Clinical practice guideline: Adult sinusitis

Rosenfeld, Richard M.; Andes, David R.; Bhattacharyya, Neil; Cheung, Dickson; Eisenberg, Steven S.; Ganiats, Théodore G.; Gelzer, Andrea; Hamilos, Daniel L.; Haydon, Richard C.; Hudgins, Patricia A.; Jones, Stacie; Krouse, Helene J.; Lee, Lawrence H.; Mahoney, Martin C.; Marple, Bradley F.; Mitchell, Col John P; Nathan, Robert A.; Shiffman, Richard N.; Smith, Timothy L.; Witsell, David L.

doi:10.1016/j.otohns.2007.06.726

Cited by 874 publications

(968 citation statements)

References 208 publications

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“…This includes collecting clinical information on the individual patient as well as laboratory data such as biomarkers to identify endotypes that underlie phenotypes and make tailored therapy possible [159,160]. Data from both randomized controlled trials [161] (with wide inclusion criteria, followed by subgroup analyses to identify the responder subpopulations [162]), as well as real world evidence should be incorporated [163]. Importantly, the major advances in the management of severe asthma are associated with phenotypes of Type 2-high asthma (e.g.…”

Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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Although a minority of asthma patients suffer from severe asthma, they represent a major clinical challenge in terms of poor symptom control despite high-dose treatment, risk of exacerbations, and side effects. Novel biological treatments may benefit patients with severe asthma, but are expensive, and are only effective in appropriately targeted patients. In some patients, symptoms are driven by other factors than asthma, and all patients with suspected severe asthma (‘difficult asthma’) should undergo systematic assessment, in order to differentiate between true severe asthma, and ‘difficult-to-treat’ patients, in whom poor control is related to factors such as poor adherence or co-morbidities. The Nordic Consensus Statement on severe asthma was developed by the Nordic Severe Asthma Network, consisting of members from Norway, Sweden, Finland, Denmark, Iceland and Estonia, including representatives from the respective national respiratory scientific societies with the aim to provide an overview and recommendations regarding the diagnosis, systematic assessment and management of severe asthma. Furthermore, the Consensus Statement proposes recommendations for the organization of severe asthma management in primary, secondary, and tertiary care.

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Section: Management Of Severe Asthmamentioning

confidence: 99%

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Porsbjerg

Ulrik

Skjold

et al. 2018

European Clinical Respiratory Journal

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“…1 These symptoms usually have an acute onset and are present for <4 weeks. 2 ARS is distinguished from the common cold by persistent sinus inflammation after the usual 10-…”

Section: Introductionmentioning

confidence: 99%

Fluticasone furoate nasal spray reduces symptoms of uncomplicated acute rhinosinusitis: a randomised placebo-controlled study

Keith

Dymek²,

Pfaar

et al. 2012

Primary Care Respiratory Journal

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“…of data in adults with acute upper respiratory tract infections (URTIs) revealed benefit in quicker symptom resolution and return to work, though the results were not statistically significant. Recently, several international expert groups recommended nasal saline irrigation in chronic rhinosinusitis with or without nasal polyps,24, 25, 26 and after endonasal surgery 24…”

mentioning

confidence: 99%

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline

Bonnomet

Luczka

Coraux

et al. 2016

Int Forum Allergy Rhinol.

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BackgroundThe regulation of mucociliary clearance is a key part of the defense mechanisms developed by the airway epithelium. If a high aggregate quality of evidence shows the clinical effectiveness of nasal irrigation, there is a lack of studies showing the intrinsic role of the different irrigation solutions allowing such results. This study investigated the impact of solutions with different pH and ionic compositions, eg, normal saline, non‐diluted seawater and diluted seawater, on nasal mucosa functional parameters.MethodsFor this randomized, controlled, blinded, in vitro study, we used airway epithelial cells obtained from 13 nasal polyps explants to measure ciliary beat frequency (CBF) and epithelial wound repair speed (WRS) in response to 3 isotonic nasal irrigation solutions: (1) normal saline 0.9%; (2) non‐diluted seawater (Physiomer®); and (3) 30% diluted seawater (Stérimar). The results were compared to control (cell culture medium).ResultsNon‐diluted seawater enhanced the CBF and the WRS when compared to diluted seawater and to normal saline. When compared to the control, it significantly enhanced CBF and slightly, though nonsignificantly, improved the WRS. Interestingly, normal saline markedly reduced the number of epithelial cells and ciliated cells when compared to the control condition.ConclusionOur results suggest that the physicochemical features of the nasal wash solution is important because it determines the optimal conditions to enhance CBF and epithelial WRS thus preserving the respiratory mucosa in pathological conditions. Non‐diluted seawater obtains the best results on CBF and WRS vs normal saline showing a deleterious effect on epithelial cell function.

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Clinical practice guideline: Adult sinusitis

Cited by 874 publications

References 208 publications

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Nordic consensus statement on the systematic assessment and management of possible severe asthma in adults

Fluticasone furoate nasal spray reduces symptoms of uncomplicated acute rhinosinusitis: a randomised placebo-controlled study

Non-diluted seawater enhances nasal ciliary beat frequency and wound repair speed compared to diluted seawater and normal saline

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