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Whitcroft KL, Altundag A, Balungwe P, Boscolo-Rizzo P, Douglas R, Enecilla MLB, Fjaeldstad AW, Fornazieri MA, Frasnelli J, Gane S, Gudziol H, Gupta N, Haehner A, Hernandez AK, Holbrook EH, Hopkins C, Hsieh JW, Huart C, Husain S, Kamel R, Kim JK, Kobayashi M, Konstantinidis I, Landis BN, Lechner M, Macchi A, Mazal PP, Miri I, Miwa T, Mori E, Mullol J, Mueller CA, Ottaviano G, Patel ZM, Philpott C, Pinto JM, Ramakrishnan VR, Roth Y, Schlosser RJ, Stjärne P, Van Gerven L, Vodicka J, Welge-Luessen A, Wormald PJ, Hummel T. Position paper on olfactory dysfunction: 2023. Rhinology 2023; 61:1-108. [PMID: 37454287 DOI: 10.4193/rhin22.483] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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: 07/18/2023]
Abstract
BACKGROUND Since publication of the original Position Paper on Olfactory Dysfunction in 2017 (PPOD-17), the personal and societal burden of olfactory disorders has come sharply into focus through the lens of the COVID-19 pandemic. Clinicians, scientists and the public are now more aware of the importance of olfaction, and the impact of its dysfunction on quality of life, nutrition, social relationships and mental health. Accordingly, new basic, translational and clinical research has resulted in significant progress since the PPOD-17. In this updated document, we present and discuss currently available evidence for the diagnosis and management of olfactory dysfunction. Major updates to the current version include, amongst others: new recommendations on olfactory related terminology; new imaging recommendations; new sections on qualitative OD and COVID-19 OD; updated management section. Recommendations were agreed by all co-authors using a modified Delphi process. CONCLUSIONS We have provided an overview of current evidence and expert-agreed recommendations for the definition, investigation, and management of OD. As for our original Position Paper, we hope that this updated document will encourage clinicians and researchers to adopt a common language, and in so doing, increase the methodological quality, consistency, and generalisability of work in this field.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
- and The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
| | - A Altundag
- Department of Otorhinolaryngology, Istanbul Surgery Hospital, Istanbul, Turkey
| | - P Balungwe
- Faculté de Médecine, Université Catholique de Bukavu, Bukavu, Democratic Republic of the Congo
- and Hôpital Provincial Général de Référence de Bukavu, Bukavu, Democratic Republic of the Congo
| | - P Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - R Douglas
- Department of Otorhinolaryngology, University of Auckland, New Zealand
| | - M L B Enecilla
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Luke's Medical Center, Global City, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otorhinolaryngology, Medical Center Taguig, Taguig, Philippines
| | - A W Fjaeldstad
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Department of Otorhinolaryngology, University Clinic for Flavour, Balance and Sleep, Regional Hospital Gødstrup, Herning, Denmark
- and Department of Clinical Medicine, Flavour Institute, Aarhus University, Aarhus, Denmark
- and Center for Eudaimonia and Human Flourishing, Linacre College, University of Oxford, Oxford, UK
| | - M A Fornazieri
- Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifícia Universidade Católica do Paraná, Londrina, Brazil
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Université du Québec à Trois-Rivières, Trois-Rivières, QC, Canada
- and Centre for Advanced Research in Sleep Medicine, Hôpital du Sacré-Coeur de Montréal, Montréal, QC, Canada
| | - S Gane
- The Centre for Olfactory Research and Applications, Institute of Philosophy, School of Advanced Studies, University of London, London, UK
- and Royal National Throat Nose and Ear Hospital, UCLH, London
| | - H Gudziol
- Department of Otorhinolaryngology, University of Jena, Jena, Germany
| | - N Gupta
- Department of Otorhinolaryngology, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Haehner
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - A K Hernandez
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
- and Department of Otolaryngology - Head and Neck Surgery, Asian Hospital and Medical Center, Muntinlupa, Philippines
- and Department of Otolaryngology - Head and Neck Surgery, Philippine General Hospital, University of the Philippines - Manila, Manila, Philippines
| | - E H Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - C Hopkins
- Guys and St Thomas NHS Trust, London, United Kingdom
| | - J W Hsieh
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - C Huart
- Department of Otorhinolaryngology, Cliniques universitaires Saint-Luc, Brussels, Belgium
- and Institute of Neuroscience, Université catholique de Louvain, Brussels, Belgium
| | - S Husain
- Department of Otorhinolaryngology-Head and Neck Surgery, Faculty of Medicine, National University of Malaysia, Kuala Lumpur, Malaysia
| | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - J K Kim
- Department of Otorhinolaryngology-Head and Neck Surgery, Konkuk University, College of Medicine, Seoul, Republic of Korea
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Tsu, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Rhinology-Olfactology Unit, Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital of Geneva Medical School, Geneva, Switzerland
| | - M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK
- and UCL Cancer Institute, University College London, London, UK
- and ENT Department, Homerton Healthcare NHS Foundation Trust, London, UK
| | - A Macchi
- ENT Clinic, University of Insubria, ASST Sette Laghi, Varese, Italy
| | - P P Mazal
- Servicio de Otorrinolaringología, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
| | - I Miri
- Service Médecine Physique Réadaptation fonctionnelle, Institut Mohamed Kassab d'Orthopédie, Mannouba, Tunisia
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - E Mori
- Department of Otorhinolaryngology, Jikei University, School of Medicine, Tokyo, Japan
| | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clínic, Universitat de Barcelona
- IDIBAPS
- CIBERES. Barcelona, Catalonia, Spain
| | - C A Mueller
- Department of Otorhinolaryngology, Medical University of Vienna, Vienna, Austria
| | - G Ottaviano
- Department of Neurosciences DNS, Otolaryngology Section, University, Padua, Italy
| | - Z M Patel
- Department of Otolaryngology, Stanford University School of Medicine, Stanford, California, USA
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
- and The Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University of School Medicine, Indianapolis, IN, USA
| | - Y Roth
- The Institute for Nose and Sinus Therapy and Clinical Investigations, Department of Otolaryngology - Head and Neck Surgery, Edith Wolfson Medical Center, Tel Aviv University Sackler Faculty of Medicine, Holon, Israel
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institute, Stockholm, Sweden
| | - L Van Gerven
- Department of Otorhinolaryngology, UZ Leuven, Belgium
- and Department of Neurosciences, Experimental Otorhinolaryngology, KU Leuven, Belgium
- and Department of Microbiology, Immunology and Transplantation, Allergy and Clinical Immunology Research Unit, KU Leuven, Belgium
| | - J Vodicka
- Department of Otorhinolaryngology and Head and Neck Surgery, Hospital Pardubice, Faculty of Health Studies, University of Pardubice, Pardubice, Czech Republic
| | - A Welge-Luessen
- University Hospital Basel - Otorhinolaryngology, Basel, Switzerland
| | - P J Wormald
- Department of Surgery-Otorhinolaryngology Head and Neck Surgery, University of Adelaide, Adelaide, SA, Australia
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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Walti L, Crone C, Helleberg M, Perch M, Villalobos APC, Clement W, Martinu T, Keshavjee S, Husain S. Effect of Statin Use for Aspergillosis Post Lung Transplant (LT) - A Multicenter Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Walti L, Henry B, Crone C, Cano A, Kothari S, Perch M, Cisneros JT, Bennett D, Aversa M, Keshavjee S, Martinu T, Husain S. Non-Aspergillus Fumigatus Mold Infections (NAFMI) in Lung Transplant (LT) Recipients, Pathogens and Risk Factors. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.214] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Walti L, Sorbo LD, Husain S. Hyperammonemia Syndrome (HS) in Lung Transplant (LT) Recipients - A Survey on Current Clinical Practice. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Walti L, Arora S, Donahoe L, Almansour S, Sorbo LD, Mazzulli T, Sidhu A, Martinu T, Keshavjee S, Chaparro C, Husain S. Donor Urease Producing Bacteria (DU) Detection and Serum Ammonium Screening for Hyperammonemia Syndrome (HS) Post-Lung Transplant: A Prospective Observational Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Runyo F, Almansour S, Arora S, Singer L, Aversa M, Keshavjee S, Bitterman R, Mazzulli T, Husain S. Aspergillus Droplet Digital PCR (ddPCR)in Exhaled Breath Condensate for the Diagnosis of Invasive Aspergillosis (IA) in Lung Transplant Recipients (LTRs). J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Bitterman R, Soualhine H, Poirier C, Ferraro P, Kabbani D, Hirji A, Tyrrell G, Bergeron C, Levy R, Wright A, Leung V, Singer L, Chaparro C, Keshavjee S, Richard-Greenblatt M, Husain S, Luong M. Mycobacterium Abscessus Complex Infections Among Lung Transplant Recipients: A National Retrospective Cohort Study. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2023] Open
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Johnson AG, Linde L, Ali AR, DeSantis A, Shi M, Adam C, Armstrong B, Armstrong B, Asbell M, Auche S, Bayoumi NS, Bingay B, Chasse M, Christofferson S, Cima M, Cueto K, Cunningham S, Delgadillo J, Dorabawila V, Drenzek C, Dupervil B, Durant T, Fleischauer A, Hamilton R, Harrington P, Hicks L, Hodis JD, Hoefer D, Horrocks S, Hoskins M, Husain S, Ingram LA, Jara A, Jones A, Kanishka FNU, Kaur R, Khan SI, Kirkendall S, Lauro P, Lyons S, Mansfield J, Markelz A, Masarik J, McCormick D, Mendoza E, Morris KJ, Omoike E, Patel K, Pike MA, Pilishvili T, Praetorius K, Reed IG, Severson RL, Sigalo N, Stanislawski E, Stich S, Tilakaratne BP, Turner KA, Wiedeman C, Zaldivar A, Silk BJ, Scobie HM. COVID-19 Incidence and Mortality Among Unvaccinated and Vaccinated Persons Aged ≥12 Years by Receipt of Bivalent Booster Doses and Time Since Vaccination - 24 U.S. Jurisdictions, October 3, 2021-December 24, 2022. MMWR Morb Mortal Wkly Rep 2023; 72:145-152. [PMID: 36757865 PMCID: PMC9925136 DOI: 10.15585/mmwr.mm7206a3] [Citation(s) in RCA: 21] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
Abstract
On September 1, 2022, CDC recommended an updated (bivalent) COVID-19 vaccine booster to help restore waning protection conferred by previous vaccination and broaden protection against emerging variants for persons aged ≥12 years (subsequently extended to persons aged ≥6 months).* To assess the impact of original (monovalent) COVID-19 vaccines and bivalent boosters, case and mortality rate ratios (RRs) were estimated comparing unvaccinated and vaccinated persons aged ≥12 years by overall receipt of and by time since booster vaccination (monovalent or bivalent) during Delta variant and Omicron sublineage (BA.1, BA.2, early BA.4/BA.5, and late BA.4/BA.5) predominance.† During the late BA.4/BA.5 period, unvaccinated persons had higher COVID-19 mortality and infection rates than persons receiving bivalent doses (mortality RR = 14.1 and infection RR = 2.8) and to a lesser extent persons vaccinated with only monovalent doses (mortality RR = 5.4 and infection RR = 2.5). Among older adults, mortality rates among unvaccinated persons were significantly higher than among those who had received a bivalent booster (65-79 years; RR = 23.7 and ≥80 years; 10.3) or a monovalent booster (65-79 years; 8.3 and ≥80 years; 4.2). In a second analysis stratified by time since booster vaccination, there was a progressive decline from the Delta period (RR = 50.7) to the early BA.4/BA.5 period (7.4) in relative COVID-19 mortality rates among unvaccinated persons compared with persons receiving who had received a monovalent booster within 2 weeks-2 months. During the early BA.4/BA.5 period, declines in relative mortality rates were observed at 6-8 (RR = 4.6), 9-11 (4.5), and ≥12 (2.5) months after receiving a monovalent booster. In contrast, bivalent boosters received during the preceding 2 weeks-2 months improved protection against death (RR = 15.2) during the late BA.4/BA.5 period. In both analyses, when compared with unvaccinated persons, persons who had received bivalent boosters were provided additional protection against death over monovalent doses or monovalent boosters. Restored protection was highest in older adults. All persons should stay up to date with COVID-19 vaccination, including receipt of a bivalent booster by eligible persons, to reduce the risk for severe COVID-19.
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Luong M, Silveira F, Morrissey O, Danziger-Isakov L, Verschuuren E, Wolfe C, Hadjiliadis D, Chambers D, Patel J, Dellgren G, So M, Verleden G, Blumberg E, Vos R, Perch M, Holm A, Müller N, Chaparro C, Husain S. Delphipanel on Antimicrobial Stewardship and Management of Clinical Syndromes in Thoracic Organ Transplants and Mechanical Circulatory Device Recipients. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gendeh HS, Husain S. COVID-19 face mask valve for nasal and laryngeal endoscopy. Ann R Coll Surg Engl 2021; 103:536-537. [PMID: 33913780 DOI: 10.1308/rcsann.2021.0009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- H S Gendeh
- Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - S Husain
- Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
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Villalobos APC, Rotstein C, Martinu T, Chaparro C, Singer L, Keshavjee S, Husain S. Histoplasma in Explanted Tissue of Lung Transplant Recipients (LTRs) from a Moderate Endemic Region. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.959] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Vishram-Nielsen J, Lambadaris M, Amadio J, Husain S, Rao V, Billia F, Alba A. Association between Continuous Flow Left Ventricular Assist Device Infections Requiring Long-Term Antibiotic Use and Post Heart Transplant Morbidity and Mortality. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Levy L, Huszti E, Tikkanen J, Fernandez-Castillo J, Ghany R, Keshavjee S, Singer L, Husain S, Martinu T. Clinical Significance of Commensal Bacteria Isolated from Bronchoalveolar Lavage of Lung Transplant Recipients. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Villalobos APC, Martinu T, Chaparro C, Singer L, Keshavjee S, Husain S. Invasive Aspergillosis (IA) in Lung Transplant Recipients (LTRs) with Isolated Positive Bronchoalveolar Lavage Galactomannan (BAL GM) in the First Month Post-Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hanauske-Abel H, Singh S, Hoque M, Husain S, Hanauske A, Soteropoulos P, Cracchiolo B. Genome-directed identification of novel, immediately druggable targets in uterine serous papillary carcinoma (USPC). Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2020.05.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Phoompoung P, Villalobos APC, Jain S, Faroutan F, Orchanian-Cheff A, Husain S. Risk Factors of Invasive Fungal Infections in Heart and Lung Transplantation: Systematic Review and Meta-Analysis. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Levy L, Huszti E, Tikkanen J, Fernandez-Castillo J, Ghany R, Keshavjee S, Singer L, Husain S, Martinu T. Clinical Significance of Commensal Bacteria Isolated from Bronchoalveolar Lavage of Lung Transplant Recipients. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Dhabaan G, Kus J, Singer L, Kumar D, Humar A, Husain S, Mazzulli T. Molecular Identification of Aspergillus Fumigatus Complex from Lung Transplant Recipients Using Multi Locus Sequencing Analysis (MLSA). J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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Gunderson C, Evans E, Radhakrishnan R, Gomathinayagam R, Husain S, Aravindan S, Moore K, Dhanasekaran D, Jayaraman M. Circulating Tumor Cell-Free DNA Genes As Biomarkers For Platinum Resistant Ovarian Cancer Diagnosis. Gynecol Oncol 2020. [DOI: 10.1016/j.ygyno.2019.11.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Fokkens WJ, Lund VJ, Hopkins C, Hellings PW, Kern R, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Alobid I, Terezinha Anselmo-Lima W, Bachert C, Baroody F, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Desrosiers M, Diamant Z, Douglas RG, Gevaert PH, Hafner A, Harvey RJ, Joos GF, Kalogjera L, Knill A, Kocks JH, Landis BN, Limpens J, Lebeer S, Lourenco O, Meco C, Matricardi PM, O'Mahony L, Philpott CM, Ryan D, Schlosser R, Senior B, Smith TL, Teeling T, Tomazic PV, Wang DY, Wang D, Zhang L, Agius AM, Ahlstrom-Emanuelsson C, Alabri R, Albu S, Alhabash S, Aleksic A, Aloulah M, Al-Qudah M, Alsaleh S, Baban MA, Baudoin T, Balvers T, Battaglia P, Bedoya JD, Beule A, Bofares KM, Braverman I, Brozek-Madry E, Richard B, Callejas C, Carrie S, Caulley L, Chussi D, de Corso E, Coste A, El Hadi U, Elfarouk A, Eloy PH, Farrokhi S, Felisati G, Ferrari MD, Fishchuk R, Grayson W, Goncalves PM, Grdinic B, Grgic V, Hamizan AW, Heinichen JV, Husain S, Ping TI, Ivaska J, Jakimovska F, Jovancevic L, Kakande E, Kamel R, Karpischenko S, Kariyawasam HH, Kawauchi H, Kjeldsen A, Klimek L, Krzeski A, Kopacheva Barsova G, Kim SW, Lal D, Letort JJ, Lopatin A, Mahdjoubi A, Mesbahi A, Netkovski J, Nyenbue Tshipukane D, Obando-Valverde A, Okano M, Onerci M, Ong YK, Orlandi R, Otori N, Ouennoughy K, Ozkan M, Peric A, Plzak J, Prokopakis E, Prepageran N, Psaltis A, Pugin B, Raftopulos M, Rombaux P, Riechelmann H, Sahtout S, Sarafoleanu CC, Searyoh K, Rhee CS, Shi J, Shkoukani M, Shukuryan AK, Sicak M, Smyth D, Sindvongs K, Soklic Kosak T, Stjarne P, Sutikno B, Steinsvag S, Tantilipikorn P, Thanaviratananich S, Tran T, Urbancic J, Valiulius A, Vasquez de Aparicio C, Vicheva D, Virkkula PM, Vicente G, Voegels R, Wagenmann MM, Wardani RS, Welge-Lussen A, Witterick I, Wright E, Zabolotniy D, Zsolt B, Zwetsloot CP. European Position Paper on Rhinosinusitis and Nasal Polyps 2020. Rhinology 2020; 58:1-464. [PMID: 32077450 DOI: 10.4193/rhin20.600] [Citation(s) in RCA: 537] [Impact Index Per Article: 134.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
The European Position Paper on Rhinosinusitis and Nasal Polyps 2020 is the update of similar evidence based position papers published in 2005 and 2007 and 2012. The core objective of the EPOS2020 guideline is to provide revised, up-to-date and clear evidence-based recommendations and integrated care pathways in ARS and CRS. EPOS2020 provides an update on the literature published and studies undertaken in the eight years since the EPOS2012 position paper was published and addresses areas not extensively covered in EPOS2012 such as paediatric CRS and sinus surgery. EPOS2020 also involves new stakeholders, including pharmacists and patients, and addresses new target users who have become more involved in the management and treatment of rhinosinusitis since the publication of the last EPOS document, including pharmacists, nurses, specialised care givers and indeed patients themselves, who employ increasing self-management of their condition using over the counter treatments. The document provides suggestions for future research in this area and offers updated guidance for definitions and outcome measurements in research in different settings. EPOS2020 contains chapters on definitions and classification where we have defined a large number of terms and indicated preferred terms. A new classification of CRS into primary and secondary CRS and further division into localized and diffuse disease, based on anatomic distribution is proposed. There are extensive chapters on epidemiology and predisposing factors, inflammatory mechanisms, (differential) diagnosis of facial pain, allergic rhinitis, genetics, cystic fibrosis, aspirin exacerbated respiratory disease, immunodeficiencies, allergic fungal rhinosinusitis and the relationship between upper and lower airways. The chapters on paediatric acute and chronic rhinosinusitis are totally rewritten. All available evidence for the management of acute rhinosinusitis and chronic rhinosinusitis with or without nasal polyps in adults and children is systematically reviewed and integrated care pathways based on the evidence are proposed. Despite considerable increases in the amount of quality publications in recent years, a large number of practical clinical questions remain. It was agreed that the best way to address these was to conduct a Delphi exercise . The results have been integrated into the respective sections. Last but not least, advice for patients and pharmacists and a new list of research needs are included. The full document can be downloaded for free on the website of this journal: http://www.rhinologyjournal.com.
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Affiliation(s)
- W J Fokkens
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - P W Hellings
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Belgium.,Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium
| | - R Kern
- Department of Otorhinolaryngology - Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - S Reitsma
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Skin and Allergy Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland
| | | | | | - I Alobid
- Rhinology and Skull Base Unit, ENT Department, Hospital Clinic de Barcelona, Universidad de Barcelona, August Pi i Sunyer Biomedical Research Institute, Barcelona, Spain
| | - W Terezinha Anselmo-Lima
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, Brazil
| | - C Bachert
- Upper Airways Research Laboratory and ENT Department, University Hospital Ghent, Ghent, Belgium.,Division of ENT Diseases, CLINTEC, Karolinska Institute, University of Stockholm, Stockholm, Sweden
| | - F Baroody
- Department of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children's Hospital, Chicago, IL, USA
| | - C von Buchwald
- Department of Otorhinolaryngology, Head and Neck Surgery and Audiology, Rigshospitalet, Copenhagen University, Hospital, Copenhagen, Denmark
| | - A Cervin
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital.,Faculty of Medicine, University of Queensland, Brisbane, Australia
| | - N Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L De Gabory
- Rhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU de Bordeaux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, France
| | - M Desrosiers
- Department of ORL-HNS, Universite de Montreal, Montreal, Canada
| | - Z Diamant
- Dept of Respiratory Medicine and Allergology, Skane University in Lund, Sweden.,Research Director Respiratory and Allergy, at QPS-Netherlands, Groningen, Netherlands.,Affiliate to Charles University, Dept of Respiratory Diseases, in Prague, Czech Republic
| | - R G Douglas
- Department of Surgery, The University of Auckland, Auckland, New Zealand
| | - P H Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - A Hafner
- University of Zagreb Faculty of Pharmacy and Biochemistry, Zagreb, Croatia
| | - R J Harvey
- Rhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, Australia
| | - G F Joos
- Department of Respiratory Medicine, Ghent University Hospital, Ghent, Belgium
| | - L Kalogjera
- ENT Department, Zagreb School of Medicine.,University Hospital Center "Sestre milosrdnice", Zagreb, Croatia
| | - A Knill
- Patient representative, Opuscomms, London, UK
| | - J H Kocks
- Department of Inhalation Medicine, Observational Pragmatic Research Institute, Singapore
| | - B N Landis
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, Switzerland
| | - J Limpens
- Medical Information Specialist, Medical Library, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Lebeer
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - O Lourenco
- FCS - UBI Faculty of Health Sciences, University of Beira Interior, Covilha, Portugal
| | - C Meco
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey.,Department of Otorhinolaryngology, Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - P M Matricardi
- Department of Pediatric Pneumology and Immunology, Charite - Universitatsmedizin Berlin, Berlin, Germany
| | - L O'Mahony
- Departments of Medicine and Microbiology, APC Microbiome Ireland, National University of Ireland, Cork, Ireland
| | - C M Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK.,ENT Department, James Paget University Hospital, Great Yarmouth, UK
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, UK.,Optimum Patient Care, Cambridgeshire, UK
| | - R Schlosser
- Department of Otorhinolaryngology Head and Neck Surgery, Medical University of South Carolina, Charleston, USA
| | - B Senior
- UNC Otorhinolaryngology / Head and Neck Surgery, Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery and Department of Neurosurgery, University of North Carolina School of Medicine, Chapel Hill, NC, USA
| | - T L Smith
- Division of Rhinology and Sinus/Skull Base Surgery, Department of Otolaryngology-Head Neck Surgery, Oregon Health and Science University, Portland, OR, USA
| | - T Teeling
- Patient representative, Task Force Healthcare, WTC Den Haag, The Netherlands
| | - P V Tomazic
- Department of Otorhinolaryngology, Head and Neck Surgery, Medical University of Graz, Graz, Austria
| | - D Y Wang
- Department of Otorhinolaryngology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - D Wang
- Rhinology Division, ENT Department.,Eye and ENT Hospital, Fudan University, Shanghai, China
| | - L Zhang
- Department of Otorhinolaryngology Head and Neck Surgery, Beijing TongRen Hospital, Beijing, China
| | - A M Agius
- Department of Medicine and Surgery in the University of Malta
| | | | - R Alabri
- ENT Division, Surgery Department, College of Medicine and Health and Sciences, Sultan Qaboos University, Muscat, Oman
| | - S Albu
- Department of Otorhinolaryngology, Iuliu Hațieganu University of Medicine and Pharmacy, Cluj-Napoca, Romania
| | | | - A Aleksic
- ENT Department, University Clinical Centre, University of Banja Luka, Bosnia and Herzegovina
| | - M Aloulah
- ENT Department, King Saud University, Riyadh, Kingdom of Saudi Arabia
| | - M Al-Qudah
- Department of Otorhinolaryngology, Jordan University of Science and Technology, Irbid, Jordan
| | - S Alsaleh
- Department of Otorhinolaryngology - Head and Neck Surgery, College of Medicine, King Saud University, Riyadh, Saudi Arabia
| | - M A Baban
- Department of Otorhinolaryngology - Head and Neck Surgery, University of Sulaimani, Sulaimayniha, Iraq
| | - T Baudoin
- Dept. of ORL-HNS Sisters of Mercy University Medical Center, School of Medicine University of Zagreb, Croatia
| | - T Balvers
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - P Battaglia
- Division of Otorhinolaryngology, Department of Biotechnology and Life Sciences, University of Insubria, Varese, Italy
| | - J D Bedoya
- Department of Otorhinolaryngology, Universidad de Antioquia, Medellin, Colombia
| | - A Beule
- Department of Otorhinolaryngology, University Clinic of Munster, Germany
| | - K M Bofares
- Department of Otorhinolaryngology, Omar Al-Moukhtar University, Albyeda, Libya
| | - I Braverman
- Department of Otorhinolaryngology - Head and Neck Surgery, Hillel Yaffe Medical Center, Israel
| | - E Brozek-Madry
- Department of Otorhinolaryngology, Medical University of Warsaw, Poland
| | - B Richard
- Department of ENT, Makerere University, Kampala, Uganda
| | - C Callejas
- Department of Otorhinolaryngology, Pontificia Catholic University, Santiago, Chile
| | - S Carrie
- Department of Otorhinolaryngology, Head and Neck Surgery, Newcastle University, United Kingdom
| | - L Caulley
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - D Chussi
- Department of Otorhinolaryngology, Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - E de Corso
- Department of Otorhinolaryngology , La Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Universita Cattolica del Sacro Cuore, Rome, Italy
| | - A Coste
- ORL et Chirurgie Cervico-Faciale, Universite Paris-Est Creteil (UPEC), France
| | - U El Hadi
- Department of Otorhinolaryngology, American University of Beirut, Lebanon
| | - A Elfarouk
- Department of Otorhinolaryngology, Cairo University, Egypt
| | - P H Eloy
- Department of ENT, CHU UCL Namur, Yvoir, Belgium
| | - S Farrokhi
- Department of Immunology and Allergy, The Persian Gulf Tropical Medicine Research Center.,The Persian Gulf Biomedical Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - G Felisati
- Department of Head and Neck, University of Milan, Italy
| | - M D Ferrari
- Department of Neurology, Leiden University Medical Center (LUMC)
| | - R Fishchuk
- Department of ENT- Organs Microsurgery, Central city clinical hospital of lvano-Frankivsk city council, Ivano-Frankivsk, Ukraine
| | - W Grayson
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Alabama Birmingham, USA
| | - P M Goncalves
- ENT Department, Centro Hospitalar de Entre Douro e Vouga, Santa Maria da Feira, Portugal
| | - B Grdinic
- ENT Department, General Hospital, Pula, Pula, Croatia
| | - V Grgic
- ENT Department, Zagreb School of Medicine.,University Hospital center 'Sestre milosrdnice', Zagreb, Croatia
| | - A W Hamizan
- Department of Otorhinolaryngology, University Kebangsaan, Kuala Lumpur, Malasyia
| | - J V Heinichen
- Department of ENT of Hospital de Clinicas, Facultad de Ciencias Medicas, Universidad Nacional de Asuncion, Paraguay
| | - S Husain
- Department of Otorhinolaryngology, Head and Neck Surgery, National University of Malaysia, Kuala Lumpur, Malaysia
| | - T I Ping
- Department ORLHNS, University Malaysia Sarawak, Kuching, Malaysia
| | - J Ivaska
- Clinic of Ear, Nose, Throat and Eye diseases, Vilnius University, Lithuania
| | - F Jakimovska
- ENT Department of Medical Faculty, St Cyril and Methodius University of Skopje, North Macedonia
| | - L Jovancevic
- Department of Otorhinolaryngology, Head and Neck Surgery, Clinical Centre of Vojvodina, Faculty of Medicine, University of Novi Sad, Serbia
| | - E Kakande
- Department of ENT Surgery, Mulago National Referral Hospital Kampala, Uganda
| | - R Kamel
- Department of Otorhinolaryngology, Head and Neck Surgery, Cairo University, Egypt
| | - S Karpischenko
- ENT Department, Director of Saint Petersburg Research Institute of Ear, Throat , Nose and Speech.,Professor and Chairman of First Pavlov State Medical University, Saint Petersburg, Russia
| | - H H Kariyawasam
- Department of Allergy and Clinical Immunology, Royal National ENT Hospital, London, England
| | - H Kawauchi
- 96. Department of Otorhinolaryngology, Shimane University, Matsue, Shimane, Japan
| | - A Kjeldsen
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Southern Denmark, Odense, Denmark
| | - L Klimek
- Center of Rhinology and Allergology, Wiesbaden, Hesse, Germany
| | - A Krzeski
- Department of Otorhinolaryngology, Warsaw Medical University, Warsaw, Poland
| | - G Kopacheva Barsova
- Department of Otorhinolaryngology, University If Medicine, st. Ciril and Methodius, Skopje
| | - S W Kim
- Department of Otorhinolaryngology, Head and Neck Surgery, Kyung Hee University, Seoul, South Korea
| | - D Lal
- Department of Otorhinolaryngology, Head and Neck Surgery, Mayo Clinic in Arizona, Phoenix, Arizona, USA
| | - J J Letort
- Department of Otorhinolaryngology, Pontifica Catholic University of Ecuador, Quito, Ecuador
| | - A Lopatin
- Department of Otorhinolaryngology, Policlinic No.1- Senior ENT Consultant and Surgeon.,President of Russian Rhinologic Society, Moscow, Russia
| | | | - A Mesbahi
- Department of Facial Surgery, Khodadoust Hospital, Ordibehesht Hospital, Shiraz, Iran
| | - J Netkovski
- Department of Otorhinolaryngology-Head and Neck Surgery, St. Cyril and Methodius, Skopje, Republic of North Macedonia
| | - D Nyenbue Tshipukane
- Department of Otorhinolaryngology, University of Kinshasa, Kinshasa, Democratic Republic of Congo
| | - A Obando-Valverde
- Department of Otorhinolaryngology and Surgery, Hospital Mexico, University of Costa Rica, San Jose, Costa Rica
| | - M Okano
- Department of Otorhinolaryngology, International University of Health and Welfare, Narita , Japan
| | - M Onerci
- Department of Otorhinolaryngology, Hacettepe, Ankara, Turkey
| | - Y K Ong
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Singapore, National University Hospital, Singapore
| | - R Orlandi
- Department of Otorhinolaryngology, University of Utah, Salt Lake City, Utah, USA
| | - N Otori
- Department of Otorhinolaryngology at The Jikei University School of Medicine,Tokyo, Japan
| | - K Ouennoughy
- Department of Otorhinolaryngology-Head and Neck Surgery, Saad Dahleb Blida 1, Blida, Algeria
| | - M Ozkan
- Department of Otorhinolaryngology, University of Health Sciences, Ankara City Hospital, Turkey
| | - A Peric
- Department of Otorhinolaryngology, Military Medical Academy, Faculty of Medicine, University of Defense, Belgrade, Serbia
| | - J Plzak
- Department of Otorhinolaryngology, Head and Neck Surgery, 1st Faculty of Medicine, Charles University, Prague, Czech Republic
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Crete, Greece
| | - N Prepageran
- Department of ENT, University Malaya, Kuala Lumpur, Malaysia
| | - A Psaltis
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Adelaide, Adelaide, Australia
| | - B Pugin
- Department of Health Sciences and Technology, ETH Zurich, Switzerland
| | - M Raftopulos
- Department of Otorhinolaryngology, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands.,Royal Australian College of Surgeons, Trainee Representative (Australia)
| | - P Rombaux
- Department of Otorhinolaryngology, University of Louvain, Brussels, Belgium
| | - H Riechelmann
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital, Ulm, Baden-Wurttemberg, Germany
| | - S Sahtout
- Faculty of Medicine of Tunis, Tunis El Manar University, Tunis, Tunisia
| | - C-C Sarafoleanu
- ENT and H NS Department, Santa Maria Hospital, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania
| | - K Searyoh
- Surgery Ear, Nose and Throat Unit, School of Medicine and Dentistry, University of Ghana, Korle-Bu Teaching Hospital, Accra, Ghana
| | - C-S Rhee
- Department of Otorhinolaryngology, Head and Neck Surgery, Seoul, Seoul National University, Seoul, Korea
| | - J Shi
- Department of Rhinology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - M Shkoukani
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - A K Shukuryan
- Department of Otorhinolaryngology, Yerevan State Medical University, Yerevan, Armenia
| | - M Sicak
- Department of Otorhinolaryngology, Head and Neck Surgery, Central Military Hospital, Slovakia, Slovak Health University Bratislava and Catholic University, Ruzom berok, Slovakia
| | - D Smyth
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal College of Surgeons in Ireland and University College Cork, Waterford, Ireland
| | - K Sindvongs
- Department of Otorhinolaryngology, Chulalongkorn University, Bangkok, Thailand
| | - T Soklic Kosak
- University Medical Centre Ljubljana, Department of Otorhinolaryngology and Cervicofacial Surgery, University of Ljubljana, Faculty of Medicine, Ljubljana, Slovenia
| | - P Stjarne
- Department of Otorhinolaryngology, Karolinska University Hospital, Stockholm, Sweden
| | - B Sutikno
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Airlangga, Surabaya, Indonesia
| | - S Steinsvag
- Department of ORL, University of Bergen, Norway
| | - P Tantilipikorn
- Department of Otorhinolaryngology, Faculty of Medicine Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - S Thanaviratananich
- Department of Otorhinolaryngology, Head and Neck Surgery, Cleveland Clinic Abu Dhabi, United Arab Emirates
| | - T Tran
- Department of ENT Hospital of Ho Chi Minh city, Faculty of medicine of Ho Chi Minh city Vietnam National University, Vietnam
| | - J Urbancic
- Department of Otorhinolaryngology and cervicofacial surgery, UMC Ljubljana, University of Ljubljana, Medical Faculty, Ljubljana, Slovenia
| | - A Valiulius
- Department of Children's diseases, Vilnius University Medical Faculty, Institute of Clinical Medicine, Vilnius, Lithuania
| | - C Vasquez de Aparicio
- Department of Paediatric Surgery, National Hospital Benjamin Bloom, National University of El Salvador, San Salvador, El Salvador
| | - D Vicheva
- Department of Otorhinolaryngology, Medical University Plovdiv, Bulgaria
| | - P M Virkkula
- Department of Otorhinolaryngology, Head and Neck Surgery, Helsinki, University Hospital, Helsinki, Finland
| | - G Vicente
- Department of Otolaryngology, St. Luke's Medical Centre, Quezon City, The Philippines
| | - R Voegels
- Department of Otorhinolaryngology, University of Sao Paulo, Sau Paulo, Brazil
| | - M M Wagenmann
- Department of Otorhinolaryngology, Dusseldorf University Hospital, Dusseldorf, German
| | - R S Wardani
- Department of Otorhinolaryngology Head and Neck Surgery, Dr. Cipto Mangunkusumo Hospital, University of Indonesia, Jakarta, Indonesia
| | - A Welge-Lussen
- Department of Otorhinolaryngology, University Hospital Basel, University Basel, Switzerland
| | - I Witterick
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Ottawa,Toronto, Canada
| | - E Wright
- Department of Surgery, University of Alberta, Edmonton, Alberta, Canada
| | - D Zabolotniy
- State Institution of O.S. Kolomiychenko Institute of Othorhnilarungology of National Academy of Medical Sciences of Ukraine, Kiev, Ukraine
| | - B Zsolt
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Szeged, Hungary
| | - C P Zwetsloot
- Department of Neurology, Dijklander Ziekenhuis, Purmerend, The Netherlandsn
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Kingdon J, Aadan H, Husain S, Atkinson C, Thomson C, Braude P. 22 Design and Implementation of A Nutrition Clinical Pathway for Patients with Fractured Neck of Femur. Age Ageing 2020. [DOI: 10.1093/ageing/afz183.22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Patients with a fractured neck of femur (FNOF) are commonly malnourished pre-admission, have reduced oral intake in hospital and a hypermetabolic state up to three months postoperatively (E Paillaud 2000). Malnutrition is associated with functional deterioration, higher morbidity and mortality.
Evidence suggests nutritional supplementation post-surgery can reduce postoperative complications. As a result, nutritional assessment is included in the National Hip Fracture Database best practice tariff (Avenell, Cochrane Database of Systematic Reviews 2016).
Introduction
Our aim was to design and implement a clinical pathway for patients with FNOF to identify malnutrition and provide appropriate nutritional support.
Intervention
A retrospective audit of 25 patients was completed to understand baseline rates of assessment, prescription of supplements and referral to dietetics. Using these data meetings were arranged to develop a clinical pathway. Key stakeholders included dietetics, orthopaedic surgeons, geriatricians, physiotherapists and nurses. The pathway was evaluated and optimised with two Plan-Do-Study-Act (PDSA) cycles looking at 25 patients each time.
Results
Baseline: 79% received a nutritional assessment, 32% had nutritional supplements prescribed and 36% (n=9) met criteria for referral to a dietician, of which 55%were referred. However, an additional 5 referrals were made to dietetics for patients who did not meet criteria, a 50% inappropriate referral rate.
PDSA cycle 1: increased nutritional assessment (85%), increased nutritional supplements prescribed (92%), decreased inappropriate referrals to dietetics (43%).
PDSA cycle 2: increased nutritional assessment & nutritional supplements prescribed (100%), increased inappropriate referrals to dietetics (80%).
Conclusions
The implementation of a nutrition pathway has led to increased identification and treatment of malnutrition, which has in addition improved accrual of the best practice tariff. However, greater number of inappropriate referrals have been made to dietetics. This is partly attributed to difficulty weighing patients on admission, and where no weight is inputted on the Malnutrition Universal Screening Tool a “High Risk” score is generated triggering a referral. We are now looking at alternative methods to obtaining a weight such a mid-upper arm circumference.
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Affiliation(s)
- J Kingdon
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
| | - H Aadan
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
| | - S Husain
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
| | - C Atkinson
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
| | - C Thomson
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
| | - P Braude
- Department of Aging and Health, Guy’s and St Thomas’s Hospital
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22
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Fischer M, Plorde M, Meischke H, Husain S. Lessons learned from a sobering center pilot for acute alcohol intoxication in South King County, Washington. Journal of Substance Use 2019. [DOI: 10.1080/14659891.2019.1664666] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Marlee Fischer
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Michele Plorde
- Emergency Medical Services Division, Public Health – Seattle & King County, Seattle, Washington, USA
| | - Hendrika Meischke
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - Sofia Husain
- Emergency Medical Services Division, Public Health – Seattle & King County, Seattle, Washington, USA
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23
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Trager M, Chen C, Husain S, Geskin L. 498 Nitrogen mustard-induced inflammation triggers lymphomatoid papulosis in patients with Mycosis Fungoides. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.07.548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Affiliation(s)
- V T Pemmaraju
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - S S Lansing
- The Ohio State University College of Medicine, Columbus, OH, USA
| | - S Husain
- Division of Colon and Rectal Surgery, Ohio State University Wexner Medical Center, N737 Doan Hall, 410 West 10th Ave, Columbus, OH, 43210, USA.
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Husain S, Allotey J, Drymoussi Z, Wilks M, Fernandez-Felix BM, Whiley A, Dodds J, Thangaratinam S, McCourt C, Prosdocimi EM, Wade WG, de Tejada BM, Zamora J, Khan K, Millar M. Effects of oral probiotic supplements on vaginal microbiota during pregnancy: a randomised, double-blind, placebo-controlled trial with microbiome analysis. BJOG 2019; 127:275-284. [PMID: 30932317 PMCID: PMC6973149 DOI: 10.1111/1471-0528.15675] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/26/2019] [Indexed: 12/12/2022]
Abstract
Objective To determine the effects on the vaginal microbiota of an oral probiotic preparation administered from early pregnancy. Design Randomised, double blind, placebo‐controlled trial. Setting Four maternity units in the UK. Population Women aged 16 years or older recruited at 9–14 weeks' gestation. Methods Participants were randomly allocated to receive oral capsules of probiotic containing Lactobacillus rhamnosus GR‐1 and Lactobacillus reuteri RC‐14 each at 2.5 × 109 colony‐forming units (CFUs) or placebo once daily from recruitment until the end of pregnancy. Main outcome measure Rates of bacterial vaginosis (BV, defined as Nugent score ≥7) at 18–20 weeks' gestation compared by logistic regression adjusted for possible confounders. Results The primary analysis included 78% (238/304) of participants who initially consented (probiotic group 123, placebo group 115). Of these participants, 95% (227/238) reported an intake of 93% or more of the required number of capsules. The rates of BV did not differ between groups at 18–20 weeks' gestation (15% (19/123) in the probiotic group vs. 9% (10/115) in the placebo group, adjusted odds ratio 1.82, 95% confidence interval 0.64–5.19). There were also no differences between the groups in the proportion of women colonised with the probiotic strains, Escherichia coli, group B streptococci or other vaginal microbiota. There were no differences in the alpha diversity or composition of the bacterial communities between or within the probiotic and placebo groups at 9–14 and 18–20 weeks’ gestation. Conclusions Oral probiotics taken from early pregnancy did not modify the vaginal microbiota. Tweetable abstract The oral probiotic preparation used in this study does not prevent BV in pregnant women. The oral probiotic preparation used in this study does not prevent BV in pregnant women.
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Affiliation(s)
- S Husain
- Barts and the London School of Medicine and Dentistry, Blizard Institute, Queen Mary University of London, London, UK.,Neonatal Unit, Homerton University Hospital NHS Foundation Trust, London, UK
| | - J Allotey
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Z Drymoussi
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M Wilks
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Barts Health NHS Trust, London, UK
| | - B M Fernandez-Felix
- CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), Madrid, Spain
| | - A Whiley
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Barts Health NHS Trust, London, UK
| | - J Dodds
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - S Thangaratinam
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - C McCourt
- City University of London, University of London, London, UK
| | - E M Prosdocimi
- Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - W G Wade
- Centre for Host-Microbiome Interactions, King's College London, London, UK
| | - B M de Tejada
- Department of Obstetrics and Gynaecology, Faculty of Medicine, University Hospitals of Geneva, Geneva, Switzerland
| | - J Zamora
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Clinical Biostatistics Unit, Hospital Ramon y Cajal (IRYCIS), Madrid, Spain
| | - K Khan
- Women's Health Research Unit, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - M Millar
- Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.,Barts Health NHS Trust, London, UK
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Gohir W, Klement W, Singer L, Palmer S, Keshavjee S, Husain S. Host miRNA Profile of Invasive Aspergillosis in Lung Transplant Recipients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Gohir W, Klement W, Singer L, Palmer S, Keshavjee S, Husain S. Host miRNA Profile of Aspergillus Colonization Resulting in CLAD in Lung Transplant Recipients. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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28
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Herrera S, Farooq A, Davoudi S, Martinu T, Kumar D, Humar A, Rotstein C, Singer L, Keshavjee S, Husain S. Late Onset Invasive Pulmonary Aspergillosis in Lung Transplant Recipients Treated with a Preemptive/ Targeted Antifungal Therapy Strategy: 4 Year Follow Up. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.537] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Tyagi M, Khan A, Husain M, Husain S. Analytical and computational studies of the nonlinear vibrations of SWCNTs embedded in viscous elastic matrix using KBM method. Chaos 2019; 29:023134. [PMID: 30823744 DOI: 10.1063/1.5079700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/02/2018] [Accepted: 02/05/2019] [Indexed: 06/09/2023]
Abstract
The forced vibration analysis of single wall carbon nanotubes (SWCNTs) embedded in the viscous elastic matrix subjected to axial parametric excitation has been investigated. The Euler Bernoulli beam model of the non-local continuum theory is used. The resonant and non-resonant solutions are analytically studied using the Krylov Bogoliubov and Mitropolsky method. It has been seen that the amplitude remains constant up to the second order of approximation. The resonant solutions are also found to analyze the possibility of chaos in the neighborhood of resonance. The computational techniques are used, and plots of time series, phase plot, and Poincaré surface of section are also drawn to confirm the chaotic behavior for certain values of parameters of SWCNTs, which may lead the aging process in the SWCNTs after a long time.
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Affiliation(s)
- M Tyagi
- Centre for Nanoscience and Nanotechnology, Jamia Millia Islamia (A Central University), New Delhi 110025, India
| | - A Khan
- Department of Mathematics, Jamia Millia Islamia (A Central University), New Delhi 110025, India
| | - M Husain
- Department of Physics, Jamia Millia Islamia (A Central University), New Delhi 110025, India
| | - S Husain
- Centre for Nanoscience and Nanotechnology, Jamia Millia Islamia (A Central University), New Delhi 110025, India
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Lum SG, Gendeh BS, Husain S, Gendeh HS, Ismail MR, Toh CJ, Izaham A, Tan HJ. Internal carotid artery injury during endonasal sinus surgery: our experience and review of the literature. ACTA ACUST UNITED AC 2019; 39:130-136. [PMID: 30745587 PMCID: PMC6522866 DOI: 10.14639/0392-100x-1312] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2016] [Accepted: 10/05/2017] [Indexed: 11/23/2022]
Abstract
Iatrogenic internal carotid artery injury is a catastrophic but uncommon complication of endonasal sinus surgery. We present our experience in managing this emergency situation. A 52-year-old man underwent revision endoscopic repair of recurrent cerebrospinal fluid leak that was complicated with profuse haemorrhage during removal of the anterior wall of sphenoid sinus using a Hajek sphenoid punch forceps. Immediate packing of the sphenoid sinus controlled the haemorrhage. Urgent angiography revealed injury at the paraclival segment of the left internal carotid artery. An endovascular stent was initially placed but thrombosed; it was subsequently converted to coil embolisation. The patient had watershed cerebral infarct with hemiparesis post procedure but made full recovery within 6 weeks. Immediate nasal packing followed by urgent angiography and endovascular stent placement is the least invasive definitive treatment. If stenting is unsuccessful, endovascular balloon occlusion or coil embolisation is the next preferred treatment, if there is adequate cross-cerebral circulation. The success of treatment relies on its immediate management by a multidisciplinary team.
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Affiliation(s)
- S G Lum
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - B S Gendeh
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - S Husain
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - H S Gendeh
- Department of Otorhinolaryngology, Head and Neck Surgery, Universiti Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia
| | - M R Ismail
- Department of Radiology, UKMMC, Kuala Lumpur, Malaysia
| | - C J Toh
- Neurosurgery Unit, Department of Surgery, UKMMC, Kuala Lumpur, Malaysia
| | - A Izaham
- Department of Anaesthesiology, UKMMC, Kuala Lumpur, Malaysia
| | - H J Tan
- Neurology Unit, Department of Medicine, UKMMC, Kuala Lumpur, Malaysia
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31
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Korczeniewska OA, Husain S, Khan J, Eliav E, Soteropoulos P, Benoliel R. Differential gene expression in trigeminal ganglia of male and female rats following chronic constriction of the infraorbital nerve. Eur J Pain 2018. [PMID: 29350446 DOI: 10.1002/ejp.2018.22.issue-510.1002/ejp.1174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/11/2023]
Abstract
BACKGROUND The mechanisms underlying sex-based differences in pain and analgesia are poorly understood. In this study, we investigated gene expression changes in trigeminal ganglia (TG) of male and female rats exposed to infraorbital nerve chronic constriction injury (IoN-CCI). METHODS Somatosensory assessments were performed prior to IoN-CCI and at selected time points postsurgery. Selected gene expression changes were examined with real-time quantitative polymerase chain reaction (RT-PCR) in ipsilateral TG at 21 days postsurgery. RESULTS Rats exposed to IoN-CCI developed significant mechanical allodynia and hyperalgesia on days 19 and 21 postsurgery. During this period, females developed significantly more allodynia but not hyperalgesia compared to males. At 21 days postsurgery, expression levels of 44 of the 84 investigated pain-related genes in ipsilateral TG were significantly regulated relative to naïve rats in either sex. Csf1 and Cx3cr1 were up-regulated in both sexes, but the magnitude of regulation was significantly higher in females (p = 0.02 and p = 0.001, respectively). Htr1a and Scn9a were down-regulated in both sexes, but the down-regulation was significantly more pronounced in males (p = 0.04 and p = 0.02, respectively). Additionally, Cck, Il1a, Pla2g1b and Tnf genes were significantly regulated in females but not in males, and Chrna4 gene was significantly down-regulated in males but not in females. CONCLUSIONS Our findings suggest sex-dependent gene regulation in response to nerve injury, which may contribute to sex dimorphism of trigeminal neuropathic pain. Further studies are needed to establish gene expression changes over time and correlate these with hormonal and other physiological parameters in male and female. SIGNIFICANCE We present novel sex-specific transcriptional regulation in trigeminal ganglia that may contribute to male-/female-based differences in trigeminal neuropathic pain. These findings are expected to open new research horizons, particularly in male versus female targeted therapeutic regimens.
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Affiliation(s)
- O A Korczeniewska
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - S Husain
- The Genomics Center, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - J Khan
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - E Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - P Soteropoulos
- The Genomics Center, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - R Benoliel
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
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Husain S, Amilia HH, Rosli MN, Zahedi FD, Sachlin IS. Management of rhinosinusitis in adults in primary care. Malays Fam Physician 2018; 13:28-33. [PMID: 29796207 PMCID: PMC5962231] [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] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Rhinosinusitis is a common health problem encountered in primary care. It is due to mucosal inflammation of the nose and paranasal sinuses. Less than 2% of the cases are associated with bacterial infections. Diagnosis is based on clinical symptoms and supported by nasal endoscopy and imaging studies. Intranasal corticosteroids and normal saline irrigation are important treatments. Antibiotics are seldom indicated.
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Affiliation(s)
- S Husain
- MMBBS (Bangalore), MS ORL-HNS (UKM), Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - H H Amilia
- MD (UKM), MMed ORL-HNS (UKM), Universiti Kebangsaan Malaysia Medical Centre, Kuala Lumpur, Malaysia
| | - M N Rosli
- MBChB (Birm), MMed Fam Med (UKM), Klinik Kesihatan Greentown, Ipoh, Malaysia
| | - F D Zahedi
- MD (UKM), MMed ORL-HNS (USM), Hospital Raja PerempuVan Zainab II, Kota Bharu, Malaysia
| | - I S Sachlin
- MBBS (University of Queensland, Australia), MMed ORL-HNS (USM) Hospital Sultanah Bahiyah, Alor Setar, Malaysia
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33
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Herrera S, Gohir W, Aguilar C, Juvet S, Martinu T, Singer L, Keshavjee S, Rotstein C, Kumar D, Humar A, Husain S. Predictive Cytokine Profile for Invasive Aspergillosis in Lung Transplant Recipients in the Setting of Pre-emptive Prophylaxis. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.530] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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34
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Aguilar C, Gohir W, Tikkanen J, Del Sorbo L, Chaparro C, Mazzulli T, Humar A, Kumar D, Cypel M, Singer L, Keshavjee S, Husain S. Ureaplasma spp. and Mycoplasma hominis PCR in Respiratory Samples from Lung Transplant Recipients with Hyperammonemia Syndrome and Cerebral Edema. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.924] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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35
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Aguilar C, LI Y, Martinu T, Tikkanen J, Kent W, Juvet S, Humar A, Kumar D, Kolls J, Keshavjee S, Singer L, Husain S. Simkania negevensis and Chronic Lung Allograft Dysfunction in Lung Transplant Recipients. J Heart Lung Transplant 2018. [DOI: 10.1016/j.healun.2018.01.427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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36
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Korczeniewska OA, Husain S, Khan J, Eliav E, Soteropoulos P, Benoliel R. Differential gene expression in trigeminal ganglia of male and female rats following chronic constriction of the infraorbital nerve. Eur J Pain 2018; 22:875-888. [PMID: 29350446 DOI: 10.1002/ejp.1174] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/10/2017] [Indexed: 11/07/2022]
Abstract
BACKGROUND The mechanisms underlying sex-based differences in pain and analgesia are poorly understood. In this study, we investigated gene expression changes in trigeminal ganglia (TG) of male and female rats exposed to infraorbital nerve chronic constriction injury (IoN-CCI). METHODS Somatosensory assessments were performed prior to IoN-CCI and at selected time points postsurgery. Selected gene expression changes were examined with real-time quantitative polymerase chain reaction (RT-PCR) in ipsilateral TG at 21 days postsurgery. RESULTS Rats exposed to IoN-CCI developed significant mechanical allodynia and hyperalgesia on days 19 and 21 postsurgery. During this period, females developed significantly more allodynia but not hyperalgesia compared to males. At 21 days postsurgery, expression levels of 44 of the 84 investigated pain-related genes in ipsilateral TG were significantly regulated relative to naïve rats in either sex. Csf1 and Cx3cr1 were up-regulated in both sexes, but the magnitude of regulation was significantly higher in females (p = 0.02 and p = 0.001, respectively). Htr1a and Scn9a were down-regulated in both sexes, but the down-regulation was significantly more pronounced in males (p = 0.04 and p = 0.02, respectively). Additionally, Cck, Il1a, Pla2g1b and Tnf genes were significantly regulated in females but not in males, and Chrna4 gene was significantly down-regulated in males but not in females. CONCLUSIONS Our findings suggest sex-dependent gene regulation in response to nerve injury, which may contribute to sex dimorphism of trigeminal neuropathic pain. Further studies are needed to establish gene expression changes over time and correlate these with hormonal and other physiological parameters in male and female. SIGNIFICANCE We present novel sex-specific transcriptional regulation in trigeminal ganglia that may contribute to male-/female-based differences in trigeminal neuropathic pain. These findings are expected to open new research horizons, particularly in male versus female targeted therapeutic regimens.
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Affiliation(s)
- O A Korczeniewska
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - S Husain
- The Genomics Center, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - J Khan
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - E Eliav
- Eastman Institute for Oral Health, University of Rochester Medical Center, Rochester, NY, USA
| | - P Soteropoulos
- The Genomics Center, New Jersey Medical School, Rutgers, The State University of New Jersey, Newark, NJ, USA
| | - R Benoliel
- Department of Diagnostic Sciences, Rutgers School of Dental Medicine, Rutgers, The State University of New Jersey, Newark, NJ, USA
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Latimer AJ, Husain S, Nolan J, Doreswamy V, Rea TD, Sayre MR, Eisenberg MS. Syringe Administration of Epinephrine by Emergency Medical Technicians for Anaphylaxis. PREHOSP EMERG CARE 2018; 22:319-325. [DOI: 10.1080/10903127.2017.1392667] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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Hamandi B, Fegbeutel C, Silveira FP, Verschuuren EA, Younus M, Mo J, Yan J, Ussetti P, Chin-Hong PV, Solé A, Holmes-Liew CL, Billaud EM, Grossi PA, Manuel O, Levine DJ, Barbers RG, Hadjiliadis D, Aram J, Singer LG, Husain S. Voriconazole and squamous cell carcinoma after lung transplantation: A multicenter study. Am J Transplant 2018; 18:113-124. [PMID: 28898527 DOI: 10.1111/ajt.14500] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2017] [Revised: 08/04/2017] [Accepted: 08/30/2017] [Indexed: 01/25/2023]
Abstract
This study evaluated the independent contribution of voriconazole to the development of squamous cell carcinoma (SCC) in lung transplant recipients, by attempting to account for important confounding factors, particularly immunosuppression. This international, multicenter, retrospective, cohort study included adult patients who underwent lung transplantation during 2005-2008. Cox regression analysis was used to assess the effects of voriconazole and other azoles, analyzed as time-dependent variables, on the risk of developing biopsy-confirmed SCC. Nine hundred lung transplant recipients were included. Median follow-up time from transplantation to end of follow-up was 3.51 years. In a Cox regression model, exposure to voriconazole alone (adjusted hazard ratio 2.39, 95% confidence interval 1.31-4.37) and exposure to voriconazole and other azole(s) (adjusted hazard ratio 3.45, 95% confidence interval 1.07-11.06) were associated with SCC compared with those unexposed after controlling for important confounders including immunosuppressants. Exposure to voriconazole was associated with increased risk of SCC of the skin in lung transplant recipients. Residual confounding could not be ruled out because of the use of proxy variables to control for some confounders. Benefits of voriconazole use when prescribed to lung transplant recipients should be carefully weighed versus the potential risk of SCC. EU PAS registration number: EUPAS5269.
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Affiliation(s)
- B Hamandi
- Department of Pharmacy, University Health Network, Toronto, ON, Canada
| | - C Fegbeutel
- Department of Cardiothoracic, Transplant, and Vascular Surgery, Hannover Medical School, Hannover, Germany
| | - F P Silveira
- Division of Infectious Diseases, University of Pittsburgh Medical Center, Pittsburgh, PA, USA
| | - E A Verschuuren
- Department of Pulmonary Diseases, University Hospital Groningen, Groningen, the Netherlands
| | | | - J Mo
- Pfizer Inc., New York, NY, USA
| | - J Yan
- Pfizer Inc., New York, NY, USA
| | - P Ussetti
- Respiratory Department, Hospital Puerta de Hierro, Madrid, Spain
| | - P V Chin-Hong
- Department of Medicine, University of California, San Francisco, San Francisco, CA, USA
| | - A Solé
- Respiratory Department, University and Polytechnic Hospital La Fe, Universidad de Valencia, Valencia, Spain
| | - C L Holmes-Liew
- Lung Research, Hanson Institute, and Department of Thoracic Medicine, Royal Adelaide Hospital, Adelaide, Australia
| | - E M Billaud
- Service de Pharmacologie, AP-HP, Hôpital Européen G Pompidou, Paris, France
| | - P A Grossi
- Infectious Diseases Department, University of Insubria, Varese, Italy
| | - O Manuel
- Infectious Diseases Service and Transplantation Center, University Hospital of Lausanne, Lausanne, Switzerland
| | - D J Levine
- Division of Pulmonary and Critical Care Medicine, University of Texas Health Science Center San Antonio, San Antonio, TX, USA
| | - R G Barbers
- Division of Pulmonary and Critical Care, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - D Hadjiliadis
- Department of Medicine, University of Pennsylvania, Hospital of the University of Pennsylvania, Philadelphia, PA, USA
| | - J Aram
- Pfizer Inc., New York, NY, USA
| | - L G Singer
- Toronto Lung Transplant Program, University Health Network, Toronto, ON, Canada
| | - S Husain
- Multi-Organ Transplant Program, University Health Network, Toronto, ON, Canada
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So M, Mamdani MM, Morris AM, Lau TTY, Broady R, Deotare U, Grant J, Kim D, Schimmer AD, Schuh AC, Shajari S, Steinberg M, Bell CM, Husain S. Effect of an antimicrobial stewardship programme on antimicrobial utilisation and costs in patients with leukaemia: a retrospective controlled study. Clin Microbiol Infect 2017; 24:882-888. [PMID: 29138099 DOI: 10.1016/j.cmi.2017.11.009] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 07/10/2017] [Revised: 11/06/2017] [Accepted: 11/07/2017] [Indexed: 12/16/2022]
Abstract
OBJECTIVES To examine the effectiveness of an antimicrobial stewardship programme on utilization and cost of antimicrobials in leukaemia patients in Canada. METHODS We conducted a multisite retrospective observational time series study from 2005 to 2013. We implemented academic detailing as the intervention of an antimicrobial stewardship programme in leukaemia units at a hospital, piloted February-July 2010, then fully implemented December 2010-March 2013, with no intervention in August-November 2010. Internal control was the same hospital's allogeneic haematopoietic stem-cell transplantation unit. External control was the combined leukaemia-haematopoietic stem-cell transplantation unit at another hospital. Primary outcome was antimicrobial utilization (antibiotics and antifungals) in defined daily dose per 100 patient-days (PD). Secondary outcomes were antimicrobial cost (Canadian dollars per PD); cost and utilization by drug class; length of stay; 30-day inpatient mortality; and nosocomial Clostridium difficile infection. We used autoregressive integrated moving average models to evaluate the impact of the intervention on outcomes. RESULTS The intervention group included 1006 patients before implementation and 335 during full implementation. Correspondingly, internal control had 723 and 264 patients, external control 1395 and 864 patients. Antimicrobial utilization decreased significantly in the intervention group (p <0.01, 278 vs. 247 defined daily dose per 100 PD), increased in external control (p = 0.02, 237.4 vs. 268.9 defined daily dose per 100 PD) and remained stable in internal control (p = 0.66). Antimicrobial cost decreased in the intervention group (p = 0.03; $154.59 per PD vs. $128.93 per PD), increased in external control (p = 0.01; $109.4 per PD vs. $135.97 per PD) but was stable in internal control (p = 0.27). Mortality, length of stay and nosocomial C. difficile rate in intervention group remained stable. CONCLUSIONS The antimicrobial stewardship programme reduced antimicrobial use in leukaemia patients without affecting inpatient mortality and length of stay.
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Affiliation(s)
- M So
- University Health Network, Toronto, Canada; Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada
| | - M M Mamdani
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; St Michael's Hospital Li Ka Shing Centre for Healthcare Analytics Research and Training, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - A M Morris
- University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Sinai Health System, Toronto, Canada
| | - T T Y Lau
- Vancouver General Hospital, Vancouver, Canada; Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, Canada
| | - R Broady
- Vancouver General Hospital, Vancouver, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - U Deotare
- University Health Network, Toronto, Canada
| | - J Grant
- Vancouver General Hospital, Vancouver, Canada; Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - D Kim
- University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - A D Schimmer
- University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - A C Schuh
- University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada
| | - S Shajari
- Vancouver General Hospital, Vancouver, Canada
| | | | - C M Bell
- University Health Network, Toronto, Canada; Institute of Health Policy, Management and Evaluation, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada; Institute for Clinical Evaluative Sciences, Toronto, Canada; Sinai Health System, Toronto, Canada
| | - S Husain
- University Health Network, Toronto, Canada; Department of Medicine, University of Toronto, Toronto, Canada.
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Bhimji A, Bhaskaran A, Singer LG, Kumar D, Humar A, Pavan R, Lipton J, Kuruvilla J, Schuh A, Yee K, Minden MD, Schimmer A, Rotstein C, Keshavjee S, Mazzulli T, Husain S. Aspergillus galactomannan detection in exhaled breath condensate compared to bronchoalveolar lavage fluid for the diagnosis of invasive aspergillosis in immunocompromised patients. Clin Microbiol Infect 2017; 24:640-645. [PMID: 28970160 DOI: 10.1016/j.cmi.2017.09.018] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2017] [Revised: 09/25/2017] [Accepted: 09/26/2017] [Indexed: 12/24/2022]
Abstract
OBJECTIVES Exhaled breath condensate (EBC) is a noninvasive means of sampling the airways that has shown significant promise in the diagnosis of many disorders. There have been no reports of its usefulness in the detection of galactomannan (GM), a component of the cell wall of Aspergillus. The suitability of EBC for the detection of GM for the diagnosis of invasive aspergillosis (IA) using the Platelia Aspergillus enzyme-linked immunosorbent assay was investigated. METHODS Prospective, cross-sectional study of lung transplant recipient and haemotologic malignancy patients at a university centre. EBC samples were compared to concomitant bronchoalveolar lavage (BAL) samples among lung transplant recipients and healthy controls. EBC was collected over 10 minutes using a refrigerated condenser according to the European Respiratory Society/American Thoracic Society recommendations, with the BAL performed immediately thereafter. RESULTS A total of 476 EBC specimens with 444 matched BAL specimens collected from lung transplant recipients (n = 197) or haemotologic malignancy patients (n = 133) were examined. Both diluted and untreated EBC optical density (OD) values (0.0830, interquartile range (IQR) 0.0680-0.1040; and 0.1130, IQR 0.0940-0.1383), respectively, from all patients regardless of clinical syndrome were significantly higher than OD values in healthy control EBCs (0.0508, IQR 0.0597-0.0652; p < 0.0001). However, the OD index values did not correlate with the diagnosis of IA (44 samples were associated with IA). Furthermore, no significant correlation was found between EBC GM and the matched BAL specimen. CONCLUSIONS GM is detectable in EBC; however, no correlation between OD index values and IA was noted in lung transplant recipients.
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Affiliation(s)
- A Bhimji
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - A Bhaskaran
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - L G Singer
- Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - D Kumar
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - A Humar
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - R Pavan
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada
| | - J Lipton
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - J Kuruvilla
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - A Schuh
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - K Yee
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - M D Minden
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - A Schimmer
- Department of Medicine, University Health Network, Toronto, Ontario, Canada; Princess Margaret Cancer Centre, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada; Division of Medical Oncology and Hematology, Mount Sinai Hospital, University Health Network, Toronto, Ontario, Canada
| | - C Rotstein
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - S Keshavjee
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada; Toronto Lung Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - T Mazzulli
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada; Department of Microbiology, Mount Sinai Hospital, Toronto, Ontario, Canada.
| | - S Husain
- Transplant Infectious Diseases, Multi-Organ Transplant Program, University Health Network, Toronto, Ontario, Canada; Department of Medicine, University Health Network, Toronto, Ontario, Canada.
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Lund VJ, Darby Y, Rimmer J, Amin M, Husain S. Nasal closure for severe hereditary haemorrhagic telangiectasia in 100 patients. The Lund modification of the Young's procedure: a 22-year experience. Rhinology 2017; 55:135-141. [PMID: 28064338 DOI: 10.4193/rhin16.315] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Hereditary haemorrhagic telangiectasia (HHT) is an autosomal dominant vascular disease characterized by recurrent epistaxis, mucocutaneous telangiectasia and visceral arteriovenous malformations. The nosebleeds can be life-threatening and in these circumstances, radical treatment is required. METHODS Since 1994, closure of the nose has been undertaken to prevent severe nasal bleeding in patients meeting specific selection criteria. Outcome data collected on this cohort pre- and post-operatively is available for analysis. RESULTS From a cohort of 515 HHT patients, 100 have undergone nasal closure, bilateral ab initio in 81%. Fifty patients completed pre- and post-operative epistaxis severity questionnaires and provided information on post-operative problems and 28 completed a Glasgow Benefit Inventory (GBI). Overall most patients derived significant benefit from the procedure with complete cessation of nasal bleeding in 94%, a highly significant improvement in the epistaxis score and a mean GBI score of 53.4. Loss of smell and taste was the most frequent post-operative complaint. CONCLUSION HHT can be associated with life-threatening epistaxis significantly affecting patients quality of life. Permanent prevention of airflow is associated with complete or near-total cessation of epistaxis in the majority of patients.
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Affiliation(s)
- V J Lund
- Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - Y Darby
- Royal National Throat Nose and Ear Hospital, London, United Kingdom
| | - J Rimmer
- Department of Otolaryngology Head and Neck Surgery, Monash Health, Melbourne, Australia
| | - M Amin
- Mater Hospital, Dublin, Ireland
| | - S Husain
- The National University of Malaysia, Kuala Lumpur, Malaysia
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Crim A, Perkins V, Husain S, Ding K, Holman L. Feasibility of two-antibody vs four-antibody mismatch repair protein immunohistochemistry as initial screening for Lynch syndrome in patients with endometrial adenocarcinoma. Gynecol Oncol 2017. [DOI: 10.1016/j.ygyno.2017.03.112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Enayetullah M, Ameen N, Islam N, Hussain M, Husain S, Islam E. Measurements of the Total Neutron Cross Section of Praseodymium Between 1 and 18 MeV. NUCL SCI ENG 2017. [DOI: 10.13182/nse71-a22343] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Affiliation(s)
| | | | | | - M. Hussain
- Department of Physics, University of Dacca, East Pakistan
| | - S. Husain
- Department of Physics, University of Dacca, East Pakistan
| | - E. Islam
- Department of Physics, University of Dacca, East Pakistan
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Watt E, Peacock M, Conroy L, Husain S, Frederick A, Roumeliotis M, Meyer T. PO-0925: Timing of post-implant analysis in permanent breast seed implant: results from a serial CT study. Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31362-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Bhimji A, Bhaskaran A, Singer L, Kumar D, Humar A, Pavan R, Rotstein C, Keshavjee S, Mazzulli T, Husain S. Aspergillus Galactomannan Detection in Exhaled Breath Condensate for the Diagnosis of Invasive Aspergillosis in Lung Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Alofi F, Singer L, Kumar D, Humar A, Rotstein C, Keshavjee S, Husain S. Correlation of Radiological Imaging with Microbiological Cure or Mortality from Invasive Pulmonary Aspergillosis (IPA) in Lung Transplant Recipients (LTRs). J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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DeRuyter NP, Husain S, Yin L, Olsufka M, McCoy AM, Maynard C, Cobb LA, Rea TD, Sayre MR. The impact of first responder turnout and curb-to-care intervals on survival from out-of-hospital cardiac arrest. Resuscitation 2017; 113:51-55. [DOI: 10.1016/j.resuscitation.2017.01.015] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2016] [Revised: 01/12/2017] [Accepted: 01/17/2017] [Indexed: 10/20/2022]
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Morrissey O, Xie R, Schaenman J, Husain S, Mooney M, Nakatani T, Kormos R, Gómez-Bueno M, Aslam S, Pya Y, Hannan M. Epidemiology of Fungal Infections (FI) in Mechanical Circulatory Support Device (MCSD) Recipients: Analysis of IMACS Registry 2013-2015. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.058] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Aguilar C, Hamandi B, Fegbeutel C, Silveira F, Verschuuren E, Ussetti P, Chin-Hong P, Sole A, Holmes-Liew C, Billaud E, Grossi P, Manuel O, Levine D, Barbers R, Hadjiliadis D, Singer L, Husain S. Clinical Risk Factors for Invasive Aspergillosis in Lung Transplant Recipients: Results of an International Cohort Study. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.050] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Bhimji A, Singer L, Kumar D, Humar A, Rotstein C, Keshavjee S, Mazzulli T, Husain S. Utility of Droplet Digital PCR for the Detection of Aspergillus DNA in Bronchoalveolar Lavage and Exhaled Breath Condensate Samples from Lung Transplant Recipients. J Heart Lung Transplant 2017. [DOI: 10.1016/j.healun.2017.01.316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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