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Results for “Chronic sinusitis”

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At least 505 records · Page 28Linked to original sources
PubMed2000

Chronic sinusitis and anosmia: pathologic changes in the olfactory mucosa.

OBJECTIVES: To evaluate histological changes in the olfactory mucosa of patients with chronic rhinosinusitis These results are analyzed in light of current understanding of the pathophysiology of anosmia secondary to nasal and sinus disease. STUDY DESIGN: Prospective study of olfaction on patients undergoing sinus surgery for the management of chronic rhinosinusitis. METHODS: Thirty patients, aged 22 to 39 years, underwent olfactory biopsy at the time of surgery with evaluation by a pathologist. Inflammatory changes were graded as mild (normal), moderate, or severe. Clinical olfactory function was evaluated using the University of Pennsylvania Smell Identification Test (UPSIT). The results correlated with the degree of olfactory dysfunction. RESULTS: Of the 30 patients 19 had unequivocal olfactory mucosa in the biopsy specimen. Eleven had only respiratory or indeterminate mucosa. Nine patients demonstrated normal olfactory mucosa and normal olfactory function (UPSIT > 35). Ten patients demonstrated pathological changes in the olfactory mucosa with an influx of lymphocytes, macrophages, and eosinophils Of these 10 patients, 7 had olfactory deficits as determined by UPSIT. The remaining three patients had normal olfactory function despite moderate chronic inflammation. These studies indicate that the olfactory mucosa is capable of mounting an inflammatory response similar to that seen in the respiratory mucosa of patients with chronic sinusitis These data suggest that the olfactory deficits in these patients may be the result of inflammatory changes within the olfactory mucosa in addition to any alteration in airflow to the olfactory cleft.

Adult↗
PubMed2006

Biofilm formation by Staphylococcus aureus and Pseudomonas aeruginosa is associated with an unfavorable evolution after surgery for chronic sinusitis and nasal polyposis.

OBJECTIVES: To determine whether biofilm-forming capacity of bacteria demonstrated in chronic rhinosinusitis (CRS) has an impact on persistence of the disease following endoscopic sinus surgery (ESS). METHOD: Thirty-one bacterial strains recovered from 19 patients with CRS at least 1 year post-ESS. Evolution of disease was assessed by questionnaire and endoscopy as favorable or unfavorable. The bacteria were cultured on a 96-well culture plaque and a semi-quantitative method using crystal violet to quantify biofilm production was used. RESULTS: Twenty-two of 31 samples produced a biofilm thicker or equal to the positive control. Biofilm production was noted in 6/10 Pseudomonas aeruginosa isolates, 8/10 Staphylococcus aureus, and 8/11 coagulase-negative staphylococci. Biofilm formation was associated with a poor evolution for Pseudomonas aeruginosa and Staphylococcus aureus, but not coagulase-negative staphylococcus. CONCLUSION: There is a correlation between in vitro biofilm-producing capacity by Pseudomonas aeruginosa and Staphylococcus aureus and unfavorable evolution after ESS, suggesting a role for biofilm production in chronic sinusitis. EBM RATING: B-2b.

Adult↗
PubMedDate not supplied

PCR analysis of nasal polyps, chronic sinusitis, and hypertrophied turbinates for DNA encoding bacterial 16S rRNA.

BACKGROUND: Nasal polyps are considered to result from chronic inflammation, but the initial or persisting stimulus for the inflammation is not known. A variety of bacteria and fungi have been cultured from nasal polyps, but approximately 35% have sterile cultures. Previously, Mycoplasma pneumoniae-specific DNA was detected in human nasal polyps using polymerase chain reaction (PCR) techniques, suggesting M. pneumoniae as a causative agent in the etiology of nasal polyps. METHODS: In this study, we tested for the presence of bacterial DNA in nasal polyps resected from 40 patients, in nasal mucosa membrane from 9 patients undergoing turbinectomy for hypertrophy, and in sinus mucosa membrane from 6 patients undergoing endoscopic surgery for chronic sinusitis. Tissue DNA was extracted and analyzed by PCR using M. pneumoniae specific primers for DNA that encode the 16S rRNA gene in 41 specimens (31 polyps, 6 turbinates, and 4 sinus), and by consensus sequence-based PCR using broad range primers for most eubacterial DNA encoding the 16S rRNA gene in 38 specimens (26 polyps, 7 turbinates, and 5 sinuses). RESULTS: Only two samples were positive for bacterial DNA encoding 16S rRNA: Streptococcus sp. DNA was isolatedfrom one polyp specimen and Pseudomonas aeruginosa DNA was isolated in one maxillary sinusitis specimen. No evidence of M. pneumoniae-specific DNA encoding 16S rRNA was found in any of the tissues. CONCLUSIONS: This study suggests that chronic bacterial infection is not a major component of nasal polyp etiology.

Base Sequence↗
PubMed2003

[Evaluation of drug sensitivity of the microorganisms isolated from chronic sinusitis treated by beta lactam antibiotics].

The drug sensitiveness to beta-lactam antibiotics of the bacterial flora, taken by sinus puncture from 115 patients with unior bilateral acute exacerbation of chronic maxillary sinusitis was analysed. About 90% of the isolated pathogens, as well as in subgroup treated with amoxicillin with potassium clavulanate and in subgroup treated with cefuroxime axetil showed antibiotic sensitivity. Among isolated pathogens before the treatment, 4 (9.5%) were resistant to the amoxicillin with potassium clavulanate disks in subgroup A and 3 (7.3%) to the cefuroxime axetil in subgroup B. There was only one pathogen isolated in the control evaluation in both group after the treatment.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed2003

Costs of broad-spectrum antibiotic use for acute sinusitis, chronic bronchitis, and pneumonia in a managed care population.

Respiratory infections place a heavy burden on patients, providers, employers, and health care systems. The prescribing of antibiotics is common, despite the fact that many respiratory conditions are caused by viruses. The economic effect of treating respiratory tract infections with broad-spectrum antibiotics was retrospectively analyzed by means of health care claims data from six managed care health plans affiliated with a large national insurer. A regression model was used to adjust for factors that can influence treatment costs, such as age, baseline cost, retreatment, and drug cost. The costs of treating chronic bronchitis, pneumonia, and acute sinusitis with moxifloxacin, gatifloxacin and nonfluoroquinolone broad-spectrum agents were significantly lower than the costs associated with levofloxacin treatment.

4-Quinolones↗
PubMed1989

[Conservative treatment of chronic sinusitis. Success of oral bacterial lysate therapy].

In a multicenter randomized double-blind study, 284 patients with chronic purulent sinusitis were treated with an oral immunostimulant or placebo in addition to standard therapy (antibiotics, mucolytics, inhalants). Treatment lasted for three ten-day periods in three consecutive months. At the start and during the therapy as well as after six months, symptoms were assessed on the basis of a scoring system and the X-rays of the nasal sinuses evaluated. During the course of therapy and the follow-up period, improvement of the major symptoms headache, purulent nasal discharge, cough, and expectoration was statistically significant in the immunostimulant group as compared with the placebo group, objective evidence being provided by the X-ray examinations and the number of reinfections during the period of observation.

Adjuvants, Immunologic↗
PubMed1991

[Comparison of nasal mucociliary clearance before and after operation in chronic sinusitis].

Nasal mucociliary clearance is a first line of defence mechanism of the respiratory system against inhaled particles. It transports particles depositing into the nasal passages to the pharynx to be swallowed or expectorated, thus protecting the respiratory system from injury. Clearance function is affected by many factors such as the chronic inflammation of the paranasal sinuses. A group of 13 healthy volunteers (controls) and a group of 17 patients suffering from chronic sinusitis was investigated in the Department of Otolaryngology of Taichung Veterans General Hospital between June and October of 1990. A radioisotope method was used to measure the velocity of nasal mucociliary transport in the participants. This involved the use of radioisotope Tc99m combined with albumin particles and measurements were made in one nasal chamber at a time. The sinusitis patients were then surgically treated and they all improved. In all 25 tests were made in the control group and the mean velocity of their mucociliary transport was found to be 4.56mm/min. In the patients 28 measurements were made and their mean velocity was found to be 2. 67mm/min before the operation and 4.03mm/min after the operation. The difference between pre- and post-operative velocities was statistically significant as was the difference between the pre-operative velocities of the patients and those of the controls. The difference between controls and patients after the operation was not significant.

Adolescent↗