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2.
Artigo em Russo | MEDLINE | ID: mdl-33338349

RESUMO

The problem of preserving health of students remains an important task due to peculiarities of their studies and life. The otorhinolaryngologic pathology, in particular rhinosinusitis, occupies one of leading positions in the structure of morbidity of students. The purpose of study is to assess morbidity in students and to develop three-stage prevention program with subsequent evaluation of its effectiveness. Materials and methods: analysis of the results of comprehensive medical examination of medical students in 2015-2017, otorhinolaryngologic pathology. The three-stage prevention program was developed and implemented. The program consisted of general strengthening basic program at the first stage, medication and physiotherapy program at the second stage and complex of Strelnikova respiratory gymnastics and with natural mineral water nasal lavage at the third stage. To evaluate effectiveness of the program, sampling of 164 students suffering of rhinosinusitis was randomized at three groups that passed the first, the second, or all 3 stages respectively. Results and conclusions. The analysis of structure of morbidity in students established high prevalence of otorhinolaryngologic pathology, mainly rhinosinusitis. The proposed three-stage prevention program, implemented in the University, decreased rate of common colds and annual hospitalizations and duration of rhinosinusitis.


Assuntos
Rinite/prevenção & controle , Sinusite/prevenção & controle , Estudantes de Medicina , Adolescente , Humanos , Prevalência
3.
PLoS One ; 15(12): e0243315, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33326455

RESUMO

Chronic rhinosinusitis (CRS) is a chronic disease that involves long-term inflammation of the nasal cavity and paranasal sinuses. Bacterial biofilms present on the sinus mucosa of certain patients reportedly exhibit resistance against traditional antibiotics, as evidenced by relapse, resulting in severe disease. The aim of this study was to determine the killing activity of human cathelicidin antimicrobial peptides (LL-37, LL-31) and their D-enantiomers (D-LL-37, D-LL-31), alone and in combination with conventional antibiotics (amoxicillin; AMX and tobramycin; TOB), against bacteria grown as biofilm, and to investigate the biological activities of the peptides on human lung epithelial cells. D-LL-31 was the most effective peptide against bacteria under biofilm-stimulating conditions based on IC50 values. The synergistic effect of D-LL-31 with AMX and TOB decreased the IC50 values of antibiotics by 16-fold and could eliminate the biofilm matrix in all tested bacterial strains. D-LL-31 did not cause cytotoxic effects in A549 cells at 25 µM after 24 h of incubation. Moreover, a cytokine array indicated that there was no significant induction of the cytokines involving in immunopathogenesis of CRS in the presence of D-LL-31. However, a tissue-remodeling-associated protein was observed that may prevent the progression of nasal polyposis in CRS patients. Therefore, a combination of D-LL-31 with AMX or TOB may improve the efficacy of currently used antibiotics to kill biofilm-embedded bacteria and eliminate the biofilm matrix. This combination might be clinically applicable for treatment of patients with biofilm-associated CRS.


Assuntos
Antibacterianos/farmacologia , Peptídeos Catiônicos Antimicrobianos/farmacologia , Bactérias/crescimento & desenvolvimento , Fenômenos Fisiológicos Bacterianos/efeitos dos fármacos , Biofilmes/efeitos dos fármacos , Células Epiteliais/microbiologia , Pulmão/microbiologia , Rinite , Sinusite , Células A549 , Adolescente , Adulto , Idoso , Biofilmes/crescimento & desenvolvimento , Doença Crônica , Células Epiteliais/metabolismo , Feminino , Humanos , Pulmão/metabolismo , Pulmão/patologia , Masculino , Pessoa de Meia-Idade , Rinite/tratamento farmacológico , Rinite/microbiologia , Rinite/patologia , Sinusite/tratamento farmacológico , Sinusite/microbiologia , Sinusite/patologia
4.
Medicine (Baltimore) ; 99(51): e23634, 2020 Dec 18.
Artigo em Inglês | MEDLINE | ID: mdl-33371097

RESUMO

BACKGROUND: The herba Houttuynia cordata Thunb. (HC) has anti-inflammatory, antibacterial and antiviral effects. Through nasal irrigation, the related preparation of HC is beneficial for treating rhinosinusitis or promoting recovery after an endoscopic sinus surgery. However, it remains controversial whether nasal irrigation with HC preparation can provide evidence-based clinical benefits for rhinosinusitis patients. METHODS: With reference to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), 8 databases are perused to perform a methodical investigation of nasal irrigation with HC preparation and health-related results amongst rhinosinusitis patients. The main research purpose is to determine the influence of PRISMA standards on medical results pertaining to rhinosinusitis patients, including quantitative symptom recording and effective rate. With reference to the Cochrane Handbook, quality assessment of qualified papers is conducted using the Cochrane Risk Assessment Tool. RESULTS: The results will be publicised through a peer-reviewed journal publication. CONCLUSION: The results of the systematic review will summarise evidences for the efficacy of nasal irrigation with HC preparation in rhinosinusitis treatment. ETHICS AND DISSEMINATION: Since this study involves a methodical investigation of issued medical papers, ethical authorisation and informed patient consent are not necessary.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Houttuynia , Fitoterapia , Rinite/tratamento farmacológico , Sinusite/tratamento farmacológico , Humanos , Metanálise como Assunto , Lavagem Nasal , Revisões Sistemáticas como Assunto
5.
Braz. j. otorhinolaryngol. (Impr.) ; 86(6): 743-747, Nov.-Dec. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1142588

RESUMO

Abstract Introduction: Chronic rhinosinusitis with nasal polyps, a prevalent disease affecting around 2% of the world population, is characterized by symptomatic inflammation of the nasal mucosa and impairment of quality of life. Chronic rhinosinusitis with nasal polyps has a multifactorial etiology, involving a dysfunctional host response to environmental factors. Thus, inflammatory models may be useful to shed light on the pathophysiology of this disease. Micronucleus count has been used to screen DNA damage in various tissues. Objective: To investigate the association between frequency of micronucleus in exfoliated cells from the nasal cavity of patients with chronic rhinosinusitis with nasal polyps and disease severity. Methods: This cross-sectional study included 21 patients with chronic rhinosinusitis with nasal polyps and 19 controls without disease. None of the participants were smokers. Results: Mean micronucleus count was 3.690 per 1000 cells (±2.165) in individuals with vs. 1.237 per 1000 cells (±0.806) in controls; (Student's t test = 4.653, p< 0.001). Nasal surgery in the past 5 years and aspirin-exacerbated respiratory disease were not associated with nicronucleus count (p= 0.251). Conclusion: Micronucleus count seems to be linked to chronic rhinosinusitis with nasal polyps, providing a new perspective for the evaluation of this disorder.


Resumo Introdução: A rinossinusite crônica com pólipos nasais, doença prevalente que afeta cerca de 2% da população mundial, é caracterizada por inflamação sintomática da mucosa nasal e comprometimento da qualidade de vida. A rinossinusite crônica com pólipos nasais tem etiologia multifatorial, envolvendo resposta disfuncional do hospedeiro a fatores ambientais. Assim, modelos inflamatórios podem ser úteis para esclarecer a fisiopatologia dessa doença. A contagem de micronúcleos tem sido usada para rastrear danos no DNA em vários tecidos. Objetivo: Investigar a associação entre a frequência de micronúcleos em células esfoliadas da cavidade nasal de pacientes com rinossinusite crônica com pólipos nasais e a gravidade da doença. Método: Estudo transversal que incluiu 21 pacientes com rinossinusite crônica com pólipos nasais e 19 controles sem doença. Nenhum dos participantes era fumante. Resultados: A contagem média de micronúcleos foi de 3,690 por 1.000 células (± 2,165) nos indivíduos doentes e 1,237 por 1.000 células (± 0,806) nos controles (teste t de Student = 4,653; p < 0,001). A cirurgia nasal nos últimos 5 anos e a doença respiratória exacerbada por aspirina não foram associadas à contagem de micronúcleos (p = 0,251). Conclusão: A contagem de micronúcleos parece estar ligada à rinossinusite crônica com pólipos nasais, proporcionando uma nova perspectiva para a avaliação dessa doença.


Assuntos
Humanos , Sinusite/complicações , Rinite/complicações , Pólipos Nasais/complicações , Qualidade de Vida , Doença Crônica , Estudos Transversais , Células Epiteliais
6.
Rhinology ; 58(5): 522-523, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-33130830

RESUMO

Social distancing with the aim of avoiding infections and pre-serve critical care capacities during the COVID-19 pandemic has been implemented in Germany according to World Health Organization (WHO) recommendations from early March onwards. Limitations of physical contacts to reduce exposure to SARS-CoV-2 infected individuals were handled strictly, particularly in medical centers dealing with airway diseases, like rhinology and pneumology clinics. Such measures and reluctance to visit out- and inpatient services resulted in a 82% decrease in consultations to the 12 German oto-rhino-laryngological (ORL) centres forming our database during the 50 days following March 09 in 2020 if compared to the same period in 2019. Our data on CRS care underline reports on undertreatment of non-COVID-19 individuals with several different diseases during the current pandemic. We should try to reduce the toll these patients have to pay as much as possible. We established telemedicine, e-Health and artificial intelligence-supported triage for selecting the right patients for onsite-consultations and to advise patients in several demands.


Assuntos
Inteligência Artificial , Infecções por Coronavirus , Pandemias , Pneumonia Viral , Rinite/diagnóstico , Rinite/terapia , Sinusite/diagnóstico , Sinusite/terapia , Betacoronavirus , Doença Crônica , Alemanha/epidemiologia , Humanos , Otolaringologia/tendências , Telemedicina
8.
Am J Otolaryngol ; 41(6): 102746, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33198053

RESUMO

With the ongoing development of the COVID-19 pandemic, research continues to emerge regarding the pathophysiology, characteristics, and treatment considerations for patients with COVID-19. No reports have highlighted the specific challenges posed in the management of pediatric patients with COVID-19 who present with complicated rhinosinusitis. In this report, we discuss our preoperative, intraoperative, and postoperative multidisciplinary treatment strategy for these cases and provide two examples of complicated rhinosinusitis cases in COVID-19 patients, treated with two different approaches. Pearls, insights, and a brief review of the literature are discussed.


Assuntos
Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Rinite/virologia , Sinusite/virologia , Adolescente , Betacoronavirus , Criança , Técnicas de Laboratório Clínico , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Infecções por Coronavirus/diagnóstico por imagem , Infecções por Coronavirus/terapia , Humanos , Masculino , Pandemias , Pneumonia Viral/diagnóstico por imagem , Pneumonia Viral/terapia , Rinite/diagnóstico por imagem , Rinite/terapia , Sinusite/diagnóstico por imagem , Sinusite/terapia
9.
Vestn Otorinolaringol ; 85(5): 40-43, 2020.
Artigo em Russo | MEDLINE | ID: mdl-33140932

RESUMO

The purpose of the study was to summarize data on modern antibiotic therapy for acute sinusitis, the role and place of topical antibacterial drugs, in particular Fluimucil-Antibiotic, in modern treatment strategies for this disease. METHODS: Search in the PUBMED electronic database (articles and related abstracts) for the keywords «acute sinusitis", «antibiotics¼, «thiamphenicol glycinate acetylcysteine¼ «biofilm¼, «respiratory tract infection¼, «N-acetylcysteine¼. RESULTS: The published research results indicate the high antibacterial activity of the Fluimucil-Antibiotic, in particular, for the topical drug use in the form of inhalations, applications, irrigation, and instillations. The published research results indicate a wide spectrum of antimicrobial action of Fluimucil-Antibiotic, its ability to destroy biofilms and prevent their formation, good pharmacokinetics, safety, which makes it possible to consider it as a potential treatment option for acute sinusitis in everyday practice.


Assuntos
Infecções Respiratórias , Sinusite , Acetilcisteína , Doença Aguda , Antibacterianos/uso terapêutico , Combinação de Medicamentos , Humanos , Infecções Respiratórias/tratamento farmacológico , Sinusite/tratamento farmacológico
10.
Acta otorrinolaringol. esp ; 71(5): 296-302, sept.-oct. 2020. graf, ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-195216

RESUMO

ANTECEDENTES Y OBJETIVO: La propagación de una infección a partir de los senos paranasales es poco frecuente pero grave. Entre un 4 y un 20% de las rinosinusitis se pueden complicar; de ellas, las orbitarias (60-75%) son las más prevalentes. La gran mayoría se presentan en la edad pediátrica, si bien en la edad adulta son más graves. Nuestro objetivo es analizar las características epidemiológicas de estos pacientes así como plantear un protocolo de actuación ante esta situación. MATERIALES Y MÉTODOS: Se realizó un estudio retrospectivo de 21 pacientes diagnosticados de una complicación orbitaria en el curso de una rinosinusitis aguda entre 2005 y 2018. El diagnóstico se basó en la historia clínica, la exploración endoscópica y las pruebas de imagen. Todos los pacientes recibieron antibioterapia intravenosa y fueron valorados por oftalmología. Se llevó a cabo un tratamiento quirúrgico urgente en caso de existir un absceso o mala evolución con el tratamiento médico. RESULTADOS: La edad media de los pacientes fue de 24 años. El 52% fueron varones y el 48% mujeres. Según la clasificación de Chandler, el 43% (9/21) fueron celulitis preseptales (7 adultos y 2 niños), el 10% (2/21) celulitis orbitarias (un adulto y un niño), el 43% (9/21) abscesos subperiósticos (2 adultos y 7 niños), hubo un caso de absceso orbitario en un adulto y ningún caso de trombosis de seno cavernoso. Se solicitó una TC a todos los pacientes y se optó por el tratamiento quirúrgico en caso de absceso subperióstico u orbitario, a excepción de 2 abscesos de pequeño tamaño (< 4 mm), subperiósticos mediales y en edad pediátrica (< 4 años) que presentaron una correcta evolución con tratamiento conservador. El abordaje quirúrgico fue por vía endoscópica endonasal: se resecó la lámina papirácea y se mantuvo intacta la periórbita en el caso de abscesos subperiósticos, pero se incidió en ella en el absceso orbitario. Se complementó con un abordaje externo palpebral en los 4 casos que presentaron una colección en el techo de la órbita o en la pared lateral. Dos pacientes adultos jóvenes (10%) presentaron de manera concomitante una complicación intracraneal. CONCLUSIONES: Las complicaciones orbitarias de la rinosinusitis aguda son poco frecuentes pero potencialmente graves. Es importante conocerlas y sospecharlas para actuar con rapidez. El tratamiento multidisciplinar, la localización y la extensión del cuadro son esenciales para el correcto manejo de estas complicaciones. El abordaje quirúrgico se realiza mediante endoscopia endonasal. Su limitación son las colecciones localizadas en el techo de la órbita o en pared lateral, en las que se tendrá que complementar la actuación con un abordaje externo palpebral


BACKGROUND AND OBJECTIVE: The spread of an infection from the paranasal sinuses is rare but severe. Between 4% and 20% of all rhinosinusitis can become complicated, orbital involvement being the most frequent (60-75%). Orbital complications are more common in children but more severe in adults. We aim to analyse the epidemiological characteristics of these patients and to propose a management algorithm. MATERIALS AND METHODS: We carried out a retrospective review of 21 patients with orbital complications of acute rhinosinusitis diagnosed in the same institution from 2005 to 2018. The diagnosis was based on clinical history, endoscopic examination and imaging tests. All patients received an intravenous antibiotic and were assessed by ophthalmology. An immediate surgical treatment was performed in the case of an abscess or poor response to medical management. RESULTS: The average age was 24 years. Fifty-two percent were males and 48% females. According to Chandler's classification, 43% (9/21) had preseptal cellulitis (7 adults and 2 children), 10% (2/21) orbital cellulitis (one adult and one child), 43% (9/21) subperiosteal abscess (2 adults and 7 children), there was one case of orbital abscess in an adult and there were no cases of cavernous sinus thrombosis. A CT scan was performed in all patients and the cases of subperiosteal or orbital abscess were treated surgically, except 2 paediatric patients (< 4 years) with a small and medial subperiosteal abscess (< 4 mm) who responded well to medical treatment. The surgical approach is performed by endonasal endoscopy, perforating the lamina papyracea in cases of subperiosteal abscess and also opening the periorbita in orbital abscess. It was combined with an external palpebral approach in the 4 cases that presented a superior or lateral abscess. Two young adults (10%) presented an intracranial complication concomitantly. CONCLUSION: Orbital complications of acute rhinosinusitis are rare but potentially severe. It is important to be aware of and suspect them in order to act quickly. It is essential to define the location and extension of the infection for correct management, as well as multidisciplinary treatment. The surgical approach is performed by endonasal endoscopy. It is limited by abscesses located on the roof of the orbit or on the lateral wall, when a combined external palpebral approach is required


Assuntos
Humanos , Masculino , Feminino , Adulto Jovem , Adulto , Sinusite/epidemiologia , Rinite/epidemiologia , Doenças Orbitárias/epidemiologia , Sinusite/complicações , Rinite/complicações , Doenças Orbitárias/etiologia , Sinusite/terapia , Rinite/terapia , Doença Aguda , Estudos Retrospectivos , Algoritmos , Espanha/epidemiologia
11.
Acta otorrinolaringol. esp ; 71(5): 303-308, sept.-oct. 2020. graf
Artigo em Espanhol | IBECS | ID: ibc-195217

RESUMO

INTRODUCCIÓN: La rinosinusitis fúngica invasiva aguda (RSFIA) es una enfermedad poco frecuente, de alta mortalidad. Se presenta principalmente en pacientes inmunocomprometidos con múltiples comorbilidades, lo que dificulta su manejo. El objetivo de este trabajo es describir una cohorte de pacientes operados por RSFIA, sus características clínicas y mortalidad, los agentes etiológicos y el rendimiento de los métodos de diagnóstico. MATERIAL Y MÉTODO: Estudio prospectivo no concurrente de pacientes operados por RSFIA entre el 2005 y 2015 en nuestro centro. RESULTADOS: Se incluyeron 32 pacientes, 62,5% (20/32) hombres, con una edad promedio de 39,4 años (16-65 años). La mortalidad global fue del 71,9%, correspondiendo un 46,9% a mortalidad en agudo y un 25% a tardía. Las neoplasias hematológicas fueron la enfermedad de base más frecuente, correspondiendo al 84,4% (27/32) de los casos, seguida de la diabetes mellitus en un 9,4% (3/32). El 62,5% (20/32) de los pacientes presentó neutropenia al diagnóstico, y un 80% (16/20) de ellos, neutropenia febril. El síntoma más frecuente fue la fiebre en un 65,6% (21/32), luego dolor facial o cefalea en un 53,1% (17/32). Se identificó Aspergillus en el 37,5% (12/32), seguido por Rhizopus en el 31,3% (10/32). No se encontró asociación entre las variables estudiadas y un mayor riesgo de mortalidad. CONCLUSIONES: La RSFIA es una enfermedad agresiva con una alta mortalidad, siendo fundamental el diagnóstico oportuno. Es necesario optimizar los criterios de sospecha para un diagnóstico precoz que permita mejorar el pronóstico


INTRODUCTION: Acute invasive fungal rhinosinusitis (AIFRS) is rare but has high mortality. It is more frequent in immunocompromised patients with multiple comorbidities, which make their management more difficult. The aim of this study is to describe a cohort of patients operated due to AIFRS, their clinical characteristics, mortality, aetiological agent and efficacy of diagnostic tests. MATERIAL AND METHOD: Non-concurrent prospective study of patients with AIFRS who were operated between 2005 and 2015 in our centre. RESULTS: Thirty-two patients were included, 62.5% (20/32) men, with an average age of 39.4 years (16-65 years). Overall mortality was 71.9%; acute mortality 46.9% and late mortality 25%. Haematological malignancies were the most common underlying disease, present in 84.4% (27/32) of cases, followed by diabetes mellitus in 9.4% (3/32). On diagnosis, 62.5% (20/32) of patients were neutropenic, 80% (16/20) of them with febrile neutropenia. Fever was the most frequent symptom, present in 65.6% (21/32) of patients, followed by facial pain or headache in 53.1% (17/32). Aspergillus was identified in 37.5% (12/32) of cases and Rhizopus in 31.3% (10/32). There was no association between the analysed variables and increased risk of mortality. CONCLUSIONS: AIFRS is an aggressive disease with a high mortality rate, therefore a timely diagnosis is fundamental. It is necessary to optimise suspicion criteria for an early diagnosis in order to improve the prognosis


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Sinusite/microbiologia , Rinite/microbiologia , Sinusite/cirurgia , Rinite/cirurgia , Infecções Fúngicas Invasivas/cirurgia , Estudos Prospectivos , Doença Aguda , Sinusite/mortalidade , Rinite/mortalidade , Infecções Fúngicas Invasivas/mortalidade , Modelos Logísticos , Fatores de Risco , Chile/epidemiologia
12.
Nat Commun ; 11(1): 5453, 2020 10 28.
Artigo em Inglês | MEDLINE | ID: mdl-33116139

RESUMO

The coronavirus SARS-CoV-2 is the causative agent of the ongoing severe acute respiratory disease pandemic COVID-19. Tissue and cellular tropism is one key to understanding the pathogenesis of SARS-CoV-2. We investigate the expression and subcellular localization of the SARS-CoV-2 receptor, angiotensin-converting enzyme 2 (ACE2), within the upper (nasal) and lower (pulmonary) respiratory tracts of human donors using a diverse panel of banked tissues. Here, we report our discovery that the ACE2 receptor protein robustly localizes within the motile cilia of airway epithelial cells, which likely represents the initial or early subcellular site of SARS-CoV-2 viral entry during host respiratory transmission. We further determine whether ciliary ACE2 expression in the upper airway is influenced by patient demographics, clinical characteristics, comorbidities, or medication use, and show the first mechanistic evidence that the use of angiotensin-converting enzyme inhibitors (ACEI) or angiotensin II receptor blockers (ARBs) does not increase susceptibility to SARS-CoV-2 infection through enhancing the expression of ciliary ACE2 receptor. These findings are crucial to our understanding of the transmission of SARS-CoV-2 for prevention and control of this virulent pathogen.


Assuntos
Antagonistas de Receptores de Angiotensina/uso terapêutico , Inibidores da Enzima Conversora de Angiotensina/uso terapêutico , Infecções por Coronavirus/patologia , Expressão Gênica/efeitos dos fármacos , Peptidil Dipeptidase A/genética , Pneumonia Viral/patologia , Sistema Respiratório/patologia , Fatores Etários , Cílios/metabolismo , Infecções por Coronavirus/virologia , Células Endoteliais , Células Caliciformes/metabolismo , Humanos , Pulmão/patologia , Pandemias , Peptidil Dipeptidase A/metabolismo , Pneumonia Viral/virologia , Sistema Respiratório/metabolismo , Sistema Respiratório/virologia , Fatores Sexuais , Sinusite/metabolismo , Fumar
13.
Head Face Med ; 16(1): 24, 2020 Oct 13.
Artigo em Inglês | MEDLINE | ID: mdl-33050926

RESUMO

BACKGROUND: Diagnosis of maxillary sinus pathology must include the clinical radiological study (CRS) and histopathological analysis. The aim of this study is 1) to describe the clinicopathological features of maxillary sinus lesions, obtained successively in a single medical centre over the last 10 years and 2) to determine the sensitivity and specificity for the diagnosis of malignant lesions based exclusively on the CRS. METHODS: It is a single-centre observational retrospective clinical study on patients who attended the University Hospital Complex of Santiago de Compostela (CHUS) with sinus pathologies during the period of 2009-2019. RESULTS: The sample consisted of 133 men (62.1%) and 81 women (37.9%), with an average age of 46.9 years (SD = 18.8). In terms of frequency, the most frequent pathology was the unspecified sinusitis (44.4%), followed by polyps (18.2%), malignant tumours (9.8%), inverting papilloma (7.5%), fungal sinusitis (4.7%), cysts (3.7%), benign tumours (2.3%), mucocele (2.3%) and other lesions (1.9%). Cysts and benign tumours were diagnosed earliest Vs malignant tumours (65.2 years (SD = 16.1)) were diagnosed the latest (p < 0.001). Based only on the CRS for malignancies, diagnostic indexes were 71.4% sensitivity and 97.9% specificity, with a Kappa value of 0.68 with (p < 0.001). CONCLUSION: Maxillary sinus pathology is very varied with therapeutic and prognostic repercussions. CRS is sometimes insufficient and histopathological confirmation is essential.


Assuntos
Seio Maxilar , Sinusite , Feminino , Humanos , Masculino , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/patologia , Neoplasias do Seio Maxilar/diagnóstico por imagem , Neoplasias do Seio Maxilar/patologia , Neoplasias do Seio Maxilar/terapia , Pessoa de Meia-Idade , Mucocele/diagnóstico por imagem , Mucocele/terapia , Pólipos Nasais/diagnóstico por imagem , Pólipos Nasais/terapia , Estudos Retrospectivos , Sinusite/diagnóstico por imagem , Sinusite/terapia , Tomografia Computadorizada por Raios X
14.
Braz. j. otorhinolaryngol. (Impr.) ; 86(5): 639-646, Sept.-Oct. 2020. tab, graf
Artigo em Inglês | LILACS | ID: biblio-1132645

RESUMO

Abstract Introduction: Currently, several different concentrations of saline are recommended for use in nasal irrigation. Increasing studies show that nasal irrigation with hypertonic saline is more effective than traditional saline in the treatment of rhinosinusitis, but there have been few systematic analyses of the effect of nasal irrigation with hypertonic saline on chronic rhinosinusitis. Objective: We sought to compare the effects of hypertonic saline and isotonic saline in the treatment of rhinosinusitis in order to provide a reference for clinical nasal irrigation for chronic rhinosinusitis treatment. Methods: Medline, cochrane library, EMBASE, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database, and other databases were searched, and the searching was supplemented by manual searches for relevant references to treatment of rhinosinusitis by saline nasal irrigation. The last retrieval date was March 2018. The included studies were evaluated for quality, and data were extracted for meta-analysis using RevMan 5.3. Results: Seven studies were included. Effects favoring hypertonic saline on nasal symptoms were greater in 4 subgroups. These were (1) patients with nasal secretion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (2) patients with congestion (SMD = 1.52; 95% CI: 1.04, 2.00; p < 0.01), (3) patients with headache (SMD = 0.82; 95% CI: 0.38, 1.26; p < 0.01), (4) patients with overall symptomatic relief (SMD = 1.63; 95% CI: 0.83, 2.44; p < 0.01). However, no difference was shown in smell improvement (SMD = 0.47; 95% CI: −0.65, 1.59; p = 0.41) and radiologic scores improvement (SMD = 2.44; 95% CI: -3.14, 8.02; p < 0.01). Besides, hypertonic saline showed greater improvement in mucociliary clearance time scores than did the isotonic saline group (SMD = 1.19; 95% CI: 0.78, 1.60; p < 0.01). Hypertonic saline brought greater minor adverse effects. Conclusion: Compared with isotonic saline, hypertonic saline nasal irrigation for the treatment of chronic rhinosinusitis is significantly more effective and has mild side effects in improving nasal symptoms and ciliary movement, but there is no significant difference in imaging findings and smell improvement. Although hypertonic saline is worthy of widespread use in clinical practice, it is still necessary to further study the exact manner and concentration of nasal irrigation.


Resumo Introdução: Atualmente, o uso de várias concentrações diferentes de solução salina é recomendado na irrigação nasal. Um número crescente de estudos mostra que a irrigação nasal com solução salina hipertônica é mais eficaz do que a solução salina tradicional no tratamento de rinossinusite, mas existem poucas análises sistemáticas do efeito da irrigação nasal com solução salina hipertônica em rinossinusite crônica. Objetivo: Comparar os efeitos da solução salina hipertônica com a solução salina isotônica no tratamento da rinossinusite, para fornecer uma referência clínica de irrigação nasal no tratamento da rinossinusite crônica. Método: Foram pesquisados os bancos de dados Medline, Cochrane Library, Embase, PubMed, Chinese biomedical journal database, China national knowledge infrastructure, Wanfang database e outros, e a pesquisa foi complementada por pesquisas manuais de referências relevantes ao tratamento da rinossinusite por irrigação nasal com solução salina. A data da última recuperação de dados foi março de 2018. Os estudos incluídos foram avaliados quanto à qualidade e os dados foram extraídos para a metanálise com o software RevMan 5.3. Resultados: Sete estudos foram incluídos. Os efeitos favoráveis à solução salina hipertônica nos sintomas nasais foram maiores em quatro subgrupos. Esses foram (1) pacientes com secreção nasal (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (2) pacientes com congestão (DMP = 1,52; IC95%: 1,04, 2,00; p ˂ 0,01); (3) Pacientes com dor de cabeça (DMP = 0,82; IC95%: 0,38, 1,26; p ˂ 0,01); (4) Pacientes com alívio sintomático geral (DMP = 1,63; IC95%: 0,83, 2,44; p ˂ 0,01). Entretanto, não houve diferença na melhoria do olfato (DMP = 0,47; IC95%: -0,65, 1,59; p = 0,41) e na melhoria dos escores radiológicos (DMP = 2,44; IC95%: -3,14, 8,02; p < 0,01). Além disso, o grupo solução salina hipertônica mostrou maior melhoria nos escores do tempo de clearence mucociliar do que o grupo solução salina isotônica (DMP = 1,19; IC95%: 0,78, 1,60; p ˂ 0,01). A solução salina hipertônica causou efeitos adversos menores. Conclusão: Em comparação com a solução salina isotônica, a irrigação nasal com solução salina hipertônica para o tratamento da rinossinusite crônica é significantemente mais eficaz e apresenta efeitos colaterais mais leves, melhoria mais acentuada dos sintomas nasais e no movimento ciliar, mas não há diferença significante nos achados de imagem e na melhoria do olfato. Embora a solução salina hipertônica seja digna de uso generalizado na prática clínica, ainda são necessários mais estudos sobre a forma de uso e a concentração ideal da solução nasal.


Assuntos
Humanos , Sinusite , Rinite , Solução Salina Hipertônica , Cloreto de Sódio , Doença Crônica , Lavagem Nasal
15.
Artigo em Chinês | MEDLINE | ID: mdl-33040503

RESUMO

Objective:To compare the nasal microbiota diversity between chronic rhinosinusitis with nasal polyp(CRSwNP) patients and controls, postoperative recurrent with non-recurrent CRSwNP, in order to provide new sight in CRSwNP treatment and prognosis. Method:Forty-eight patients with CRSwNP were recruited as the experimental group, and 33 patients who underwent FESS and had no sinus inflammatory disease, including nasal septum deviation,inverted papilloma, pituitary adenomas, chronic dacryocystitis,or optical canal fractures, were recruited as control group. High-throughput sequencing of 16S rRNA was used to detect the bacterial communities in the nasal secretion which was collected from middle meatus during the operation. The difference of the microbiota diversity between CRSwNP and controls was compared. Patients with CRSwNP were followed up for 1 year after surgery to observe whether they had relapsed or not, and nasal secretions were collected again for bacterial microbiota detection. The difference between postoperative and preoperative microbiota of the non-recurrent CRSwNP were compared, and the difference between postoperative and preoperative microbiota of the recurrent CRSwNP were compared. Result:One year after surgery, 12 cases of CRSwNP recurred(recurrent rate 25%). The clinical history of the recurrent group was longer than that of the non-recurrent group(P=0.018), and the preoperative CT score(P=0.001), nasal polyp size score(P=0.004) and the severity of postnasal drip symptom(P=0.032) in the recurrent group were significantly higher than non-recurrent group. Comparing the preoperative nasal microbiota of CRSwNP with control, there was no significant difference about the richness, α diversity and ß diversity, but the relative abundance of Actinobacteria(FDR P=0.004) and Corynebacterium(FDR P=0.005) of CRSwNP were significantly lower than that of control. After operation, the relative abundance of Actinobacteria(FDR P=0.012) and Corynebacterium(FDR P=0.003) increased, while the Bacteroidetes(FDR P=0.040) decreased in the non-recurrent CRSwNP; However, there was no change in the nasal bacterial microbiota in the recurrent group. Conclusion:CRSwNP was associated with nasal bacterial dysbiosis, and the postoperative improvement of dysbiosis was correlated with the prognosis of CRSwNP.


Assuntos
Microbiota , Pólipos Nasais , Rinite , Sinusite , Humanos , Pólipos Nasais/cirurgia , Recidiva Local de Neoplasia , Prognóstico , RNA Ribossômico 16S/genética , Sinusite/cirurgia
16.
Artigo em Chinês | MEDLINE | ID: mdl-33040504

RESUMO

Objective:To observe the microbiological characteristics and clinical correlation of chronic rhinosinusitis with different clinical phenotypes. Method:One hundred and ninety-six patients with chronic rhinosinusitis(CRS) underwent nasal endoscopic surgery, including 126 patients with Chronic rhinosinusitis with nasal polyps(CRSwNP) and 70 patients with chronic rhinosinusitis without nasal polyps(CRSsNP); 78 patients with nasal septum deviation(control group) were enrolled. The nasal discharge samples were collected before operation, and the bacteria were isolated and identified by the traditional culture method. The bacteria were compared between the two groups by Pearson chi-square test or Fisher exact test, and the bacteria were compared between groups by Kruskal-Wallis rank sum test. Out statistically significant variables(P<0.05). Result:The total bacterial detection rate was 73.0% in the three groups, 76.2% in the CRSwNP group, 68.6% in the CRSsNP group and 71.8% in the control group, respectively(P=0.579). The detection rate of the bacteria was mainly Gram-positive bacteria. The higher detection rate included: Staphylococcus epidermidis, Pseudodiphtheria, Staphylococcus aureus, Haemophilus influenzaemola, Haemella influenzaemola. The detection rate of Haemophilus influenzae in the CRSwNP group and the control group(13.5% vs 2.6%, P=0.009), but there were statistical differences CRSsNP.There was no statistically significant difference in the detection rate of the bacteria(8.6% vs 2.6%, P=0.15) between the CRSsNP group and the control group; The difference of staphylococcus aureus detection rate between NonECRSwNP group and ECRSwNP group was statistically significant (9.6% vs 28.1%,P=0.017).There was no significant difference in staphylococcus aureus detection rate between NonECRSsNP group and ECRSsNP group (9.4% vs 16.7%, P=0.482). Conclusion:Haemophilus influenzae may be a potential cause of CRSwNP; S. aureus may promote the eosinophilic granulocyte inflammatory response to CRSwNP.


Assuntos
Pólipos Nasais , Rinite , Sinusite , Humanos , Fenótipo , Staphylococcus aureus
18.
Rhinology ; 58(5): 417, 2020 Oct 01.
Artigo em Inglês | MEDLINE | ID: mdl-32902518

RESUMO

The October 2020 issue of Rhinology is a very interesting edition as it illustrates how world-wide colleagues pave the way for a better future of patients affected by nose and sinus diseases. After the successful launch of EPOS2020 in Spring 2020, the editorial team of Rhinology is proud to present to you the latest and most exciting data in Rhinology research. Getting insight into the complexity and relevance of proteomics in CRS, epithelial-mesenchymal contribution to CRS, zinc levels in nasal and systemic compartment of CRS, nasal biomarkers of CRSwNP that predict recurrence of disease after sinus surgery, and the odor identification test for children, called "U-Sniff", and FID scores (Frequency, Intensity and Duration) scores for epistaxis are all in the 2020 October issue and highly relevant for Rhinology practice. These studies build further on the solid grounds of previous Rhinology research meeting the unmets needs in the field.


Assuntos
Rinite , Sinusite , Criança , Doença Crônica , Infecções por Coronavirus , Humanos , Pólipos Nasais , Pandemias , Publicações Periódicas como Assunto , Pneumonia Viral , Zinco/sangue
19.
Vestn Otorinolaringol ; 85(4): 80-84, 2020.
Artigo em Russo | MEDLINE | ID: mdl-32885643

RESUMO

This article presents the clinical case of a woman aged 61 years with massive bilateral synechial obstruction of the nasal cavity after anterior tamponade with clinical manifestations in the form of a significant deterioration in nasal breathing, nasal congestion, postnasal nasal congestion and recurrent sinusitis. The stages of diagnosis of pathology, including differential, are presented and the most rational method of surgical treatment is selected.


Assuntos
Obstrução Nasal , Sinusite , Endoscopia , Feminino , Humanos , Pessoa de Meia-Idade , Cavidade Nasal , Nariz
20.
Zhonghua Yi Xue Za Zhi ; 100(33): 2591-2595, 2020 Sep 08.
Artigo em Chinês | MEDLINE | ID: mdl-32892604

RESUMO

Objective: To observe the perioperative efficacy of stellate ganglion block (SGB) in functional endoscopic sinus surgery (FESS) in chronic sinusitis patients with hypertension. Methods: A total of 60 patients with chronic sinusitis complicated with hypertension who were scheduled to undergo FESS in the Department of Otorhinolaryngology, the First Affiliated Hospital of Soochow University from April 2018 to December 2019 were selected and divided into SGB group and control group by random number table method. SGB were performed at 24 hours before surgery and induction of general anesthesia alternately, while the control group was not treated. During the operation, controlled hypotension were performed in both groups. Hemodynamic parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) and heart rate (HR) were recorded at 24 hours before surgery(T(0)), before anesthesia induction (T(1)), at the beginning of surgery (T(2)), at the end of surgery (T(3)), and at 24 hours after surgery(T(4)).Plasma epinephrine and norepinephrine concentrations were measured at T(0), T(1), T(3) and T(4). The dosage of anesthesia and other drugs, operative time, bleeding amount and extubation time were recorded, while the quality of the operative field was evaluated. VAS scores were assessed at 1, 6 and 24 hours after surgery. Results: In the SGB group, SBP, DBP and MAP in T(1), T(2), T(3), T(4) and HR in T(1), T(4) were lower than those in the control group (all P<0.05). Compared with T(0), SBP, DBP, MAP and HR in T(1), T(2), T(3), T(4) all decreased in SGB group (all P<0.05); In the control group, SBP, DBP and MAP only decreased in T(2) and T(3), and HR fluctuated significantly (P<0.05). In the SGB group, plasma epinephrine and norepinephrine concentrations at T(1), T(3) and T(4) were lower than those in the control group (P<0.05). Compared with T(0), plasma epinephrine and norepinephrine concentrations in the SGB group fluctuated in positive and negative phases, while those in the control group increased (P<0.05). The pain scores in SGB group at 6 and 24 hours after surgery were 1.3±0.7 and 2.6±0.9, which were lower than 1.7±0.7 and 3.1±0.9 in the control group (t=-2.290, -2.050, all P<0.05). Conclusion: SGB may effectively improve hemodynamics, maintain homeostasis, reduce anesthesia and surgical complications in patients with chronic sinusitis and hypertension in perioperative period.


Assuntos
Bloqueio Nervoso Autônomo , Hipertensão , Sinusite , Humanos , Período Perioperatório , Gânglio Estrelado
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