11145513/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140058483","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
期刊
American Journal of Rhinology & Allergy
全部 Acc. Chem. Res. ACS Applied Bio Materials ACS Appl. Electron. Mater. ACS Appl. Energy Mater. ACS Appl. Mater. Interfaces ACS Appl. Nano Mater. ACS Appl. Polym. Mater. ACS BIOMATER-SCI ENG ACS Catal. ACS Cent. Sci. ACS Chem. Biol. ACS Chemical Health & Safety ACS Chem. Neurosci. ACS Comb. Sci. ACS Earth Space Chem. ACS Energy Lett. ACS Infect. Dis. ACS Macro Lett. ACS Mater. Lett. ACS Med. Chem. Lett. ACS Nano ACS Omega ACS Photonics ACS Sens. ACS Sustainable Chem. Eng. ACS Synth. Biol. Anal. Chem. BIOCHEMISTRY-US Bioconjugate Chem. BIOMACROMOLECULES Chem. Res. Toxicol. Chem. Rev. Chem. Mater. CRYST GROWTH DES ENERG FUEL Environ. Sci. Technol. Environ. Sci. Technol. Lett. Eur. J. Inorg. Chem. IND ENG CHEM RES Inorg. Chem. J. Agric. Food. Chem. J. Chem. Eng. Data J. Chem. Educ. J. Chem. Inf. Model. J. Chem. Theory Comput. J. Med. Chem. J. Nat. Prod. J PROTEOME RES J. Am. Chem. Soc. LANGMUIR MACROMOLECULES Mol. Pharmaceutics Nano Lett. Org. Lett. ORG PROCESS RES DEV ORGANOMETALLICS J. Org. Chem. J. Phys. Chem. J. Phys. Chem. A J. Phys. Chem. B J. Phys. Chem. C J. Phys. Chem. Lett. Analyst Anal. Methods Biomater. Sci. Catal. Sci. Technol. Chem. Commun. Chem. Soc. Rev. CHEM EDUC RES PRACT CRYSTENGCOMM Dalton Trans. Energy Environ. Sci. ENVIRON SCI-NANO ENVIRON SCI-PROC IMP ENVIRON SCI-WAT RES Faraday Discuss. Food Funct. Green Chem. Inorg. Chem. Front. Integr. Biol. J. Anal. At. Spectrom. J. Mater. Chem. A J. Mater. Chem. B J. Mater. Chem. C Lab Chip Mater. Chem. Front. Mater. Horiz. MEDCHEMCOMM Metallomics Mol. Biosyst. Mol. Syst. Des. Eng. Nanoscale Nanoscale Horiz. Nat. Prod. Rep. New J. Chem. Org. Biomol. Chem. Org. Chem. Front. PHOTOCH PHOTOBIO SCI PCCP Polym. Chem.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
0
微信
客服QQ
Book学术公众号 扫码关注我们
反馈
×
意见反馈
请填写您的意见或建议
请填写您的手机或邮箱
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
现在去查看 取消
×
提示
确定
Book学术官方微信
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术
文献互助 智能选刊 最新文献 互助须知 联系我们:info@booksci.cn
Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。
Copyright © 2023 Book学术 All rights reserved.
ghs 京公网安备 11010802042870号 京ICP备2023020795号-1