scholarly journals Overview of the Presentation and Updated Management of Sinusitis

2021 ◽  
pp. 23-30
Author(s):  
Khaled Abdullah S. Alasmari ◽  
Lena Defallah G. Alzahrani ◽  
Sultan Suliman Q. Al-ruwaili ◽  
Rahaf Naif A. Alenezi ◽  
Sarah Fahad M. Bukhari ◽  
...  
Keyword(s):  
Primary Care ◽  
Watchful Waiting ◽  
Chronic Sinusitis ◽  
Clinical Findings ◽  
Mucosal Inflammation ◽  
Upper Respiratory Tract ◽  
Mucous Membranes ◽  
Mucociliary Function ◽  
Upper Respiratory ◽  
Nose And Paranasal Sinuses

Acute and chronic sinusitis are common primary care presentations. They are caused by mucosal inflammation, which inhibits mucociliary function of the nose and paranasal sinuses. Because it affects the mucous membranes that line both the nose and the sinuses, the complete medical word for sinusitis is "rhinosinusitis". Sinusitis is usually caused by a viral upper respiratory tract infection, with bacterial sinusitis occurring in about 2% of cases, yet in most cases overall antibiotics are being used and prescribed which is in most part are not needed, and cases often resolves without antibiotics need, most general practitioners rely on clinical findings to make the diagnosis. Watchful waiting and symptom treatment with nasal oxymetazoline, pseudoephedrine, and saline nasal irrigation are recommended. In this paper, we overview the presentation and management of sinusitis.

scholarly journals Correction of the nasal septum in children with surgical pathology of the paranasal sinuses (literature review)

2021 ◽  
Vol 23 (3) ◽  
pp. 226-230
Author(s):  
Svetlana I. Alekseenko ◽  
◽  
Svetlana I. Alekseenko ◽  
Svetlana I. Alekseenko ◽  
Sergey A. Karpishchenko ◽  
...  
Keyword(s):  
Paranasal Sinuses ◽  
Nasal Septum ◽  
Surgical Intervention ◽  
Chronic Sinusitis ◽  
Upper Respiratory Tract ◽  
Time Data ◽  
Nasal Breathing ◽  
Endoscopic Control ◽  
Upper Respiratory ◽  
Nose And Paranasal Sinuses

Diseases of a nose and paranasal sinuses are in the lead among pathology of upper respiratory tract. The incidence of chronic sinusitis in children ranges from 16 to 34%. Deviation of a nasal septum is detected in 74% of children at the age of 14 years. There are researches proving efficiency of one-stage performing septoplasty and FESS operations at adult patients. At the same time, data on efficiency and safety of carrying out onestage septum-operation and FESS at children’s age aren’t enough. Improvement of nasal breathing and providing broad access to the surgical area is a result of such interventions. It is also possible to refer decrease anesthesiology load of the child and readmission number. Carrying out low-invasive operations on structures of nose and paranasal sinuses under endoscopic control allows to reduce traumatization of a mucous membrane and improves visibility of the surgery field for the operator. Simultaneous surgical treatment of paranasal sinuses and a nasal septum deviation using methods of FESS in children is a perspective and safe method of treatment. Such surgery demands good practical skills, up-to-date equipment, correct algorithm of performing surgical intervention and also thorough observation of the patient in preoperative and postoperative periods.

ASSESSMENT OF THE TOXICITY AND HAZARD OF SODIUM LAURYL SULFATE AT DIFFERENT EXPOSURE ROUTES

2020 ◽  
pp. 56-59
Author(s):  
M. V. Bidevkina ◽  
M. I. Golubeva ◽  
A. V. Limantsev ◽  
I. N. Razumnaya ◽  
T. N. Potapova ◽  
...  
Keyword(s):  
Sodium Lauryl Sulfate ◽  
Exposure Level ◽  
Hazardous Substance ◽  
Lauryl Sulfate ◽  
Upper Respiratory Tract ◽  
Mucous Membranes ◽  
Chloroprene Rubber ◽  
Upper Respiratory ◽  
Exposure Routes ◽  
Number Of Cells

Sodium lauryl sulfate is the most common surfactant used in the production of detergents, chloroprene rubber, plastics, artificial furs and in pharmaceutical industry. Sodium lauryl sulfate is a moderately hazardous substance when introduced into the stomach (DL50 for white mice and rats is in the range of 2086-2700 mg/kg), has a pronounced local irritant effect on the skin and mucous membranes of the eyes, has a skin-resorptive, sensitizing and pronounced cumulative effects. The threshold for acute inhalation action is set at 15,3 mg/m3 for changes in the function of the nervous system and irritating effects on the mucous membranes of the upper respiratory tract (an increase in the total number of cells in the nasal flushes).Recommended for approval tentative safe exposure level of sodium lauryl sulfate in the air of the working area is 0.2+ mg/m3 (aerosol).

scholarly journals Inappropriate Azithromycin Use in Nine Primary-Care Clinics Before and After Implementation of Provider Guidance in the EMR

2020 ◽  
Vol 41 (S1) ◽  
pp. s292-s293
Author(s):  
Alexandria May ◽  
Allison Hester ◽  
Kristi Quairoli ◽  
Sheetal Kandiah
Keyword(s):  
Primary Care ◽  
Retrospective Chart Review ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
National Guidelines ◽  
Targeted Interventions ◽  
Primary Care Clinics ◽  
Before And After ◽  
Upper Respiratory ◽  
Tract Infections

Background: According to the CDC Core Elements of Outpatient Stewardship, the first step in optimizing outpatient antibiotic use the identification of high-priority conditions in which antibiotics are commonly used inappropriately. Azithromycin is a broad-spectrum antimicrobial commonly used inappropriately in clinical practice for nonspecific upper respiratory infections (URIs). In 2017, a medication use evaluation at Grady Health System (GHS) revealed that 81.4% of outpatient azithromycin prescriptions were inappropriate. In an attempt to optimize outpatient azithromycin prescribing at GHS, a tool was designed to direct the prescriber toward evidence-based therapy; it was implemented in the electronic medical record (EMR) in January 2019. Objective: We evaluated the effect of this tool on the rate of inappropriate azithromycin prescribing, with the goal of identifying where interventions to improve prescribing are most needed and to measure progress. Methods: This retrospective chart review of adult patients prescribed oral azithromycin was conducted in 9 primary care clinics at GHS between February 1, 2019, and April 30, 2019, to compare data with that already collected over a 6-month period in 2017 before implementation of the antibiotic prescribing guidance tool. The primary outcome of this study was the change in the rate of inappropriate azithromycin prescribing before and after guidance tool implementation. Appropriateness was based on GHS internal guidelines and national guidelines. Inappropriate prescriptions were classified as inappropriate indication, unnecessary prescription, excessive or insufficient treatment duration, and/or incorrect drug. Results: Of the 560 azithromycin prescriptions identified during the study period, 263 prescriptions were included in the analysis. Overall, 181 (68.8%) of azithromycin prescriptions were considered inappropriate, representing a 12.4% reduction in the primary composite outcome of inappropriate azithromycin prescriptions. Bronchitis and unspecified upper respiratory tract infections (URI) were the most common indications where azithromycin was considered inappropriate. Attending physicians prescribed more inappropriate azithromycin prescriptions (78.1%) than resident physicians (37.0%) or midlevel providers (37.0%). Also, 76% of azithromycin prescriptions from nonacademic clinics were considered inappropriate, compared with 46% from academic clinics. Conclusions: Implementation of a provider guidance tool in the EMR lead to a reduction in the percentage of inappropriate outpatient azithromycin prescriptions. Future targeted interventions and stewardship initiatives are needed to achieve the stewardship program’s goal of reducing inappropriate outpatient azithromycin prescriptions by 20% by 1 year after implementation.Funding: NoneDisclosures: None

scholarly journals THE STATE OF SKIN AND MUCOSAL MICROBIOTES IN WORKERS AS AN ADAPTATION CRITERION TO OCCUPATIONAL FACTORS (BASED ON THE OIL EXTRACTION INDUSTRY)

2019 ◽  
Vol 98 (9) ◽  
pp. 1015-1020
Author(s):  
G. G. Gimranova ◽  
Lyaylya M. Masyagutova ◽  
L. G. Gizatullina
Keyword(s):  
Respiratory Tract ◽  
Working Conditions ◽  
Oil Production ◽  
Oil Extraction ◽  
Upper Respiratory Tract ◽  
Occupational Factors ◽  
Mucous Membranes ◽  
Number Of Microorganisms ◽  
Deep Layers ◽  
Upper Respiratory

Introduction. The working conditions of workers in oil-producing industries do not exclude the negative impact of a harmful biological factor of the working environment. The combined effect of harmful and dangerous factors (noise, vibration, a complex of chemicals of varying intensity), adverse climatic and geographical conditions in the process of oil production lead to violations of the structural and functional state of the body and increase the risk of disease caused by opportunistic microorganisms. Material and methods. To study the effect of working conditions of workers engaged in oil extraction on the qualitative and quantitative composition of the microorganism, an investigation of skin microbiota and microbiocenosis of the upper respiratory tract mucosa was carried out. Using the method of skin prints from the inner surface of the forearm on a plate with blood agar allowed, along with the total number of microorganisms, to determine the presence of hemolytic forms on the surface and in deep layers of the skin of oil workers. Estimate the influence of working conditions on the microbiocenosis of the upper respiratory tract and mucosal anti-infective resistance of the mucous membrane analyzed the species composition of the microbiota of the nasal mucosa and pharynx in workers, directly and indirectly engaged in oil production. Results. Studies show in workers directly involved in oil extraction, the number of microorganisms of the skin is significantly higher than that of healthy people in average by 2.0-3.6 times on the surface and 1.7-3.7 times in the deep layers. For machinists, these differences achieve 2.5-4.0 and 1.2-4.0 times, respectively, and for engineering and technical workers, 1.4-2.3 on the skin surface and 1.2-2.5 in the deep layers. For drillers, drillers’ assistants, operators, the presence of conditionally pathogenic microorganisms of 3-5 or more components on the nasal and pharyngeal polymicrobial associations is typical, and for engineers, engineers and technicians from 2-4, less often 5 components. Conclusion. The impact of occupational factors affecting workers in the process of oil extraction, contributes to the development of microbiocenosis lesions of the skin and mucous membranes. On the surface of the skin and mucous membranes of the upper respiratory tract there are a wide variety and specific structure of the microflora, specific to each of the studied groups in the workers examined.

scholarly journals Treatment of Upper Respiratory Tract Infections in Primary Care: A Randomized Study Using Aromatic Herbs

2011 ◽  
Vol 2011 ◽  
pp. 1-7 ◽  
Author(s):  
Eran Ben-Arye ◽  
Nativ Dudai ◽  
Anat Eini ◽  
Moshe Torem ◽  
Elad Schiff ◽  
...  
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Essential Oils ◽  
Symptom Severity ◽  
Respiratory Tract Infections ◽  
Upper Respiratory Tract Infections ◽  
Study Group ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

This study is a prospective randomized double-blind controlled trial whose aim was to investigate the clinical effects of aromatic essential oils in patients with upper respiratory tract infections. The trial was conducted in six primary care clinics in northern Israel. A spray containing aromatic essential oils of five plants (Eucalyptus citriodora, Eucalyptus globulus, Mentha piperita, Origanum syriacum,andRosmarinus officinalis)as applied 5 times a day for 3 days and compared with a placebo spray. The main outcome measure was patient assessment of the change in severity of the most debilitating symptom (sore throat, hoarseness or cough). Sixty patients participated in the study (26 in the study group and 34 in the control group). Intention-to-treat analysis showed that 20 minutes following the spray use, participants in the study group reported a greater improvement in symptom severity compared to participants in the placebo group (). There was no difference in symptom severity between the two groups after 3 days of treatment (). In conclusion, spray application of five aromatic plants reported in this study brings about significant and immediate improvement in symptoms of upper respiratory ailment. This effect is not significant after 3 days of treatment.

scholarly journals Results from a Patient-Based Health Education Intervention in Reducing Antibiotic Use for Acute Upper Respiratory Tract Infections in the Private Sector Primary Care Setting in Singapore

2017 ◽  
Vol 61 (5) ◽  
Author(s):  
Magdalene Hui Min Lee ◽  
Darius Shaw Teng Pan ◽  
Joyce Huixin Huang ◽  
Mark I-Cheng Chen ◽  
Joash Wen Chen Chong ◽  
...  
Keyword(s):  
Primary Care ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Care Setting ◽  
Primary Care Setting ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

ABSTRACT We investigated the efficacy of patient-targeted education in reducing antibiotic prescriptions for upper respiratory tract infections (URTIs) among adults in the private primary care setting in Singapore. Our randomized controlled trial enrolled patients aged 21 years and above presenting at general practitioner (GP) clinics with URTI symptoms for 7 days or less. Intervention arm patients were verbally educated via pamphlets about the etiology of URTIs, the role of antibiotics in treating URTIs, and the consequences of inappropriate antibiotic use. Control arm patients were educated on influenza vaccinations. Both arms were compared regarding the proportions prescribed antibiotics and the patients' postconsultation views. A total of 914 patients consulting 35 doctors from 24 clinics completed the study (457 in each arm). The demographics of patients in both arms were similar, and 19.1% were prescribed an antibiotic, but this varied from 0% to 70% for individual GPs. The intervention did not significantly reduce antibiotic prescriptions (odds ratio [OR], 1.20; 95% confidence interval [CI], 0.83–1.73) except in patients of Indian ethnicity (OR, 0.28; 95% CI, 0.09–0.93). Positive associations between the intervention and the view that antibiotics were not needed most of the time for URTIs (P = 0.047) and on being worried about the side effects of antibiotics (P = 0.018) were restricted to the Indian subgroup. GPs in limited liability partnerships or clinic chains prescribed less (OR, 0.36; 95% CI, 0.14 to 0.92), while certain inappropriate patient responses were associated with the receipt of antibiotics. Follow-up studies to investigate differences in responses to educational programs between ethnicities and to explore GP-targeted interventions are recommended.

scholarly journals Knowledge, Attitudes, and Reported Practices Among Obstetrician-Gynecologists in the USA Regarding Antibiotic Prescribing for Upper Respiratory Tract Infections

2005 ◽  
Vol 13 (1) ◽  
pp. 17-24 ◽  
Author(s):  
Shadi Chamany ◽  
Jay Schulkin ◽  
Charles E. Rose ◽  
Laura E. Riley ◽  
Richard E. Besser
Keyword(s):  
Primary Care ◽  
Respiratory Tract Infections ◽  
Antibiotic Use ◽  
Upper Respiratory Tract Infections ◽  
Antibiotic Prescribing ◽  
Upper Respiratory Tract ◽  
Office Visits ◽  
The Common ◽  
Upper Respiratory ◽  
Tract Infections

Background:Knowledge, attitudes, and practices regarding antibiotic prescribing for upper respiratory tract infections (URIs) have not been well described among obstetrician-gynecologists (OB/GYNs). This information is useful for determining whether an OB/GYN-specific program promoting appropriate antibiotic use would significantly contribute to the efforts to decrease inappropriate antibiotic use among primary care providers.Methods:An anonymous questionnaire asking about the treatment of URIs was sent to 1031 obstetrician-gynecologists.Results:The overall response rate was 46%. The majority of respondents (92%) were aware of the relationship between antibiotic use and antibiotic resistance, and respondents estimated that 5% of their patients had URI symptoms at their office visits. Overall, 56% of respondents reported that they would prescribe an antibiotic for uncomplicated bronchitis and 43% for the common cold. OB/GYNs with the fewest years of experience were less likely than those with the most years of experience to report prescribing for uncomplicated bronchitis (Odds ratio (OR) 0.46, 95% confidence interval (CI) 0.23 to 0.91) or the common cold (OR 0.44, CI 0.22 to 0.89). The majority of respondents (60%) believed that most patients wanted an antibiotic for URI symptoms, with male OB/GYNs being more likely than female OB/GYNs (OR 2.1, CI 1.2 to 3.8) to hold this belief. Both male OB/GYNs (OR 1.9, CI 1.1 to 3.4) and rural practitioners (OR 2.1, CI 1.1 to 4.0) were more likely to believe that it was hard to withhold antibiotics for URI symptoms because other physicians prescribe antibiotics for these symptoms. OB/GYNs who believed that postgraduate training prepared them well for primary care management were more likely than those who did not (OR 2.1, CI 1.1 to 4.2) to believe that they could reduce antibiotic prescribing without reducing patient satisfaction.Conclusion:Multiple demographic factors affect attitudes and reported practices regarding antibiotic prescribing. However, in view of the low proportion of office visits for URIs, an OB/GYN-specific program is not warranted.

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