scholarly journals Risk of COVID-19 Infection Among Chronic Rhinosinusitis Patients Receiving Oral Corticosteroids

2021 ◽  
pp. 019459982110069
Author(s):  
Lauren E. Miller ◽  
Neil Bhattacharyya
Keyword(s):  
Conservative Treatment ◽  
Chronic Rhinosinusitis ◽  
Treatment Regimen ◽  
Medical Management ◽  
Steroid Use ◽  
Positive Diagnosis ◽  
Increased Risk ◽  
Significant Difference ◽  
Oral Corticosteroids

Chronic rhinosinusitis (CRS) management frequently comprises conservative treatment, including a combination of topical and oral corticosteroids (OCSs). However, in the midst of the coronavirus disease 2019 (COVID-19) pandemic, providers may have been reluctant to prescribe OCSs out of possible concern for an increased risk of contracting COVID-19 or developing more severe COVID-19 symptoms. This study thus sought to explore the association between the use of OCSs and the development of COVID-19 in patients with CRS. We found no statistically significant difference in the rates of patients with a positive diagnosis of COVID-19 who underwent an OCS treatment regimen compared to those who did not, both within 28 days ( P = .389) and 14 days ( P = .676) prior to the COVID-19 test. Given OCSs are often a major component of medical management of CRS, this study proves helpful in counseling patients on risks of steroid use in CRS treatment during the COVID-19 pandemic.

scholarly journals Oral Corticosteroid Regimens in the Management of Chronic Rhinosinusitis

2020 ◽  
pp. 014556131987690
Author(s):  
Ahmed Mansi ◽  
Roger Bui ◽  
Mohamad R. Chaaban
Keyword(s):  
Side Effects ◽  
Chronic Rhinosinusitis ◽  
Medical Management ◽  
Oral Corticosteroid ◽  
Surgical Intervention ◽  
Controlled Trials ◽  
Level Of Evidence ◽  
Randomized Controlled ◽  
Before And After ◽  
Oral Corticosteroids

Background: Oral corticosteroids are often used in the medical management of chronic rhinosinusitis (CRS) with and without polyps. The purpose of our study is to review the literature for studies reporting the dosage of oral corticosteroids as part of the appropriate medical management prior to, immediately before, and after surgical intervention. Methods: We reviewed the literature for oral corticosteroid regimens given to patients with CRS from March 2012 to September 2018. Studies that did not disclose the exact doses of the regimen were excluded from our analysis. Results: Our search resulted in 7 articles with 4 studies of Level of Evidence (LOE) 1b, 2 studies with LOE III, and 1 study with LOE IV. The daily doses varied from 15 mg to 1 mg/kg, and with total doses ranging from 150 to 352 mg. In addition, several studies gave the same regimen to both subtypes of CRS. There was no mention of side effects in most of the studies. Conclusion: There is a wide variation in the steroid doses given to patients with CRS and prospective or randomized controlled trials are needed to provide better improved evidence.

Abstract 15371: Risk of Early Recurrent Myocardial Infarction After Index Myocardial Infarction Stratified by Index Treatment Strategy

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Raunak Nair ◽  
Michael Johnson ◽  
Kathleen A Kravitz ◽  
Jeevanantham Rajeswaran ◽  
Moses Anabila ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Treatment Strategy ◽  
Medical Management ◽  
Focal Point ◽  
Medical Center ◽  
Standard Of Care ◽  
Increased Risk ◽  
Significant Difference ◽  
Acute Mi ◽  
Index Treatment

Introduction: Survivors of Myocardial Infarction (MI) remain at increased risk for another cardiovascular event. The purpose of our study was to assess the role of index treatment strategy in developing early recurrent MI after acute MI. Methods: We analyzed all cases of MI at a single quaternary care medical center from January 1 st , 2010 to January 1 st , 2017, and identified all cases of recurrent MI within 90 days of index MI. Early recurrent MI cases were further stratified depending on the treatment strategy for index MI. Reinfarctions were also stratified according to the time of readmission into early (0-30 days after discharge) and late (30-90 days after discharge) time periods. Results: We identified 6,626 patients admitted with an acute MI and 168 cases of recurrent MI within 90 days of discharge. Among the index MI patients, 4354 (66%) patients underwent revascularization whereas 2272 (34%) underwent medical management. An unadjusted comparison of the risk of readmission among the 3 different revascularization strategies showed that the CABG group appeared to have the lowest risk of readmission with a recurrent MI, and there was no significant difference in the late risk of readmission between PCI and CABG groups (P=0.8). The medically managed group had the highest late risk of readmission with a recurrent MI. Conclusions: The risk of readmission with a recurrent MI is higher in patients who undergo medical management for index MI. Aiming to improve the standard of care in these patients should be the focal point of interest to curb these reinfarctions.

Outcomes in Treatment of Rhinosinusitis in the Setting of Medication Induced Immunosuppression

2020 ◽  
pp. 194589242094793
Author(s):  
Rahul Alapati ◽  
Jayakar V. Nayak ◽  
Peter H. Hwang ◽  
Zara M. Patel
Keyword(s):  
Chronic Rhinosinusitis ◽  
Surgical Management ◽  
Medical Management ◽  
Care Center ◽  
Tertiary Care ◽  
Treatment Pathways ◽  
Acute Rhinosinusitis ◽  
Significant Difference ◽  
Immunosuppressed Patients ◽  
Snot 22

Background There is no data currently available to direct nuanced treatment for recurrent acute and chronic rhinosinusitis (RARS, CRS) in patients on daily, long term medications that suppress the immune system. Objective This study sought to evaluate the outcomes of different treatment pathways when treating immunosuppressed patients with chronic rhinosinusitis or recurrent acute rhinosinusitis. Methods A retrospective review of patients on immune suppressing medication presenting to a tertiary care center with RARS or CRS between the years 2014–2019 was completed. Patients were categorized into three groups based on treatment: medical management alone (MM), surgery after medical management (SAMM), or upfront surgery (US). Lund-Kennedy scores (LKS) and SNOT-22 scores were evaluated at baseline, 1 month, 3 months and 6 months from presentation. Results 68 patients met inclusion criteria, with no difference in demographics between groups. Patients who were treated with US and SAMM had significantly higher baseline LKS than those who were treated with MM alone (p = 0.050, p = 0.039). Once this difference was controlled for, there was no significant difference in overall change of LKS between the three groups over time. There was no significant disparity in baseline SNOT-22 scores between the three groups, but patients who underwent US had a significantly higher improvement in SNOT-22 from baseline compared to those undergoing MM alone (p = 0.013). Conclusion Patients experiencing chronic rhinosinusitis and recurrent acute rhinosinusitis who are taking immunosuppressive medication can significantly improve from both medical and surgical management, but upfront surgical management appears to result in greater disease resolution relative to medical management in those with CRS. More study is needed in the RARS patient population regarding upfront surgery versus medical management.

Appropriate medical management of chronic rhinosinusitis reduces use of antibiotics and oral corticosteroids

2019 ◽  
Vol 130 (12) ◽  
Author(s):  
Marlene M. Speth ◽  
Katie M. Phillips ◽  
Lloyd P. Hoehle ◽  
David S. Caradonna ◽  
Stacey T. Gray ◽  
...  
Keyword(s):  
Chronic Rhinosinusitis ◽  
Medical Management ◽  
Oral Corticosteroids

Risk of venous thromboembolism following surgical treatment of superficial venous incompetence

VASA ◽  
2017 ◽  
Vol 46 (6) ◽  
pp. 484-489 ◽  
Author(s):  
Tom Barker ◽  
Felicity Evison ◽  
Ruth Benson ◽  
Alok Tiwari
Keyword(s):  
Venous Thromboembolism ◽  
Varicose Vein ◽  
Lower Incidence ◽  
Varicose Veins ◽  
Secondary Data ◽  
Foam Sclerotherapy ◽  
Increased Risk ◽  
Significant Difference ◽  
Chi Squared ◽  
One Year

Abstract. Background: The invasive management of varicose veins has a known risk of post-operative deep venous thrombosis and subsequent pulmonary embolism. The aim of this study was to evaluate absolute and relative risk of venous thromboembolism (VTE) following commonly used varicose vein procedures. Patients and methods: A retrospective analysis of secondary data using Hospital Episode Statistics database was performed for all varicose vein procedures performed between 2003 and 2013 and all readmissions for VTE in the same patients within 30 days, 90 days, and one year. Comparison of the incidence of VTEs between procedures was performed using a Pearson’s Chi-squared test. Results: In total, 261,169 varicose vein procedures were performed during the period studied. There were 686 VTEs recorded at 30 days (0.26 % incidence), 884 at 90 days (0.34 % incidence), and 1,246 at one year (0.48 % incidence). The VTE incidence for different procedures was between 0.15–0.35 % at 30 days, 0.26–0.50 % at 90 days, and 0.46–0.58 % at one year. At 30 days there was a significantly lower incidence of VTEs for foam sclerotherapy compared to other procedures (p = 0.01). There was no difference in VTE incidence between procedures at 90 days (p = 0.13) or one year (p = 0.16). Conclusions: Patients undergoing varicose vein procedures have a small but appreciable increased risk of VTE compared to the general population, with the effect persisting at one year. Foam sclerotherapy had a lower incidence of VTE compared to other procedures at 30 days, but this effect did not persist at 90 days or at one year. There was no other significant difference in the incidence of VTE between open, endovenous, and foam sclerotherapy treatments.

Interpersonal Violence and Substance Use Among Female Sexual Minorities

2019 ◽  
Author(s):  
Cort M. Dorn-Medeiros ◽  
Cass Dykeman ◽  
Timothy Bergquist
Keyword(s):  
New York ◽  
Tobacco Use ◽  
Interpersonal Violence ◽  
Sexual Minorities ◽  
Sample Population ◽  
Life Outcomes ◽  
City Community ◽  
Increased Risk ◽  
Significant Difference ◽  
Community Health Survey

This archived data study used results from the New York City Community Health Survey to explore the relationship between interpersonal violence among female sexual minorities (FSM) and their levels of alcohol and tobacco use. A total of 92 FSM were included in the sample population. There was a significant difference in the mean number of alcoholic drinks consumed between FSM who reported past experience of interpersonal violence and those who did not. No difference was found in levels of tobacco use between FSM who reported interpersonal violence and those who did not. Results of the present study support current research indicating FSM may be at increased risk for elevated alcohol use and respective negative life outcomes related to the experience of interpersonal violence.

Association between hTERT Polymorphisms and Female Papillary Thyroid Carcinoma

2019 ◽  
Vol 14 (3) ◽  
pp. 268-279
Author(s):  
Ying Liu ◽  
Zhi Li ◽  
Xinyue Tang ◽  
Min Li ◽  
Feng Shi
Keyword(s):  
Papillary Thyroid Carcinoma ◽  
Thyroid Carcinoma ◽  
Genome Wide Association Study ◽  
Papillary Thyroid ◽  
Clinicopathologic Characteristics ◽  
Female Population ◽  
Genome Wide ◽  
Increased Risk ◽  
Significant Difference ◽  
Thyroid Cancer Risk

Background: A previous genome-wide association study showed that hTERT rs10069690 and rs2736100 polymorphisms were associated with thyroid cancer risk. Objective: This study further investigated the association between increased risk and clinicopathologic characteristics for Papillary Thyroid Carcinoma (PTC) and hTERT polymorphisms rs10069690 or rs2736100 in a Chinese female population. Methods: The hTERT genotypes of 276 PTC patients and 345 healthy subjects were determined with regard to SNPs rs10069690 and rs2736100. The association between these SNPs and the risk of PTC and clinicopathologic characteristics was investigated by logistic regression. Results: We found a significant difference between PTC and rs10069690 (Odds Ratio (OR) = 1.515; P = 0.005), but not between PTC and rs2736100. When the analysis was limited to females, rs10069690 and rs2736100 were both associated with increased risk for PTC in female individuals (OR = 1.647, P = 0.007; OR = 1.339, P = 0.041, respectively). Further haplotype analysis revealed a stimulative effect of haplotypes TC and CA of TERT rs10069690-rs2736100, which increased risk for PTC in female individuals (OR = 1.579, P = 0.014; OR = 0.726, P = 0.025, respectively). Furthermore, the heterozygote A/C of rs2736100 showed significant difference for age (OR = 0.514, P = 0.047). Conclusion: Our finding suggests that hTERT polymorphisms rs10069690 and rs2736100 are associated with increased risk for PTC in Chinese female population and rs2736100 may be related to age. Consistent with US20170360914 and US20170232075, they are expected to be a potential molecular target for anti-cancer therapy.

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