Manifestation and associated factors of systemic and local allergy among patients with allergic fungal rhinosinusitis: An observational study.

Allergic fungal rhinosinusitis (AFRS) is a subtype of chronic rhinosinusitis, characterized by excessive immune responses to environmental molds or fungi. The diagnosis and classification of AFRS into systemic and local types remain clinically challenging due to overlapping characteristics. This study investigated the prevalence of AFRS, its manifestation and associated factors in systemic and local AFRS. A total of 200 patients diagnosed with fungal rhinosinusitis underwent both skin provocation tests (SPT) and nasal provocation tests (NPT) to confirm AFRS and classify systemic and local types. Patients were considered to have AFRS if either the SPT or NPT was positive. Among these, patients with systemic AFRS were those who had a SPT positive. Local AFRS was when patients had a negative SPT and a positive NPT. Medical history, serum total IgE level, nasal endoscopy examinations, and CT scans were also recorded. Most patients were female (65.8%), with a mean age of 55.6 years (SD = 14.4). Based on the SPT and NPT results, 31% of patients (n = 62) were diagnosed with AFRS. Among these, 54.8% (n = 34) had systemic AFRS, while 45.2% (n = 28) had local AFRS. Patients with AFRS exhibited significantly higher levels of total IgE, eosinophils, and more pronounced signs and symptoms compared to those without AFRS. However, no statistically significant differences were observed between patients with systemic AFRS and those with local AFRS. AFRS was prevalent in our study. Among patients with AFRS, both systemic AFRS and local AFRS were also prevalent. While allergic indicators and clinical presentations can aid in AFRS diagnosis, minimal distinctions were observed between systemic and local AFRS. A comprehensive assessment incorporating both local and systemic allergic responses through provocation tests, such as a combination of skin and nasal tests, is imperative for optimizing AFRS diagnosis and management.

A comparison of effectiveness between Posisep and Merocel nasal packing after endoscopic sinus surgery: Findings from a randomized, double-blinded, controlled trial.

BACKGROUND: The effectiveness of nonabsorbable and biodegradable nasal packing is still controversial, and the choice of nasal packing type can alter the outcome of endoscopic sinus surgery. This study compared the effectiveness of Posisep and Merocel as nasal packing materials with regard to hemostasis, adhesion, wound healing, patient's satisfaction and health-related quality of life after endoscopic sinus surgery (ESS). METHODS: A prospective, randomized, double-blinded, controlled trial was conducted in patients with chronic rhinosinusitis refractory undergoing symmetrical bilateral ESS. At the completion of surgery, a nasal packing (either Merocel or Posisep) was randomly chosen and placed into the middle meatus of each nasal cavity. All patients were scheduled for follow-up visits at 24 hours, 5 days, 3 weeks, and 5 weeks days after surgery. Health-related quality of life was measured using the Sino-Nasal Outcome Test (SNOT-22). The overall inflammatory burden of chronic rhinosinusitis was measured by the Lund-Mackay postoperative endoscopic score (LMES). RESULTS: Among 62 patients included in data analysis (n = 31 for each group), the mean age was 42.4 years and 54.8% were females. Patients with Posisep after ESS had more improvement and better symptoms measured through SNOT-22 and LMES at 24 hours, 5 days, and 3 weeks than those with Merocel after ESS. While some aspects measured by LMES such as discharge and scarring were still better until 5 weeks after surgery, all symptoms measured by SNOT-22 were similar between the 2 groups 5 weeks after surgery. CONCLUSION: Posisep containing chitosan provided patients with a better quality of life throughout the early recovery period compared with Merocel. Although more studies are needed, our findings support the use of Posisep after ESS.

Simulation on the Factors Affecting the Crystallization Process of FeNi Alloy by Molecular Dynamics.

This paper investigates the crystallization process of FeNi alloys with different impurity concentrations of Ni(x) [x = 10% (Fe90Ni10), 20% (Fe80Ni20), 30% (Fe70Ni30), 40% (Fe60Ni40), and 50% (Fe50Ni50)] at temperature (T) = 300 K and Fe70Ni30 at heating rates of 4 × 1012, 4 × 1013, and 4 × 1014 K/s at different temperatures, T = 300, 400, 500, 600, 700, 900, 1100, and 1300 K. Molecular dynamics models with the Sutton-Chen embedded interaction potential and recirculating boundary conditions are used to calculate the molecular parameters of alloys, such as radial distribution function, total energy of the system (E tot), size (l), and crystallization temperature (through the relationship between E tot and T). The common neighborhood analysis method is used to confirm the theoretical results of crystallization for Fe-Fe, Fe-Ni, and Ni-Ni. The annealing process did not have an effect on the crystallization process of FeNi alloys. The effect of Ni content, heating rate, and annealing time on structural unit numbers, such as face-centered cubic, hexagonal close-packed, blocked cubic center, and amorphous, and the crystallization process of FeNi alloys is also investigated.