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Sedaghat AR, Derbarsegian A, Yu VT, Alsayed A, Bitner BF, Yeom B, Liu DT, Schneider S, Adams SM, Houssein FA, Walters ZA, Tripathi S, Walker VL, Singerman KW, Meier JC, Kim R, Kuan EC, Alsaleh S, Phillips KM. Patient perspectives on recall period and response options in patient-reported outcome measures for chronic rhinosinusitis symptomatology: An international multi-centered study. Int Forum Allergy Rhinol 2024; 14:898-908. [PMID: 37788156 DOI: 10.1002/alr.23280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2023] [Revised: 09/12/2023] [Accepted: 09/18/2023] [Indexed: 10/05/2023]
Abstract
BACKGROUND Existing patient-reported outcome measures (PROMs) for chronic rhinosinusitis (CRS) use a variety of recall periods and response scales to assess CRS symptom burden. Global perspectives of CRS patients regarding optimal recall periods and response scales for CRS PROMs are unknown. METHODS This was a multi-center, cross-sectional study recruiting 461 CRS patients from sites across the United States, Saudi Arabia, New Zealand, and Austria. Participants chose which CRS symptom recall period (1 day, 2 weeks, 1 month, >1 month) was most reflective of their current disease state and upon which to best base treatment recommendations (including surgery). Participants also chose which of six response scales (one visual analogue scale and five Likert scales ranging from four to eight items) was easiest to use, understand, and preferred. RESULTS A plurality of participants (40.0%) felt their CRS symptoms' current state was best reflected by a 1-month recall period. However, most patients (56.9%) preferred treatment recommendations to be determined by symptoms experienced over a >1 month period. The four- and five-item Likert scales were the easiest to understand (26.0% and 25.4%, respectively) and use (23.4% and 26.7%, respectively). The five-item (26.4% rating it most preferred and 70.9% rating it preferred) and four-item Likert (22.3% rating it most preferred and 56.4% rating it preferred) response scales were most preferred. CONCLUSION Future PROMs for CRS should consider assessment of symptoms over a 1-month period and use a four- or five-item Likert response scale to reflect global patient preferences. These findings also inform interpretation of current CRS PROMs.
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Affiliation(s)
- Ahmad R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Armo Derbarsegian
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Victor T Yu
- Department of Surgery, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
| | - Ahmed Alsayed
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Benjamin F Bitner
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, USA
| | - Brian Yeom
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - David T Liu
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Sven Schneider
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - Sarah M Adams
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Firas A Houssein
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Zoe A Walters
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Siddhant Tripathi
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Victoria L Walker
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
| | - Kyle W Singerman
- Department of Otolaryngology-Head and Neck Surgery, University of Kansas, Lawrence, Kansas, USA
| | - Josh C Meier
- Department of Surgery, University of Nevada, Reno School of Medicine, Reno, Nevada, USA
- Nevada ENT and Hearing Associates, Reno, Nevada, USA
| | - Raymond Kim
- Department of Surgery, University of Auckland, Auckland, New Zealand
| | - Edward C Kuan
- Department of Otolaryngology-Head and Neck Surgery, University of California Irvine, Orange, USA
| | - Saad Alsaleh
- Department of Otolaryngology-Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - Katie M Phillips
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, Ohio, USA
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Ali A, Fakunle DR, Yu V, McDermott S, Previtera MJ, Meier JC, Phillips KM, Sedaghat AR. Heterogeneity in the definition of chronic rhinosinusitis disease control: a systematic review of the scientific literature. Eur Arch Otorhinolaryngol 2023; 280:5345-5352. [PMID: 37378726 DOI: 10.1007/s00405-023-08090-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 06/21/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE Disease control is conceptually recognized to be an important outcome measure for chronic rhinosinusitis (CRS). However, inconsistent usage is a significant factor in disadoption of important concepts and it is presently unclear how consistently the construct of CRS 'control' is being defined/applied. The objective of this study was to determine the heterogeneity of CRS disease control definitions in the scientific literature. METHODS Systematic review of PubMed and Web of Science databases from inception through December 31, 2022. Included studies used CRS disease control as an explicitly stated outcome measure. The definitions of CRS disease control were collected. RESULTS Thirty-one studies were identified with more than half published in 2021 or later. Definitions of CRS control were variable, although 48.4% of studies used the EPOS (2012 or 2020) criteria to define control, 14 other unique definitions of CRS disease control were also implemented. Most studies included the burden CRS symptoms (80.6%), need for antibiotics or systemic corticosteroids (77.4%) or nasal endoscopy findings (61.3%) as criteria in their definitions of CRS disease control. However, the specific combination of these criteria and prior time periods over which they were assessed were highly variable. CONCLUSION CRS disease control is not consistently defined in the scientific literature. Although many studies conceptually treated 'control' as the goal of CRS treatment, 15 different criteria were used to define CRS disease control, representing significant heterogeneity. Scientific derivation of criteria and collaborative consensus building are needed for the development of a widely-accepted and -applied definition of CRS disease control.
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Affiliation(s)
- Ayad Ali
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA
| | - Damilola R Fakunle
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA
| | - Victor Yu
- University of Nevada, Reno School of Medicine, Reno, NV, USA
| | - Sean McDermott
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA
| | - Melissa J Previtera
- Health Sciences Library, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - Josh C Meier
- University of Nevada, Reno School of Medicine, Reno, NV, USA
- Nevada ENT and Hearing Associates, Reno, NV, USA
| | - Katie M Phillips
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA
| | - Ahmad R Sedaghat
- Department of Otolaryngology - Head and Neck Surgery, University of Cincinnati College of Medicine, 231 Albert Sabin Way, Cincinnati, OH, 45267-0528, USA.
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Feng AL, Wesely NC, Hoehle LP, Phillips KM, Yamasaki A, Campbell AP, Gregorio LL, Killeen TE, Caradonna DS, Meier JC, Gray ST, Sedaghat AR. A validated model for the 22-item Sino-Nasal Outcome Test subdomain structure in chronic rhinosinusitis. Int Forum Allergy Rhinol 2017; 7:1140-1148. [DOI: 10.1002/alr.22025] [Citation(s) in RCA: 65] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2017] [Revised: 09/05/2017] [Accepted: 09/20/2017] [Indexed: 12/16/2022]
Affiliation(s)
- Allen L. Feng
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | | | - Lloyd P. Hoehle
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Katie M. Phillips
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Alisa Yamasaki
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Adam P. Campbell
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Luciano L. Gregorio
- Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço (Department of Otorhinolaryngology and Head and Neck Surgery); Universidade Federal de São Paolo; São Paulo Brazil
| | - Thomas E. Killeen
- School of Medicine; University of Nevada, Reno; Reno NV
- Nevada ENT and Hearing Associates; Reno NV
| | - David S. Caradonna
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Division of Otolaryngology; Beth Israel Deaconess Medical Center; Boston MA
| | - Josh C. Meier
- School of Medicine; University of Nevada, Reno; Reno NV
- Nevada ENT and Hearing Associates; Reno NV
| | - Stacey T. Gray
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Ahmad R. Sedaghat
- Department of Otolaryngology; Harvard Medical School; Boston MA
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Division of Otolaryngology; Beth Israel Deaconess Medical Center; Boston MA
- Department of Otolaryngology and Communications Enhancement; Boston Children's Hospital; Boston MA
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Yarlagadda BB, Meier JC, Lin DT, Emerick KS, Deschler DG. Locoregional control of tongue base adenoid cystic carcinoma with primary resection and radial forearm free flap reconstruction. Ear Nose Throat J 2017; 96:37-40. [PMID: 28122103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2023] Open
Abstract
Adenoid cystic carcinoma of the minor salivary glands can be challenging and marked by high rates of local recurrence despite appropriate surgical resection. Management of this pathology in the base of the tongue is particularly difficult given the poor functional outcomes traditionally associated with an aggressive surgical approach. This article presents a case series of patients who underwent up-front surgical resection followed by free tissue transfer reconstruction. A retrospective analysis was performed of patients with adenoid cystic carcinoma of the base of the tongue who underwent composite resection and reconstruction with a radial forearm free flap. Three patients met inclusion criteria and underwent analysis. All patients achieved locoregional control after at least 4 years of surveillance. In addition, all patients were decannulated and were swallowing without the need for gastrostomy tube feeding. This series demonstrates that for select patients with adenoid cystic carcinoma of the base of the tongue, excellent locoregional control can be achieved with acceptable functional outcomes and prolonged survival when appropriate reconstructive measures are employed.
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Meier JC, Scangas GA, Remenschneider AK, Sadow P, Chambers K, Dedmon M, Lin DT, Holbrook EH, Metson R, Gray ST. Skull base erosion and associated complications in sphenoid sinus fungal balls. Allergy Rhinol (Providence) 2016; 7:227-232. [PMID: 28683250 PMCID: PMC5244283 DOI: 10.2500/ar.2016.7.0182] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND Sphenoid sinus fungal balls (SSFB) are rare entities that can result in serious orbital and intracranial complications. There are few published reports of complications that result from SSFB. OBJECTIVE To review the incidence of skull base erosion and orbital or intracranial complications in patients who present with SSFB. METHODS A retrospective review was performed of all the patients with SSFB who were treated at the Massachusetts Eye and Ear Infirmary from 2006 to 2014. Presenting clinical data, radiology, operative reports, pathology, and postoperative course were reviewed. RESULTS Forty-three patients with SSFB were identified. Demographic data were compared between patients with (39.5%) and those without (61.5%) skull base erosion. Two patients underwent emergent surgery for acute complications of SSFB (one patient with blindness, one patient who had a seizure). Both patients with acute complications had evidence of skull base erosion, whereas no patients with an intact skull base developed an orbital or intracranial complication (p = 0.15). All the patients were surgically managed via an endoscopic approach. CONCLUSION SSFBs are rare but may cause significant skull base erosion and potentially severe orbital and intracranial complications if not treated appropriately. Endoscopic sphenoidotomy is effective in treating SSFB and should be performed emergently in patients who presented with associated complications.
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Affiliation(s)
- Josh C Meier
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Boson, Massachusetts, USA
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6
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Meier JC, Remenschneider AK, Gray ST, Holbrook EH, Gliklich RE, Metson R. The impact of surgical trainee participation on sinus surgery outcomes. Laryngoscope 2015; 126:316-21. [PMID: 26360316 DOI: 10.1002/lary.25504] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/22/2015] [Indexed: 12/21/2022]
Abstract
OBJECTIVES/HYPOTHESIS To determine the effect of otolaryngology trainee participation on clinical outcomes in patients who undergo endoscopic sinus surgery (ESS) for chronic rhinosinusitis. STUDY DESIGN Secondary analysis of prospectively collected data. METHODS Patients enrolled in a sinus surgery outcomes study between May 2011 and March 2013 were stratified into two groups--those who were operated on by an attending alone and those operated on by an attending with a trainee present (resident, fellow, or both). Patients completed quality of life (QOL) surveys including the Chronic Sinusitis Survey (CSS), 22-item Sino-Nasal Outcome Test (SNOT-22), and EuroQol 5-dimension survey preoperatively and 1 year postoperatively. Operative time, estimated blood loss (EBL), complication rates, and survey scores were compared between groups. RESULTS The study population consisted of 452 patients. The attending alone (n = 119) and trainee (n = 333) groups were statistically comparable in terms of patient demographics, disease severity, and extent of surgery. Mean operative time was significantly shorter in the attending-alone group (80.0 vs. 90.6 minutes, P < .01). Mean EBL (105 mL attending vs. 117 mL trainee, P = .39) and complication rates (3.3% attending vs. 0.6% trainee, P = .07) were similar between groups. Observed changes in QOL measures following ESS were comparable between groups, although absolute improvement in the SNOT-22 scores (19.0 attending vs. 24.5 trainee, P = .05) did show a trend toward greater improvement in the trainee group. CONCLUSIONS Trainee participation in ESS is associated with prolongation in surgical time; however, such participation was not found to adversely affect patient safety or clinical outcomes. LEVEL OF EVIDENCE 2b.
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Affiliation(s)
- Josh C Meier
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Aaron K Remenschneider
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Stacey T Gray
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Eric H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Richard E Gliklich
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
| | - Ralph Metson
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary.,Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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Winkelmann A, Semtner M, Meier JC. Chloride transporter KCC2-dependent neuroprotection depends on the N-terminal protein domain. Cell Death Dis 2015; 6:e1776. [PMID: 26043076 PMCID: PMC4669822 DOI: 10.1038/cddis.2015.127] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2014] [Revised: 03/27/2015] [Accepted: 03/30/2015] [Indexed: 01/04/2023]
Abstract
Neurodegeneration is a serious issue of neurodegenerative diseases including epilepsy. Downregulation of the chloride transporter KCC2 in the epileptic tissue may not only affect regulation of the polarity of GABAergic synaptic transmission but also neuronal survival. Here, we addressed the mechanisms of KCC2-dependent neuroprotection by assessing truncated and mutated KCC2 variants in different neurotoxicity models. The results identify a threonine- and tyrosine-phosphorylation-resistant KCC2 variant with increased chloride transport activity, but they also identify the KCC2 N-terminal domain (NTD) as the relevant minimal KCC2 protein domain that is sufficient for neuroprotection. As ectopic expression of the KCC2-NTD works independently of full-length KCC2-dependent regulation of Cl(-) transport or structural KCC2 C-terminus-dependent regulation of synaptogenesis, our study may pave the way for a selective neuroprotective therapeutic strategy that will be applicable to a wide range of neurodegenerative diseases.
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Affiliation(s)
- A Winkelmann
- RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin 13125, Germany
| | - M Semtner
- RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin 13125, Germany
| | - J C Meier
- RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin 13125, Germany
- Division of Cell Physiology, TU Braunschweig, Zoological Institute, Braunschweig 38106, Germany
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8
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Fossati G, Morini R, Corradini I, Antonucci F, Trepte P, Edry E, Sharma V, Papale A, Pozzi D, Defilippi P, Meier JC, Brambilla R, Turco E, Rosenblum K, Wanker EE, Ziv NE, Menna E, Matteoli M. Reduced SNAP-25 increases PSD-95 mobility and impairs spine morphogenesis. Cell Death Differ 2015; 22:1425-36. [PMID: 25678324 DOI: 10.1038/cdd.2014.227] [Citation(s) in RCA: 49] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Revised: 10/22/2014] [Accepted: 11/26/2014] [Indexed: 12/24/2022] Open
Abstract
Impairment of synaptic function can lead to neuropsychiatric disorders collectively referred to as synaptopathies. The SNARE protein SNAP-25 is implicated in several brain pathologies and, indeed, brain areas of psychiatric patients often display reduced SNAP-25 expression. It has been recently found that acute downregulation of SNAP-25 in brain slices impairs long-term potentiation; however, the processes through which this occurs are still poorly defined. We show that in vivo acute downregulation of SNAP-25 in CA1 hippocampal region affects spine number. Consistently, hippocampal neurons from SNAP-25 heterozygous mice show reduced densities of dendritic spines and defective PSD-95 dynamics. Finally, we show that, in brain, SNAP-25 is part of a molecular complex including PSD-95 and p140Cap, with p140Cap being capable to bind to both SNAP-25 and PSD-95. These data demonstrate an unexpected role of SNAP-25 in controlling PSD-95 clustering and open the possibility that genetic reductions of the protein levels - as occurring in schizophrenia - may contribute to the pathology through an effect on postsynaptic function and plasticity.
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Affiliation(s)
- G Fossati
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - R Morini
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - I Corradini
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - F Antonucci
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - P Trepte
- Neuroproteomics, Max Delbrueck Center for Molecular Medicine (MDC), Berlin 13125, Germany
| | - E Edry
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - V Sharma
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - A Papale
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute and University, Milano 20132, Italy
| | - D Pozzi
- Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
| | - P Defilippi
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino 10124, Italy
| | - J C Meier
- 1] RNA Editing and Hyperexcitability Disorders Helmholtz Group, Max Delbrück Center for Molecular Medicine, Berlin, Germany [2] TU Braunschweig, Zoological Institute, Division of Cell Biology and Cell Physiology, Braunschweig, Germany
| | - R Brambilla
- Division of Neuroscience, Institute of Experimental Neurology, San Raffaele Scientific Institute and University, Milano 20132, Italy
| | - E Turco
- Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino 10124, Italy
| | - K Rosenblum
- Sagol Department of Neurobiology, Center for Gene Manipulation in the Adult Brain (CGMB), Haifa University, Haifa, Israel
| | - E E Wanker
- Neuroproteomics, Max Delbrueck Center for Molecular Medicine (MDC), Berlin 13125, Germany
| | - N E Ziv
- Network Biology Labs and Faculty of Medicine, Technion, 33000 Haifa, Israel
| | - E Menna
- 1] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy [2] Istituto di Neuroscienze del CNR, Milano 20129, Italy
| | - M Matteoli
- 1] Department of Biotechnology and Translational Medicine, University of Milan, Milano 20129, Italy [2] Humanitas Clinical and Research Center, Laboratory of Pharmacology and Brain Pathology, Via Manzoni 56, Rozzano, 20089 Milano, Italy
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Remenschneider AK, Scangas G, Meier JC, Gray ST, Holbrook EH, Gliklich RE, Metson R. EQ-5D-derived health utility values in patients undergoing surgery for chronic rhinosinusitis. Laryngoscope 2014; 125:1056-61. [PMID: 25431320 DOI: 10.1002/lary.25054] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 10/29/2014] [Accepted: 10/31/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES/HYPOTHESIS Health utility value (HUV) is an index used to measure health-related quality of life for the valuation and comparison of treatments. The Euroqol 5-Dimension (EQ-5D) questionnaire is a widely used method for determining HUV, but it has not been applied for this purpose in patients with chronic rhinosinusitis (CRS) who undergo sinus surgery. STUDY DESIGN Prospective cohort study. METHODS Patients with CRS, who were recruited from 11 different otolaryngologic practices, completed the EQ-5D questionnaire at baseline, as well as 3, 12, and 24 months after surgery. HUVs calculated from the results of this questionnaire were compared to those reported in the general U.S. population and to patients suffering from other chronic diseases. RESULTS Baseline EQ-5D surveys were completed by 242 patients. Mean baseline HUV (standard deviation) was 0.81 (0.13). Female gender, revision surgery, and the use of intraoperative image guidance were associated was significantly lower baseline values. HUV rose at 3 months to 0.89 (0.12) and remained improved at 12 months 0.88 (0.10) and 24 months 0.89 (0.10) (P < 0.001). Baseline HUV in CRS (0.81[0.13]) is lower than the general U.S. population (0.85 [0.18]) and appears appropriately positioned among other common chronic conditions including asthma (0.82-0.92), migraine (0.81-0.91), and seasonal allergies (0.94). CONCLUSIONS Sinus surgery provides improvement in HUV in patients with CRS. These values may be paired with costs of care to perform cost-utility analysis on this group of patients. LEVEL OF EVIDENCE 2c.
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Affiliation(s)
- Aaron K Remenschneider
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Department of Otology and Laryngology, Harvard Medical School, Boston, Massachusetts, U.S.A
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Meier JC, Remenschneider AK, D'Amico L, Holbrook EH, Gray ST, Metson R. A new model for collection of clinical outcomes data in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol 2014; 4:411-5. [DOI: 10.1002/alr.21282] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2013] [Revised: 11/17/2013] [Accepted: 12/03/2013] [Indexed: 11/07/2022]
Affiliation(s)
- Josh C. Meier
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Department of Otology and Laryngology; Harvard Medical School; Boston MA
| | - Aaron K. Remenschneider
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Department of Otology and Laryngology; Harvard Medical School; Boston MA
| | - Laura D'Amico
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
| | - Eric H. Holbrook
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Department of Otology and Laryngology; Harvard Medical School; Boston MA
| | - Stacey T. Gray
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Department of Otology and Laryngology; Harvard Medical School; Boston MA
| | - Ralph Metson
- Department of Otolaryngology; Massachusetts Eye and Ear Infirmary; Boston MA
- Department of Otology and Laryngology; Harvard Medical School; Boston MA
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11
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Singh B, Henneberger C, Betances D, Arevalo MA, Rodríguez-Tébar A, Meier JC, Grantyn R. Altered balance of glutamatergic/GABAergic synaptic input and associated changes in dendrite morphology after BDNF expression in BDNF-deficient hippocampal neurons. J Neurosci 2006; 26:7189-200. [PMID: 16822976 PMCID: PMC6673958 DOI: 10.1523/jneurosci.5474-05.2006] [Citation(s) in RCA: 51] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Cultured neurons from bdnf-/- mice display reduced densities of synaptic terminals, although in vivo these deficits are small or absent. Here we aimed at clarifying the local responses to postsynaptic brain-derived neurotrophic factor (BDNF). To this end, solitary enhanced green fluorescent protein (EGFP)-labeled hippocampal neurons from bdnf-/- mice were compared with bdnf-/- neurons after transfection with BDNF, bdnf-/- neurons after transient exposure to exogenous BDNF, and bdnf+/+ neurons in wild-type cultures. Synapse development was evaluated on the basis of presynaptic immunofluorescence and whole-cell patch-clamp recording of miniature postsynaptic currents. It was found that neurons expressing BDNF::EGFP for at least 16 h attracted a larger number of synaptic terminals than BDNF-deficient control neurons. Transfected BDNF formed clusters in the vicinity of glutamatergic terminals and produced a stronger upregulation of synaptic terminal numbers than high levels of ambient BDNF. Glutamatergic and GABAergic synapses reacted differently to postsynaptic BDNF: glutamatergic input increased, whereas GABAergic input decreased. BDNF::EGFP-expressing neurons also differed from BDNF-deficient neurons in their dendrite morphology: they exhibited weaker dendrite elongation and stronger dendrite initiation. The upregulation of glutamatergic synaptic input and the BDNF-induced downregulation of GABAergic synaptic terminal numbers by postsynaptic BDNF depended on tyrosine receptor kinase B activity, as deduced from the blocking effects of K252a. The suppression of dendrite elongation was also prevented by block of tyrosine receptor kinase B but required, in addition, glutamate receptor activity. Dendritic length decreased with the number of glutamatergic contacts. These results illuminate the role of BDNF as a retrograde synaptic regulator of synapse development and the dependence of dendrite elongation on glutamatergic input.
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Affiliation(s)
- B Singh
- Developmental Physiology Group, Johannes Mueller Institute for Neurophysiology, University Medical School (Charité) of the Humboldt University, D-10117 Berlin, Germany
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