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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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Gokani SA, Sadik HS, Espehana A, Jegatheeswaran L, Luke L, Philpott C, Nassif R. Manipulation under anaesthesia of fractured nasal bones - a 10-year retrospective study. J Laryngol Otol 2023; 137:1126-1129. [PMID: 36373494 DOI: 10.1017/s0022215122002432] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Nasal bone fractures are treated by manipulation under general or local anaesthesia procedures. Data on long-term benefits of manipulation under local anaesthesia are limited. This study aimed to quantify the proportion of patients requiring septoplasty or septorhinoplasty after manipulation under general and local anaesthesia procedures. METHODS Anonymised data were collected from electronic records of all patients who underwent manipulation under anaesthesia at our centre over a 10-year period, including demographics, manipulation under anaesthesia timing and further surgery requirements. RESULTS The study identified 625 manipulation under general anaesthesia and 52 manipulation under local anaesthesia procedures. Manipulation under local anaesthesia procedures were performed earlier (local anaesthesia = 9 days, general anaesthesia = 15 days; p < 0.05) and were more likely to achieve manipulation (local anaesthesia = 83 per cent, general anaesthesia = 76 per cent; p < 0.05). There was no difference between techniques in the percentage of patients requiring further surgery. CONCLUSION This paper describes a large cohort of patients who underwent manipulation under anaesthesia over a 10-year period. Manipulation under local anaesthesia procedures have increased since the coronavirus disease 2019 pandemic, and the results are comparable to manipulation under general anaesthesia, with reduced delays between injury and manipulation.
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Affiliation(s)
- S A Gokani
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - H S Sadik
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A Espehana
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - L Jegatheeswaran
- Department of ENT, Norfolk and Norwich University Hospital, Norwich, UK
| | - L Luke
- Department of ENT, James Paget University Hospital, Great Yarmouth, Norfolk, UK
| | - C Philpott
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK
| | - R Nassif
- Department of ENT, Norfolk and Norwich University Hospital, Norwich, UK
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Philpott C, Kumaresan K, Fjaeldstad AW, Macchi A, Monti G, Frasnelli J, Konstantinidis I, Pinto J, Mullol J, Boardman J, Vodička J, Holbrook E, Ramakrishnan VR, Lechner M, Hummel T. Developing a core outcome set for clinical trials in olfactory disorders: a COMET initiative. Rhinology 2023; 0:3082. [PMID: 37243690 DOI: 10.4193/rhin22.116] [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: 05/29/2023]
Abstract
STATEMENT OF PROBLEM Evaluating the effectiveness of the management of Olfactory Dysfunction (OD) has been limited by a paucity of high-quality randomised and/or controlled trials. A major barrier is heterogeneity of outcomes in such studies. Core outcome sets (COS) -standardized sets of outcomes that should be measured/reported as determined by consensus-would help overcome this problem and facilitate future meta-analyses and/or systematic reviews (SRs). We set out to develop a COS for interventions for patients with OD. METHODS A long-list of potential outcomes was identified by a steering group utilising a literature review, thematic analysis of a wide range of stakeholders' views and systematic analysis of currently available Patient Reported Outcome Measures (PROMs). A subsequent e-Delphi process allowed patients and healthcare practitioners to individually rate the outcomes in terms of importance on a 9-point Likert scale. RESULTS After 2 rounds of the iterative eDelphi process, the initial outcomes were distilled down to a final COS including subjective questions (visual analogue scores, quantitative and qualitative), quality of life measures, psychophysical testing of smell, baseline psychophysical testing of taste, and presence of side effects along with the investigational medicine/device and patient's symptom log. CONCLUSIONS Inclusion of these core outcomes in future trials will increase the value of research on clinical interventions for OD. We include recommendations regarding the outcomes that should be measured, although future work will be required to further develop and revalidate existing outcome measures.
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Affiliation(s)
- C Philpott
- James Paget University Hospital, Great Yarmouth, United Kingdom
| | - K Kumaresan
- James Paget University Hospital, Great Yarmouth, United Kingdom
| | - A W Fjaeldstad
- Flavour Clinic, University Clinic for Flavour, Balance and Sleep, Department of Otorhinolaryngology, Regional Hospital Gødstrup, Denmark
| | - A Macchi
- ENT University of Insubria, Italian Academy of Rhinology, Varese, Italy
| | - G Monti
- Department of Biomedicine, Aarhus University, Denmark
| | - J Frasnelli
- Department of Anatomy, Université du Québec à Trois-Rivières, Canada
| | | | - J Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago, Chicago, IL, USA
| | | | - J Boardman
- Fifth Sense UK Charity, Bicester, United Kingdom
| | - J Vodička
- Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital and University of Pardubice, Czech Republic
- Department of Otorhinolaryngology and Head and Neck Surgery, Regional Hospital and Faculty of Heath Studies, University of Pardubice, Czech Republic
| | - E Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - V R Ramakrishnan
- Department of Otolaryngology-Head and Neck Surgery, Indiana University School of Medicine, Indiana
| | - M Lechner
- Division of Surgery and Interventional Science and UCL Cancer Institute, University College London and Barts Health NHS Trust, United Kingdom
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, Technische Universität Dresden, Dresden Germany
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Hellings PW, Fokkens WJ, Orlandi R, Adriaensen GF, Alobid I, Baroody FM, Bjermer L, Senior BA, Cervin A, Cohen NA, Constantinidis J, De Corso E, Desrosiers M, Diamant Z, Douglas RG, Gane S, Gevaert P, Han JK, Harvey RJ, Hopkins C, Kern RC, Landis BN, Lee JT, Lee SE, Leunig A, Lund VJ, Bernal-Sprekelsen M, Mullol J, Philpott C, Prokopakis E, Reitsma S, Ryan D, Salmi S, Scadding G, Schlosser RJ, Steinsvik A, Tomazic PV, Van Staeyen E, Van Zele T, Vanderveken O, Viskens AS, Conti D, Wagenmann M. The EUFOREA pocket guide for chronic rhinosinusitis. Rhinology 2023; 61:85-89. [PMID: 36507741 DOI: 10.4193/rhin22.344] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Chronic rhinosinusitis (CRS) is known to affect around 5 % of the total population, with major impact on the quality of life of those severely affected (1). Despite a substantial burden on individuals, society and health economies, CRS often remains underdiagnosed, under-estimated and under-treated (2). International guidelines like the European Position Paper on Rhinosinusitis and Nasal Polyps (EPOS) (3) and the International Consensus statement on Allergy and Rhinology: Rhinosinusitis 2021 (ICAR) (4) offer physicians insight into the recommended treatment options for CRS, with an overview of effective strategies and guidance of diagnosis and care throughout the disease journey of CRS.
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Affiliation(s)
- P W Hellings
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium; University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium; Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Nethe
| | - W J Fokkens
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - R Orlandi
- Rhinology and Skull Base, Department of Otorhinolaryngology, Hospital Clinic, Universidad de Barcelona, Centro Medico Teknon, Barcelona, Spain
| | - G F Adriaensen
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - I Alobid
- Rhinology and Skull Base, Department of Otorhinolaryngology, Hospital Clinic, Universidad de Barcelona, Centro Medico Teknon, Barcelona, Spain
| | - F M Baroody
- The University of Chicago Medicine, Chicago, IL, United States
| | - L Bjermer
- Dept of Respiratory Medicine and Allergology, Skane University Hospital, Lund, Sweden
| | - B A Senior
- Division of Rhinology, Allergy, and Endoscopic Skull Base Surgery, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - A Cervin
- The university of Queensland Centra for Clinical Research, Herston, Australia; Royal Brisbane and Women's Hospital, Brisbane, Australia
| | - N A Cohen
- Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - E De Corso
- Department of Otolaryngology Head and Neck Surgery, Fondazione Policlinico Universitario A. Gemelli IRCSS, Universita; Cattolica Sacro Cuore, Rome, Italy
| | - M Desrosiers
- Department of Otolaryngology-Head and Neck Surgery, Universita de Montreal, Montreal, Canada
| | - Z Diamant
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; Dept of Respiratory Medicine and Allergology, Skane University Hospital, Lund, Sweden; Department Clinical Pharmacy and Pharmacology, University Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - R G Douglas
- Department of Surgery, The University of Auckland, New Zealand
| | - S Gane
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, London, United Kingdom
| | - P Gevaert
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
| | - J K Han
- Department of Otolaryngology and Head and Neck Surgery at Eastern Virginia Medical School, Norfolk, Virginia, USA
| | - R J Harvey
- Rhinology and Skull Base, Applied Medical Research Center, Department of Otolaryngology and Head and Neck Surgery at Eastern Virginia Medical School, Norfolk, Virginia, USA; Faculty of medicine and heath sciences, Macquarie University, Sydney, Australia
| | - C Hopkins
- Ear, Nose and Throat Department, Guys and St. Thomas Hospital, London, United Kingdom
| | - R C Kern
- Department of Otolaryngology, Head and Neck Surgery, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA; Division of Allergy-Immunology, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - B N Landis
- Hopitaux Universitaires de Geneve, Geneve, Geneve, Switzerland
| | - J T Lee
- Brigham and Women's Hospital, Harvard Medical School, Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, Section of Rhinology and Skull Base Surgery, Massachusetts, USA
| | - S E Lee
- Department of Head and Neck Surgery, University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, USA
| | - A Leunig
- Rhinology Center, Munich and ENT-Clinic, Munich, Germany
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH, London, UK
| | | | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, IDIBAPS, Universitat de Barcelona, CIBERES. Barcelona, Catalonia, Spain
| | - C Philpott
- NIHR UCLH Biomedical research Centre, London, UK; Ear Institute, University College London, London, UK
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Heraklion, Greece
| | - S Reitsma
- Department of otorhinolaryngology and head/neck surgery, Amsterdam University Medical Centres, location AMC, University of Amsterdam, Amsterdam, The Netherland
| | - D Ryan
- Usher institute, University of Edinburgh, Edinburgh, UK
| | - S Salmi
- Medicum, Haartman Institute, University of Helsinki, Helsinki, Finland; Skin and Allergy Hospital, Helsinki University Hospital, Helsinki, Finland
| | - G Scadding
- Royal National Ear, Nose and Throat and Eastman Dental Hospitals, London, United Kingdom
| | - R J Schlosser
- Department of Otolaryngology Head and Neck surgery, Medical University of South Carolina, Charleston, SC, USA
| | | | - P V Tomazic
- Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria
| | - E Van Staeyen
- University Hospitals Leuven, Department of Otorhinolaryngology, Leuven, Belgium
| | - T Van Zele
- University Hospital Ghent, Department of Otorhinolaryngology, Laboratory of Upper Airways Research, Ghent, Belgium
| | - O Vanderveken
- Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium; Department of ENT, Head and Neck Surgery, Antwerp University Hospital, Edegem, Antwerp, Belgium; Multidisciplinary Sleep Disorder Center, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - A-S Viskens
- KU Leuven Department of Microbiology, Immunology and Transplantation, Laboratory of Allergy and Clinical Immunology Research Group, Leuven, Belgium; Faculty of Medicine and Health Sciences, University of Antwerp, Wilrijk, Antwerp, Belgium
| | | | - M Wagenmann
- Department of Otorhinolaryngology, Universitatsklinikum Disseldorf, Dusseldorf, Germany
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Hatter M, Abdelwahab M, Holsinger FC, Capasso R, Nayak JV, Hwang PH, Patel ZM, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The burden of olfactory dysfunction during the COVID-19 pandemic in the United Kingdom. Rhinology 2023; 61:93-96. [PMID: 36286227 DOI: 10.4193/rhin22.232] [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: 02/02/2023]
Affiliation(s)
- M Lechner
- Division of Surgery and Interventional Science, University College London, London, UK; UCL Cancer Institute, University College London, London, UK; ENT Department, Barts Health NHS Trust, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | - D Chandrasekharan
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- Division of Surgery and Interventional Science, University College London, London, UK
| | - R Gupta
- Division of Surgery and Interventional Science, University College London, London, UK
| | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - M Hatter
- Medical University of South Carolina, Charleston, SC, USA
| | - M Abdelwahab
- Medical University of South Carolina, Charleston, SC, USA
| | - F C Holsinger
- Medical University of South Carolina, Charleston, SC, USA
| | - R Capasso
- Medical University of South Carolina, Charleston, SC, USA
| | - J V Nayak
- Medical University of South Carolina, Charleston, SC, USA
| | - P H Hwang
- Medical University of South Carolina, Charleston, SC, USA
| | - Z M Patel
- Medical University of South Carolina, Charleston, SC, USA
| | - S Paun
- Division of Surgery and Interventional Science, University College London, London, UK
| | - N Eynon-Lewis
- Division of Surgery and Interventional Science, University College London, London, UK
| | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- Division of Surgery and Interventional Science, University College London, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospitals NHS Trust, London, UK
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6
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Pratas A, Shaida Z, Gavrilovic J, Philpott C. Time-dependent effect of clarithromycin on pro-inflammatory cytokines in CRS. RHINOL 2022. [DOI: 10.4193/rhinol/21.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Background: The purpose of this study was to assess the time-effect of clarithromycin on the inflammatory response in chronic rhinosinusitis (CRS), to further explore the use of macrolides in cell culture as a model for CRS, and its action on the immune system. Methodology: The time effect of clarithromycin on several cytokines was examined for IL-1β, IL-4, IL-5, IL-8 and GM-CSF. Samples prior and post-incubation were assessed, as well as samples collected 24h following removal of clarithromycin to determine if any immunomodulatory effect persisted. Cytokines were quantified using ProcartaPlexTM assays. Results: Of the 5 cytokines assessed, only IL-1β and IL-8 production were significantly inhibited at 4h. Increased levels of IL-4 were observed at 72 hours of incubation and returned to near baseline levels after its removal. IL-8 showed the most time-dependent relationship with clarithromycin. No differences between the expression of IL-5 and GM-CSF were found. Conclusions: The present work suggests a specific and dose-dependent impact of clarithromycin on the inflammatory response in CRS. Moreover, the immunomodulatory effects of clarithromycin on the cytokines IL-4 and IL-8 varied depending on length of exposure to clarithromycin. Further studies to further establish the relationship between length of exposure and cytokine expression, and with additional “actors” in CRS pathophysiology should be considered. This may enable us in the future to determine appropriate duration of macrolide therapy in patients with CRS.
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7
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Lechner M, Liu J, Counsell N, Gillespie D, Chandrasekharan D, Ta NH, Jumani K, Gupta R, Rao-Merugumala S, Rocke J, Williams C, Tetteh A, Amnolsingh R, Khwaja S, Batterham RL, Yan CH, Treibel TA, Moon JC, Woods J, Brunton R, Boardman J, Paun S, Eynon-Lewis N, Kumar BN, Jayaraj S, Hopkins C, Philpott C, Lund VJ. The COVANOS trial - insight into post-COVID olfactory dysfunction and the role of smell training. Rhinology 2022; 60:188-199. [PMID: 35901492 DOI: 10.4193/rhin21.470] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfactory dysfunction is a cardinal symptom of COVID-19 infection, however, studies assessing long-term olfactory dysfunction are limited and no randomised-controlled trials (RCTs) of early olfactory training have been conducted. METHODOLOGY We conducted a prospective, multi-centre study consisting of baseline psychophysical measurements of smell and taste function. Eligible participants were further recruited into a 12-week RCT of olfactory training versus control (safety information). Patient-reported outcomes were measured using an electronic survey and BSIT at baseline and 12 weeks. An additional 1-year follow-up was open to all participants. RESULTS 218 individuals with a sudden loss of sense of smell of at least 4-weeks were recruited. Psychophysical smell loss was observed in only 32.1%; 63 participants were recruited into the RCT. The absolute difference in BSIT improvement after 12 weeks was 0.45 higher in the intervention arm. 76 participants completed 1-year follow-up; 10/19 (52.6%) of participants with an abnormal baseline BSIT test scored below the normal threshold at 1-year, and 24/29 (82.8%) had persistent parosmia. CONCLUSIONS Early olfactory training may be helpful, although our findings are inconclusive. Notably, a number of individuals who completed the 1-year assessment had persistent smell loss and parosmia at 1-year. As such, both should be considered important entities of long-Covid and further studies to improve management are highly warranted.
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Affiliation(s)
- M Lechner
- ENT Department, Barts Health NHS Trust, London, UK; UCL Cancer Institute, University College London, London, UK; Division of Surgery and Interventional Science, University College London, London, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - N Counsell
- CRUK and UCL Cancer Trials Centre, University College London, London, UK
| | - D Gillespie
- UCL Cancer Institute, University College London, London, UK
| | | | - N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - K Jumani
- ENT Department, Barts Health NHS Trust, London, UK
| | - R Gupta
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - J Rocke
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - C Williams
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - A Tetteh
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - R Amnolsingh
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - S Khwaja
- Department of Otolaryngology, Manchester University NHS Foundation Trust, Manchester, UK
| | - R L Batterham
- Centre for Obesity Research, University College London, London, UK; Bariatric Centre for Weight Management and Metabolic Surgery, University College London Hospitals NHS Foundation Trust, London, UK; National Institute for Health Research, UCLH Biomedical Research Centre, London, UK
| | - C H Yan
- Department of Otolaryngology-Head and Neck Surgery, University of San Diego School of Medicine, San Diego, USA
| | - T A Treibel
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J C Moon
- National Institute for Health Research, UCLH Biomedical Research Centre, London, UK; Barts Heart Centre, St. Bartholomew's Hospital, London, UK; Institute of Cardiovascular Sciences, University College London, UK
| | - J Woods
- The Norfolk Smell and Taste Clinic, Norfolk
| | - R Brunton
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | | | - S Paun
- ENT Department, Barts Health NHS Trust, London, UK
| | | | - B N Kumar
- ENT Department, Wrightington, Wigan and Leigh NHS Foundation Trust, Wigan, UK
| | - S Jayaraj
- ENT Department, Barts Health NHS Trust, London, UK
| | - C Hopkins
- ENT Department, Guy's Hospital, Guy's and St. Thomas' NHS Foundation Trust, London, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK
| | - V J Lund
- Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, UK
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8
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Ohla K, Veldhuizen MG, Green T, Hannum ME, Bakke AJ, Moein ST, Tognetti A, Postma EM, Pellegrino R, Hwang DLD, Albayay J, Koyama S, Nolden AA, Thomas-Danguin T, Mucignat-Caretta C, Menger NS, Croijmans I, Ã-ztà Rk L, YanÄ K H, Pierron D, Pereda-Loth V, Nunez-Parra A, Martinez Pineda AM, Gillespie D, Farruggia MC, Cecchetto C, Fornazieri MA, Philpott C, Voznessenskaya V, Cooper KW, Rohlfs Dominguez P, Calcinoni O, de Groot J, Boesveldt S, Bhutani S, Weir EM, Exten C, Joseph PV, Parma V, Hayes JE, Niv MY. A follow-up on quantitative and qualitative olfactory dysfunction and other symptoms in patients recovering from COVID-19 smell loss. Rhinology 2022; 60:207-217. [PMID: 35398877 PMCID: PMC11016179 DOI: 10.4193/rhin21.415] [Citation(s) in RCA: 30] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Sudden smell loss is a specific early symptom of COVID-19, which, prior to the emergence of Omicron, had estimated prevalence of ~40% to 75%. Chemosensory impairments affect physical and mental health, and dietary behavior. Thus, it is critical to understand the rate and time course of smell recovery. The aim of this cohort study was to characterize smell function and recovery up to 11 months post COVID-19 infection. METHODS This longitudinal survey of individuals suffering COVID-19-related smell loss assessed disease symptoms and gustatory and olfactory function. Participants (n=12,313) who completed an initial survey (S1) about respiratory symptoms, chemosensory function and COVID-19 diagnosis between April and September 2020, were invited to complete a follow-up survey (S2). Between September 2020 and February 2021, 27.5% participants responded (n=3,386), with 1,468 being diagnosed with COVID-19 and suffering co-occurring smell and taste loss at the beginning of their illness. RESULTS At follow-up (median time since COVID-19 onset ~200 days), ~60% of women and ~48% of men reported less than 80% of their pre-illness smell ability. Taste typically recovered faster than smell, and taste loss rarely persisted if smell recovered. Prevalence of parosmia and phantosmia was ~10% of participants in S1 and increased substantially in S2: ~47% for parosmia and ~25% for phantosmia. Persistent smell impairment was associated with more symptoms overall, suggesting it may be a key marker of long-COVID illness. The ability to smell during COVID-19 was rated slightly lower by those who did not eventually recover their pre-illness ability to smell at S2. CONCLUSIONS While smell ability improves for many individuals who lost it during acute COVID-19, the prevalence of parosmia and phantosmia increases substantially over time. Olfactory dysfunction is associated with broader persistent symptoms of COVID-19, and may last for many months following acute COVID-19. Taste loss in the absence of smell loss is rare. Persistent qualitative smell symptoms are emerging as common long-term sequelae; more research into treatment options is strongly warranted given that even conservative estimates suggest millions of individuals may experience parosmia following COVID-19. Healthcare providers worldwide need to be prepared to treat post COVID-19 secondary effects on physical and mental health.
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Affiliation(s)
- K Ohla
- Helmut-Schmidt-University, University of the Armed Forces Hamburg, Germany; Firmenich SA, Satigny, Switzerland; The Pennsylvania State University, USA
| | | | - T Green
- The Hebrew University of Jerusalem, Israel
| | - M E Hannum
- Monell Chemical Senses Center, Philadelphia, USA
| | - A J Bakke
- The Pennsylvania State University, USA
| | - S T Moein
- Institute for Research in Fundamental Sciences (IPM), Iran
| | - A Tognetti
- Karolinska Institutet, Stockholm, Sweden
| | - E M Postma
- Wageningen University and Research, the Netherlands
| | - R Pellegrino
- Monell Chemical Senses Center, Philadelphia, USA
| | | | | | | | - A A Nolden
- University of Massachusetts, Amherst, USA
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - S Boesveldt
- Wageningen University and Research, the Netherlands
| | | | - E M Weir
- The Pennsylvania State University, USA
| | - C Exten
- The Pennsylvania State University, USA
| | - P V Joseph
- National Institutes of Health, NINR, NIAAA, USA
| | - V Parma
- Monell Chemical Senses Center, Philadelphia, USA
| | - J E Hayes
- The Pennsylvania State University, USA
| | - M Y Niv
- The Hebrew University of Jerusalem, Israel
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9
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Collins R, Addison A, Paul C, Clark A, Philpott C. 918 Nasal Packing Duration in The Management of Epistaxis: A Cohort Study. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.556] [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: 11/13/2022]
Abstract
Abstract
Aim
Nasal packing is one of the mainstays of inpatient treatment for epistaxis. However, no current guidelines exist on optimal duration of nasal packing. This paper seeks to determine the optimal duration of nasal packing in terms of re-bleeding.
Method
A retrospective cohort study was conducted on patients admitted over a two-year period. Data collected included re-bleeding events following pack removal, age, gender, site of epistaxis, hypertension, trauma and anticoagulation medication.
Results
The rate of re-bleeding increased with length of pack duration; over 12 hours was associated with greater re-bleeding rates (p = <0.001) and continued to be statistically significant when controlling for co-founders (p = 0.01). Those packed over 24 hours were over five times more likely to re-bleed than those packed less than 12 hours (p = 0.01. OR 5.34).
Conclusions
A packing duration of less than 12 hours is associated with lower rates of re-bleeding. Admitting teams should therefore aim to ensure that patient pathways involve early pack removal.
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Affiliation(s)
- R Collins
- University of East Anglia, Norwich, United Kingdom
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - A Addison
- Norfolk and Norwich University Hospital, Norwich, United Kingdom
| | - C Paul
- Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - A Clark
- University of East Anglia, Norwich, United Kingdom
| | - C Philpott
- University of East Anglia, Norwich, United Kingdom
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10
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Huart C, Philpott C, Konstantinidis I, Altundag A, Whitcroft KL, Trecca EMC, Cassano M, Rombaux P, Hummel T. Comparison of COVID-19 and common cold chemosensory dysfunction. Rhinology 2020; 58:623-625. [PMID: 32812014 DOI: 10.4193/rhin20.251] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Anosmia constitutes a prominent symptom of COVID-19. However, anosmia is also a common symptom of acute colds of various origins. In contrast to an acute cold, it appears from several questionnaire-based studies that in the context of COVID-19 infection, anosmia is the main rhinological symptom and is usually not associated with other rhinological symptoms such as rhinorrhoea or nasal obstruction. Until now, no study has directly compared smell and taste function between COVID-19 patients and patients with other causes of upper respiratory tract infection (URTI) using valid and reliable psychophysical tests. In this study, we aimed to objectively assess and compare olfactory and gustatory functions in 10 COVID-19 patients (PCR diagnosed, assessed on average 2 weeks after infection), 10 acute cold (AC) patients (assessed before the COVID-19 outbreak) and 10 healthy controls, matched for age and sex. Smell performance was assessed using the extended "Sniffin' Sticks" test battery (4), while taste function was assessed using "taste strips" (5). Receiver Operating Characteristic (ROC) curves were built to probe olfactory and gustatory scores in terms of their discrimination between COVID-19 and AC patients. Our results suggest that mechanisms of COVID-19 related olfactory dysfunction are different from those seen in an AC and may reflect, at least to some extent, a specific involvement at the level of central nervous system in some COVID-19 patients. In the future, studies to assess the prevalence of persistent anosmia and neuroanatomical changes on MRI correlated to chemosensory function, will be useful to understand these mechanisms.
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Affiliation(s)
- C Huart
- Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - C Philpott
- The Norfolk Smell and Taste Clinic, James Paget University Hospital, Gorleston, UK
| | - I Konstantinidis
- 2nd Academic ORL Department, Papageorgiou Hospital, Aristotle University, Thessaloniki, Greece
| | - A Altundag
- Department of Otorhinolaryngology, Acibadem Taksim Hospital, Istanbul, Turkey
| | - K L Whitcroft
- UCL Ear Institute, University College London, London, UK
| | - E M C Trecca
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - M Cassano
- Department of Otorhinolaryngology, University Hospital of Foggia, Foggia, Italy
| | - Ph Rombaux
- Cliniques universitaires Saint-Luc, Brussels, Belgium
| | - T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
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11
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Lechner M, Chandrasekharan D, Jumani K, Liu J, Gane S, Lund VJ, Philpott C, Jayaraj S. Anosmia as a presenting symptom of SARS-CoV-2 infection in healthcare workers - A systematic review of the literature, case series, and recommendations for clinical assessment and management. Rhinology 2020; 58:394-399. [PMID: 32386285 DOI: 10.4193/rhin20.189] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Healthcare workers are at the forefront of the ongoing COVID-19 pandemic and are at high risk for both the contraction and subsequent spread of virus. Understanding the role of anosmia as an early symptom of infection may improve monitoring and management of SARS-CoV2 infection. METHODOLOGY We conducted a systematic review of the literature of SARS-CoV2 infection/COVID-19 and anosmia to help inform management of anosmia in healthcare works. We report a case series of healthcare workers, who presented with a loss of sense of smell secondary to COVID-19 infection to demonstrate management principles. RT-PCR was used to confirm COVID-19 positivity and psychophysical testing of olfaction was performed using the British version of the University of Pennsylvania Smell Identification Test, UPSIT. RESULTS The systematic literature search returned 31 articles eligible for inclusion in the study and informed our recommendations for clinical assessment and management. All three healthcare professionals who presented with loss of sense of smell subsequently tested positive for SARS-CoV-2. Psychophysical testing of olfaction using the UPSIT confirmed mild and moderate microsmia in two, respectively, and normosmia at day 17 in one. CONCLUSIONS Olfactory (± gustatory) dysfunction is indicative of COVID-19 infection and thus has important implications in the context of healthcare workers, or key workers in general, who work in close contact with others if not recognised as suffering from COVID. This leads to a potentially higher likelihood of spreading the virus. In conjunction with our literature review these findings have helped with creating recommendations on the assessment and management of olfactory dysfunction during the ongoing COVID-19 pandemic, both for healthcare workers and patients.
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Affiliation(s)
- M Lechner
- Whipps Cross University Hospital, Barts Health NHS Trust, UK; UCL Cancer Institute, University College London, London, UK
| | | | - K Jumani
- Whipps Cross University Hospital, Barts Health NHS Trust, UK
| | - J Liu
- UCL Cancer Institute, University College London, London, UK
| | - S Gane
- Royal National Throat, Nose and Ear Hospital, UCLH Foundation Trust, London, UK
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, UCLH Foundation Trust, London, UK
| | - C Philpott
- The Norfolk Smell and Taste Clinic, Norfolk and Waveney ENT Service, UK; Norwich Medical School, University of East Anglia, Norwich, UK
| | - S Jayaraj
- Whipps Cross University Hospital, Barts Health NHS Trust, UK
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12
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Ansa-Addo EA, Huang HC, Riesenberg B, Iamsawat S, Borucki D, Nelson MH, Nam JH, Chung D, Paulos CM, Liu B, Yu XZ, Philpott C, Howe PH, Li Z. RNA binding protein PCBP1 is an intracellular immune checkpoint for shaping T cell responses in cancer immunity. Sci Adv 2020; 6:eaaz3865. [PMID: 32523987 PMCID: PMC7259945 DOI: 10.1126/sciadv.aaz3865] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Accepted: 03/25/2020] [Indexed: 05/11/2023]
Abstract
Distinct lineages of T cells can act in response to various environmental cues to either drive or restrict immune-mediated pathology. Here, we identify the RNA binding protein, poly(C)-binding protein 1 (PCBP1) as an intracellular immune checkpoint that is up-regulated in activated T cells to prevent conversion of effector T (Teff) cells into regulatory T (Treg) cells, by restricting the expression of Teff cell-intrinsic Treg commitment programs. This was critical for stabilizing Teff cell functions and subverting immune-suppressive signals. T cell-specific deletion of Pcbp1 favored Treg cell differentiation, enlisted multiple inhibitory immune checkpoint molecules including PD-1, TIGIT, and VISTA on tumor-infiltrating lymphocytes, and blunted antitumor immunity. Our results demonstrate a critical role for PCBP1 as an intracellular immune checkpoint for maintaining Teff cell functions in cancer immunity.
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Affiliation(s)
- Ephraim A. Ansa-Addo
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
- Pelotonia Institute for Immuno-Oncology and Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, Columbus, OH 43210, USA
| | - Huai-Cheng Huang
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
- National Taiwan University College of Medicine, Graduate Institute of Clinical Medicine, No.7 Chung San South Road, Taipei City 10002, Taiwan
| | - Brian Riesenberg
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
- Pelotonia Institute for Immuno-Oncology and Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, Columbus, OH 43210, USA
| | - Supinya Iamsawat
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Davis Borucki
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Michelle H. Nelson
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Jin Hyun Nam
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Dongjun Chung
- Pelotonia Institute for Immuno-Oncology and Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, Columbus, OH 43210, USA
- Department of Public Health Sciences, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Chrystal M. Paulos
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Bei Liu
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Xue-Zhong Yu
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Caroline Philpott
- Genetics and Metabolism Section, Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), Bethesda, MD 20892, USA
| | - Philip H. Howe
- Department of Biochemistry and Molecular Biology, Medical University of South Carolina, Charleston, SC 29425, USA
| | - Zihai Li
- Department of Microbiology and Immunology and Hollings Cancer Center, Medical University of South Carolina, Charleston, SC 29425, USA
- Pelotonia Institute for Immuno-Oncology and Division of Medical Oncology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center-James, Columbus, OH 43210, USA
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13
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Hopkins C, Williamson E, Morris S, Clarke CS, Thomas M, Evans H, Little P, Lund VJ, Blackshaw H, Schilder A, Philpott C, Carpenter J, Denaxas S. Antibiotic usage in chronic rhinosinusitis: analysis of national primary care electronic health records. Rhinology 2020; 57:420-429. [PMID: 31490466 DOI: 10.4193/rhin19.136] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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
BACKGROUND The aim of this study was to analyse rates of antibiotic usage in chronic rhinosinusitis (CRS) in primary care in England and Wales and to identify trends in the choice of antibiotics prescribed. METHODS We used linked data from primary care EHRs, with diagnoses coded using the Read terminology (Clinical Practice Research Datalink) from consenting general practices, with (2) hospital care administrative records (Hospital Episode Statistics, HES recorded using ICD-10). RESULTS From the total of 88,317 cases of CRS identified, 40,462 (46%) had an antibiotic prescription within 5 days of their first CRS diagnosis. Of patients receiving a first line antibiotic within 5 days of CRS diagnosis, over 80%, in each CRS group, received a subsequent prescription for an antibiotic. Within 5 years of diagnosis, 9% are estimated to have had 5 or more antibiotics within 5 days of a CRS-related consultation. With data spanning almost 20 years, it was possible to discern trends in antibiotics prescriptions, with a clear increasing trend towards macrolide and tetracycline prescribing evident. CONCLUSIONS While antibiotics may have been prescribed for acute exacerbations, we have found high rates of repeated antibiotic prescription in some patients with CRS in primary care. There is a need for stronger evidence on the role of antibiotics in CRS management.
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Affiliation(s)
- C Hopkins
- ENT Department, Guy's and St Thomas NHS Foundation Trust, London, UK
| | - E Williamson
- Department of Medical Statistics, London School of Hygiene
| | - S Morris
- Department of Applied Health Research, University College London, London, UK
| | - C S Clarke
- Department of Primary Care and Population Health, UCL, London, UK
| | - M Thomas
- University of Southampton, Southampton, UK
| | - H Evans
- Department of Medical Statistics, London School of Hygiene
| | - P Little
- University of Southampton, Southampton, UK
| | | | | | | | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; ENT Department, James Paget University Hospital NHS Founda tion Trust, Great Yarmouth, UK
| | - J Carpenter
- ENT Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK; Institute of Health Informatics, UCL, London, UK
| | - S Denaxas
- Department of Medical Statistics, London School of Hygiene
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14
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Ta NH, Hopkins C, Vennik J, Philpott C. Optimising trial outcomes and patient retention for the MACRO trial for chronic rhinosinusitis. Rhinology 2019; 57:358-366. [PMID: 31403137 DOI: 10.4193/rhin19.142] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [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
BACKGROUND This study aimed to evaluate current subjective and objective outcome assessments for the MACRO (defining best Management for Adults with Chronic RhinOsinusitis) Trial which compares antibiotics, placebo and sinus surgery. This was to identify any redundant assessments and to include patient perspectives to determine acceptability for confirmation in the trial. METHODS Adults CRS patients meeting the provisional eligibility criteria for the MACRO trial were recruited to this mixed-method study at 2 sites. Correlations between the objective outcome measures and SNOT-22 scores were evaluated. Selected participants took part in a semi-structured telephone interview to explore their experiences and views of undergoing outcome measures. RESULTS Seventy patients (37% male) were recruited, 36 had CRS without nasal polyps, 34 had CRS with nasal polyps. There was a weak inverse correlation between the SNOT-22 â€Blockage†ratings and Peak Nasal Inspiratory Flow readings, a moderate inverse correlation between the SNOT-22 â€Smell†ratings and Sniffin’ Sticks scores, but no significant correlation between the SNOT-22 and Saccharin test results. The participants’ experience of the trial visit was positive with an acceptable duration of trial visit. Most proposed outcome measures were valued by participants with the exception of the Saccharin test. DISCUSSION The Sniffin’ Sticks test and PNIF correlate with their respective component SNOT-22 scores but are considered important by patients; PNIF is simple, cheap test to perform. The Saccharin test will be removed as participants did not value it and was not highly rated in parallel work on a core outcome set for CRS.
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Affiliation(s)
- N H Ta
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Hopkins
- ENT Department, Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - J Vennik
- University of Southampton, Southampton, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; ENT Department, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK
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15
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Williamson E, Denaxas S, Morris S, Clarke CS, Thomas M, Evans H, Direk K, Gonzalez-Izquierdo A, Little P, Lund V, Blackshaw H, Schilder A, Philpott C, Hopkins C, Carpenter J, Programme Team OBOTM. Risk of mortality and cardiovascular events following macrolide prescription in chronic rhinosinusitis patients: a cohort study using linked primary care electronic health records. Rhinology 2019; 57:252-260. [PMID: 30928998 DOI: 10.4193/rhin18.237] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [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
BACKGROUND Macrolide antibiotics have demonstrated important anti-inflammatory and immunomodulatory properties in chronic rhinosinusitis (CRS) patients. However, reports of increased risks of cardiovascular events have led to safety concerns. We investigated the risk of all-cause and cardiac death, and cardiovascular outcomes, associated with macrolide use. METHODOLOGY Observational cohort (1997-2016) using linked data from the Clinical Practice Research Datalink, Hospital Episodes Statistics, and the Office for National Statistics. Patients aged 16-80 years with CRS prescribed a macrolide antibiotic or penicillin were included, comparing prescriptions for macrolide antibiotics to penicillin. Outcomes were all-cause mortality, cardiac death, myocardial infarction, stroke, diagnosis of peripheral vascular disease, and cardiac arrhythmia. RESULTS Analysis included 320,798 prescriptions received by 66,331 patients. There were 3,251 deaths, 815 due to cardiovascular causes, 925 incident myocardial infarctions, 859 strokes, 637 diagnoses of peripheral vascular disease, and 1,436 cardiac arrhythmias. A non-statistically significant trend towards increased risk of myocardial infarction during the first 30 days following macrolide prescription was observed. No statistically significant short- or long-term risks were observed for macrolide prescription. No significant risks were identified for clarithromycin in particular. CONCLUSIONS Although not statistically significant, our best estimates suggest an increased short-term risk of myocardial infarction in patients with CRS following macrolide prescription, supporting previous observational evidence. However, confounding by indication remains a possible explanation for this apparent increased risk. We found no evidence of longer term increased risks.
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Affiliation(s)
- E Williamson
- Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, UK; HDR UK, London, UK
| | - S Denaxas
- HDR UK, London, UK; Institute of Health Informatics, UCL, London, UK
| | - S Morris
- Department of Applied Health Research, University College London, London, UK
| | - C S Clarke
- Research Department of Primary Care and Population Health, University College London, London, UK
| | - M Thomas
- Primary Care and Population Science, University of Southampton, UK
| | - H Evans
- HDR UK, London, UK; Institute of Health Informatics, UCL, London, UK; Ear Institute, UCL, London, UK
| | - K Direk
- Institute of Health Informatics, UCL, London, UK
| | | | - P Little
- Primary Care and Population Science, University of Southampton, UK
| | - V Lund
- Ear Institute, UCL, London, UK
| | | | | | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK; ENT Department, James Paget University Hospital NHS Foundation Trust, Great Yarmouth, UK
| | - C Hopkins
- ENT Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Carpenter
- Department of Medical Statistics, London School of Hygiene
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16
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Fokkens W, Desrosiers M, Harvey R, Hopkins C, Mullol J, Philpott C, Alobid I, Anselmo-Lima W, Bachert C, Baroody F, Bernal-Sprekelsen M, von Buchwald C, Cervin A, Cohen N, Constantinidis J, De Gabory L, Douglas R, Gevaert P, Hafner A, Hellings P, Joos G, Kalogjera L, Kern R, Knill A, Kocks J, Landis B, Limpens J, Lebeer S, Lourenco O, Matricardi P, Meco C, O'Mahony L, Reitsma S, Ryan D, Schlosser R, Senior B, Teeling T, Tomazic P, Toppila-Salmi S, Wang D, Wang D, Zhang L, Lund V. EPOS2020: development strategy and goals for the latest European Position Paper on Rhinosinusitis. Rhinology 2019; 57:162-168. [DOI: 10.4193/rhin19.080] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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17
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Ta NH, Addison A, Beigi B, Philpott C. Unilateral visual loss resulting from orbital encroachment of an ethmoidal juvenile trabecular ossifying fibroma. Ann R Coll Surg Engl 2019; 101:e111-e114. [PMID: 30854866 DOI: 10.1308/rcsann.2019.0030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Ossifying fibromas are mainly found in the mandible and maxilla. Reports of them arising in the ethmoid sinuses and orbits are rare. We present a case of an otherwise healthy 20-year-old man with gradual onset of right visual disturbance signified by right relative afferent pupillary defect due to a large unilateral ossifying fibroma arising from the ethmoid sinus compressing the medial half of the right orbit. We emphasise the multidisciplinary combined endoscopic endonasal and external approach to ensure a successful debulking of the fibroma.
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Affiliation(s)
- N H Ta
- Norwich Medical School, University of East Anglia , Norwich , UK
| | - A Addison
- Ear, Nose and Throat Department, James Paget University Hospital , Great Yamouth , UK
| | - B Beigi
- Ophthalmology Department, Norfolk and Norwich University Hospitals NHS Foundation , Norwich , UK
| | - C Philpott
- Norwich Medical School, University of East Anglia , Norwich , UK
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18
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Ta NH, Addison A, Philpott C. Wooden spatula sinusitis following maxillary expansion surgery. Ann R Coll Surg Engl 2018; 101:e20-e22. [PMID: 30286642 DOI: 10.1308/rcsann.2018.0169] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Sinusitis is a recognised rare complication of palatine expansion procedures and is usually caused by the presence of an oroantral fistula. We report the first case of unilateral sinusitis as a result of a retained foreign body (a wooden spatula) following a surgically assisted rapid palatine expansion procedure.
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Affiliation(s)
- N H Ta
- Norwich Medical School, University of East Anglia , Norwich , UK.,Norfolk and Norwich University Hospitals NHS Foundation Trust , Norwich , UK
| | - A Addison
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth , Norfolk , UK
| | - C Philpott
- James Paget University Hospitals NHS Foundation Trust, Great Yarmouth , Norfolk , UK
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19
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Maniakas A, Desrosiers M, Asmar M, Al Falasi M, Endam L, Hopkins C, Philpott C, Erskine S, Smith R, Kilty S. Eustachian tube symptoms are frequent in chronic rhinosinusitis and respond well to endoscopic sinus surgery. Rhinology 2018; 56:118-121. [DOI: 10.4193/rhin17.165] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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20
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehne A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2018. [PMID: 29528615 DOI: 10.4193/rhino16.248] [Citation(s) in RCA: 373] [Impact Index Per Article: 62.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Background Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major
health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following:
• Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy
with small diameter endoscopes.
• Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability.
• Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour
threshold, and/or one of odour identification or discrimination.
• Comprehensive chemosensory assessment should include gustatory screening.
• Smell training can be helpful in patients with olfactory loss of several aetiologies. Conclusions We hope the current manuscript 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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21
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Hopkins C, Hettige R, Soni-Jaiswal A, Lakhani R, Carrie S, Cervin A, Douglas R, Fokkens W, Harvey R, Hellings P, Leunig A, Lund V, Philpott C, Smith T, Wang D, Rudmik L. CHronic Rhinosinusitis Outcome MEasures (CHROME), developing a core outcome set for trials of interventions in chronic rhinosinusitis. Rhinology 2018; 56:22-32. [DOI: 10.4193/rhin17.247] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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22
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Philpott C, Erskine S, Smith R, Hopkins C, Kara N, Farboud A, Salam M, Robertson A, Almeyda R, Kumar B, Anari S, Ray J, Cathcart R, Carrie S, Ahmed S, Khalil H, Clark A, Thomas M. Current use of baseline medical treatment in chronic rhinosinusitis: Data from the National Chronic Rhinosinusitis Epidemiology Study (CRES). Clin Otolaryngol 2017; 43:509-524. [DOI: 10.1111/coa.13012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/12/2017] [Indexed: 11/29/2022]
Affiliation(s)
- C. Philpott
- James Paget University Hospital NHS Foundation Trust; Gorleston UK
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - S. Erskine
- James Paget University Hospital NHS Foundation Trust; Gorleston UK
| | - R. Smith
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - C. Hopkins
- Guys & St Thomas Hospital NHS Foundation Trust; London UK
| | - N. Kara
- County Durham & Darlington NHS Foundation Trust; Darlington UK
| | | | - M. Salam
- Ipswich Hospital NHS Foundation Trust; Ipswich UK
| | - A. Robertson
- Queen Elizabeth University Hospital Campus; Glasgow UK
| | - R. Almeyda
- Royal Berkshire NHS Foundation Trust; Reading UK
| | - B.N. Kumar
- Wrightington Wigan and Leigh NHS Foundation Trust; Wigan UK
| | - S. Anari
- Heart of England NHS Trust; Birmingham UK
| | - J. Ray
- Sheffield Teaching Hospitals NHSFT; Sheffield UK
| | | | | | - S. Ahmed
- University Hospitals Birmingham NHS Foundation Trust; Birmingham UK
| | | | - A. Clark
- Norwich Medical School; University of East Anglia; Norfolk UK
| | - M. Thomas
- Primary Care and population Sciences; University of Southampton; Southampton UK
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23
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Hellings PW, Akdis CA, Bachert C, Bousquet J, Pugin B, Adriaensen G, Advani R, Agache I, Anjo C, Anmolsingh R, Annoni E, Bieber T, Bizaki A, Braverman I, Callebaut I, Castillo Vizuete JA, Chalermwatanachai T, Chmielewski R, Cingi C, Cools L, Coppije C, Cornet ME, De Boeck I, De Corso E, De Greve G, Doulaptsi M, Edmiston R, Erskine S, Gevaert E, Gevaert P, Golebski K, Hopkins C, Hox V, Jaeggi C, Joos G, Khwaja S, Kjeldsen A, Klimek L, Koennecke M, Kortekaas Krohn I, Krysko O, Kumar BN, Langdon C, Lange B, Lekakis G, Levie P, Lourijsen E, Lund VJ, Martens K, Mő Sges R, Mullol J, Nyembue TD, Palkonen S, Philpott C, Pimentel J, Poirrier A, Pratas AC, Prokopakis E, Pujols L, Rombaux P, Schmidt-Weber C, Segboer C, Spacova I, Staikuniene J, Steelant B, Steinsvik EA, Teufelberger A, Van Gerven L, Van Gool K, Verbrugge R, Verhaeghe B, Virkkula P, Vlaminck S, Vries-Uss E, Wagenmann M, Zuberbier T, Seys SF, Fokkens WJ. EUFOREA Rhinology Research Forum 2016: report of the brainstorming sessions on needs and priorities in rhinitis and rhinosinusitis. Rhinology 2017; 55:202-210. [PMID: 28501885 DOI: 10.4193/rhin17.028] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016.
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Affiliation(s)
- P W Hellings
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C A Akdis
- Swiss Institute of Allergy and Asthma Research (SIAF), University of Zurich, Christine-Kuhne Center for Allergy Research and Education, Davos, Switzerland
| | - C Bachert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - J Bousquet
- Department of Respiratory Disease, University Hospital Arnaud de Villeneuve, Montpellier, France
| | - B Pugin
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Adriaensen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - R Advani
- Health Education North West, Manchester, UK
| | - I Agache
- Faculty of Medicine, Transylvania University, Brasov, Romania
| | - C Anjo
- Department of Otorhinolaryngology, Hospital Sao Jose, Hospital Centre of Central Lisbon, Lisbon, Portugal
| | - R Anmolsingh
- Department of Otorhinolaryngology, Wigan Wrightington and Leigh NHS Foundation Trust, Wigan, UK
| | | | - T Bieber
- Department of Dermatology and Allergy, Christine Kuhne-Center for Allergy Research and Education, Friedrich-Wilhelms-University, Bonn, Germany
| | | | - I Braverman
- Hillel Yaffe Medical Center, Hadera Technion Faculty of Medicine, Haifa, Israel
| | - I Callebaut
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | - T Chalermwatanachai
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - R Chmielewski
- Department of Otolaryngology, Military Institute of Aviation Medicine, Warsaw, Poland
| | - C Cingi
- Department of Otolaryngology, Head and Neck Surgery, University of Eskisehir Osmangazi, Eskisehir, Turkey
| | - L Cools
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - C Coppije
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - M E Cornet
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I De Boeck
- Department of Bioscience Engineering, University of Antwerp, Antwerp, Belgium
| | - E De Corso
- Agostino Gemelli Hospital Foundation, Catholic University of the Sacred Heart, Head and Neck Surgery Area, Institute of Otorhinolaryngology, Rome, Italy
| | - G De Greve
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - M Doulaptsi
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Edmiston
- Health Education North West, Manchester, UK
| | - S Erskine
- Norwich Medical School, University of East Anglia, UK
| | - E Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - P Gevaert
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - K Golebski
- Department of Experimental Immunology, Academic Medical Center, Amsterdam, The Netherlands
| | - C Hopkins
- ENT Departments, Guys and St Thomas Hospitals NHS Trust, London and James Paget University Hospital, Gorieston, United Kingdom
| | - V Hox
- Departement Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Jaeggi
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - G Joos
- Department of Respiratory Medicine, Ghent University, Belgium
| | - S Khwaja
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - A Kjeldsen
- Department Of Otorhinolaryngology, Odense University Hospital, Denmark
| | - L Klimek
- Center for Rhinology and Allergology, Wiesbaden, Germany
| | - M Koennecke
- University Hospital Schleswig-Holstein, Campus Lubeck, Department of Otorhinolaryngology, Lubeck, Germany
| | | | - O Krysko
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - B N Kumar
- Department of Otolaryngology-Head and Neck, WWL NHS Foundation Trust and NIHR CRN, Greater Manchester, UK
| | - C Langdon
- Rhinology Unit and Smell Clinic, Department of Otorhinolaryngology, Clinical and Experimental Respiratory Immunology, IDIBAPS, Barcelona, Spain
| | - B Lange
- Department of Otolaryngology, University Hospital of South Manchester, Manchester, UK
| | - G Lekakis
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | - P Levie
- ENT Clinic Messidor, Brussels, Belgium
| | - E Lourijsen
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - V J Lund
- Royal National Throat, Nose and Ear Hospital, University College London Hospitals, London, United Kingdom
| | - K Martens
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - R Mő Sges
- Faculty of Medicine, Institute of Medical Statistics, Informatics and Epidemiology, University of Cologne, Cologne, Germany
| | - J Mullol
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - T D Nyembue
- Department of OtoRhinoLaryngology, University of Kinshasa, Congo
| | - S Palkonen
- European Federation of Allergy and Airways Diseases Patients Associations (EFA), Brussels, Belgium
| | - C Philpott
- Norwich Medical School, University of East Anglia, UK
| | - J Pimentel
- Hospital de Egas Moniz and Hospital da Luz, Lisbon, Portugal
| | - A Poirrier
- ENT department, University Hospital of Liege, Belgium
| | - A C Pratas
- Norwich Medical School, University of East Anglia, UK
| | - E Prokopakis
- Department of Otorhinolaryngology, University of Crete School of Medicine, Greece
| | - L Pujols
- Clinical and Experimental Respiratory Allergy, IDIBAPS, CIBERES. Hospital Clinic, Universitat de Barcelona, Barcelona, Catalonia, Spain
| | - P Rombaux
- Departement d Otorhinolaryngologie, Cliniques Universitaires Saint-Luc, Belgium
| | - C Schmidt-Weber
- Center of Allergy and Environment (ZAUM), Technical University and Helmholtz Center Munich, Munich, Germany
| | - C Segboer
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
| | - I Spacova
- Centre of Microbial and Plant Genetics, KU Leuven, Leuven, Belgium
| | - J Staikuniene
- Lithuanian Universitys of health sciences, Department of Immunology and allergology, Kaunas, Lithuania
| | - B Steelant
- Laboratory of Clinical Immunology, KU Leuven, Belgium
| | - E A Steinsvik
- Department of Otorhinolaryngology, Oslo University Hospital, Rikshospitalet, Oslo, Norway
| | - A Teufelberger
- Upper Airways Research Laboratory, Department of Otorhinolaryngology-Head and Neck Surgery, Ghent University, Belgium
| | - L Van Gerven
- Department of Otorhinolaryngology-Head and Neck Surgery, UZ Leuven, Belgium
| | | | | | - B Verhaeghe
- Department of Otorhinolaryngology, Sint-Jozefskliniek, Izegem, Belgium
| | - P Virkkula
- Department of Otorhinolaryngology and Head and Neck Surgery, Helsinki University Hospital, Helsinki, Finland
| | - S Vlaminck
- Department of Otorhinolaryngology, AZ St. Johns Hospital, Bruges, Belgium
| | | | - M Wagenmann
- Department of Otorhinolaryngology, University Hospital Dusseldorf, Dusseldorf, Germany
| | - T Zuberbier
- Comprehensive Allergy-Centre-Charite, Department of Dermatology and Allergy, Charite-Universitatsmedizin Berlin, Germany
| | - S F Seys
- European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA), Brussels, Belgium
| | - W J Fokkens
- Department of Otorhinolaryngology, Academic Medical Center, Amsterdam, The Netherlands
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24
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Jennings B, Prinsley P, Philpott C, Willis G, Bhutta M. The genetics of cholesteatoma. A systematic review using narrative synthesis. Clin Otolaryngol 2017; 43:55-67. [DOI: 10.1111/coa.12900] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/03/2017] [Indexed: 02/04/2023]
Affiliation(s)
- B.A. Jennings
- Norwich Medical School; University of East Anglia; Norwich UK
| | - P. Prinsley
- ENT Department; James Paget University Hospitals NHS Foundation Trust; Great Yarmouth UK
| | - C. Philpott
- Norwich Medical School; University of East Anglia; Norwich UK
- ENT Department; James Paget University Hospitals NHS Foundation Trust; Great Yarmouth UK
| | - G. Willis
- Department of Molecular Genetics; Norfolk and Norwich University Hospital; Norwich UK
| | - M.F. Bhutta
- School of Paediatrics and Child Health; University of Western Australia; Subiaco WA Australia
- Royal Perth Hospital; Perth WA Australia
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25
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Hummel T, Whitcroft KL, Andrews P, Altundag A, Cinghi C, Costanzo RM, Damm M, Frasnelli J, Gudziol H, Gupta N, Haehner A, Holbrook E, Hong SC, Hornung D, Hüttenbrink KB, Kamel R, Kobayashi M, Konstantinidis I, Landis BN, Leopold DA, Macchi A, Miwa T, Moesges R, Mullol J, Mueller CA, Ottaviano G, Passali GC, Philpott C, Pinto JM, Ramakrishnan VJ, Rombaux P, Roth Y, Schlosser RA, Shu B, Soler G, Stjärne P, Stuck BA, Vodicka J, Welge-Luessen A. Position paper on olfactory dysfunction. Rhinology 2017. [PMID: 28623665 DOI: 10.4193/rhin16.248] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Olfactory dysfunction is an increasingly recognised condition, associated with reduced quality of life and major health outcomes such as neurodegeneration and death. However, translational research in this field is limited by heterogeneity in methodological approach, including definitions of impairment, improvement and appropriate assessment techniques. Accordingly, effective treatments for smell loss are limited. In an effort to encourage high quality and comparable work in this field, among others, we propose the following ideas and recommendations. Whilst the full set of recommendations are outlined in the main document, points include the following: - Patients with suspected olfactory loss should undergo a full examination of the head and neck, including rigid nasal endoscopy with small diameter endoscopes. - Subjective olfactory assessment should not be undertaken in isolation, given its poor reliability. - Psychophysical assessment tools used in clinical and research settings should include reliable and validated tests of odour threshold, and/or one of odour identification or discrimination. - Comprehensive chemosensory assessment should include gustatory screening. - Smell training can be helpful in patients with olfactory loss of several aetiologies. CONCLUSIONS We hope the current manuscript 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)
- T Hummel
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - K L Whitcroft
- Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
| | - P Andrews
- UCL Ear Institute, Faculty of Brain Sciences, University College London, London, UK
| | - A Altundag
- Department of Otorhinolaryngoglogy, Istanbul Surgery Hospital, Istanbul, Turkey
| | - C Cinghi
- Department of Otolaryngology; Eskisehir Osmangazi University, Istanbul, Turkey
| | - R M Costanzo
- Smell and Taste Disorders Center, Department of Otolaryngology Head and Neck Surgery, VCU School of Medicine, Richmond, VA, USA
| | - M Damm
- Department of Otorhinolaryngology, Head and Neck Surgery, University of Cologne Medical Center, Cologne, Germany
| | - J Frasnelli
- Research Chair in Chemosensory Neuroanatomy, Department of Anatomy, Universite du Quebec a Trois-Rivieres, Trois-Rivieres, QC, Canada
| | - 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
| | - E Holbrook
- Department of Otolaryngology, Massachusetts Eye and Ear Infirmary, Harvard Medical School, Boston, MA, USA
| | - S C Hong
- Department of Otorhinolaryngology, Konkuk University Medical Center, Hwayang-dong, Gwangjin-gu, Seoul, South Korea
| | - D Hornung
- Dept. of Biology, St. Lawrence University, Canton, NY, USA
| | | | - R Kamel
- Department of Otorhinolaryngology, Cairo University, Cairo, Egypt
| | - M Kobayashi
- Department of Otorhinolaryngology-Head and Neck Surgery, Mie University Graduate School of Medicine, Mie, Japan
| | - I Konstantinidis
- Smell and Taste Clinic, Second Academic Otorhinolaryngology Department, Papageorgiou Hospital, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - B N Landis
- Department for ENT, Head and Neck Surgery, Bern University Hospital, Bern, Switzerland
| | - D A Leopold
- Division of Otorhinolaryngology-Head and Neck Surgery, Department of Surgery, University of Vermont Medical Center, Burlington, Vermont, USA
| | - A Macchi
- ENT Clinic, University of Insubria, ASST, sette laghi, Varese, Italy
| | - T Miwa
- Department of Otorhinolaryngology, Kanazawa Medical University, Uchinada, Kahoku, Ishikawa, Japan
| | - R Moesges
- Institute of Medical Statistics, Informatics and Epidemiology, University Hospital of Cologne, Cologne, Germany
| | - J Mullol
- Rhinology Unit and Smell Clinic, IDIBAPS, University of Barcelona, 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
| | - G C Passali
- Head and Neck section, Department of Aging, Neurosciences, Head and Neck and Orthopedic; Catholic University of Sacred heart, A. Gemelli Hospital Foundation, Rome, Italy
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - J M Pinto
- Section of Otolaryngology-Head and Neck Surgery, The University of Chicago Medicine and Biological Sciences, Chicago, IL, USA
| | - V J Ramakrishnan
- Departments of Otolaryngology and Neurosurgery, University of Colorado, Aurora, CO, USA
| | - P Rombaux
- Universite Catholique de Louvain, Institute of Neurosciences, Unit of Otorhinolaryngology, Brussels, Belgium
| | - 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 A Schlosser
- Department of Otolaryngology, Head and Neck Surgery, Medical Univeristy of South Carolina, Charleston, SC, USA
| | - B Shu
- Department of Otolaryngology, Taipei Veterans General Hospital, National Yang Ming University School of Medicine Faculty of Medicine, Taipei, Taiwan
| | - G Soler
- Division of Otorhinolaryngology, Area of Smell and Taste, Hospital de Clinicas, University of Buenos Aires, Buenos Aires City, Argentina
| | - P Stjärne
- Section of Rhinology, Department of Otorhinolaryngology, Karolinska University Hospital and Karolinska Institutet, Stockholm, Sweden
| | - B A Stuck
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Essen, University Duisburg-Essen, Germany
| | - 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
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Whitcroft KL, Merkonidis C, Cuevas M, Haehner A, Philpott C, Hummel T. Intranasal sodium citrate solution improves olfaction in post-viral hyposmia. Rhinology 2017; 54:368-374. [PMID: 27316224 DOI: 10.4193/rhino16.054] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [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
BACKGROUND Calcium plays an integral role in olfactory signal transduction, including feedback inhibition. Sodium citrate acts as a calcium sequestrant and when applied intranasally, reduces free calcium available for feedback inhibition, which should theoretically improve olfaction. We aimed to investigate the utility of intranasal sodium citrate in improving the olfactory function of hyposmic patients, by performing this prospective placebo controlled, single-blind trial. METHODOLOGY Monorhinal olfactory testing for odour identification and threshold was performed in hyposmic patients using Sniffin Sticks, before and after treatment. Treatment consisted of one-off sodium citrate solution application to the olfactory cleft. Sodium chloride solution was applied to the contralateral olfactory cleft, which therefore acted as placebo control. Patients were blinded to the side of sodium citrate application, and side of treatment was randomized between patients. RESULTS 57 patients participated, aged 22-79. Causes of hyposmia included: post-viral (7); posttraumatic (10); sinonasal disease (30) and idiopathic (10). Compared with placebo, there was significant improvement in the identification scores of participants with post-viral hyposmia, following sodium citrate treatment. No significant change in olfactory function occurred for either identification or threshold in any other aetiological subgroup. CONCLUSIONS Intranasal sodium citrate may be of benefit to patients with post-viral hyposmia.
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Affiliation(s)
- K L Whitcroft
- Smell and Taste Clinic, Department of ORL, TU Dresden, Dresden, Germany
| | - C Merkonidis
- ENT Department, The Ipswich Hospital NHS Trust, Ipswich, Suffolk, United Kingdom
| | - M Cuevas
- Smell and Taste Clinic, Department of ORL, TU Dresden, Dresden, Germany
| | - A Haehner
- Smell and Taste Clinic, Department of ORL, TU Dresden, Dresden, Germany
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - T Hummel
- Smell and Taste Clinic, Department of ORL, TU Dresden, Dresden, Germany
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Erskine S, Hopkins C, Kumar N, Wilson J, Clark A, Robertson A, Kara N, Sunkaraneni V, Anari S, Philpott C. A cross sectional analysis of a case-control study about quality of life in CRS in the UK; a comparison between CRS subtypes. Rhinology 2017; 54:311-315. [PMID: 27315942 DOI: 10.4193/rhino15.361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [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
BACKGROUND The Sinonasal Outcome Test (SNOT-22) has been used as a patient reported outcome measure to grade symptom severity before and after treatment for chronic rhinosinusitis (CRS). METHODOLOGY This analysis uses data from the CRS Epidemiology Study (CRES). The overarching aim of CRES was to determine factors that influence the onset and severity of CRS. A study-specific questionnaire including SNOT-22 was distributed to patients with CRS attending ENT clinics across 30 centres in the United Kingdom. The aim of this analysis was to compare SNOT-22 scores between those with different types of CRS to determine any differences present in the total score or the subdomains and to assess whether any differences varied according to gender. RESULTS There were a total of 1249 CRS participants in the following subgroups: CRS without nasal polyps (CRSsNPs) (n=553), CRS with nasal polyps (CRSwNPs) (n=651), allergic fungal rhinosinusitis (AFRS) (n=45). Since there were differing gender ratios in each subgroup, males and females were analysed separately. The mean and standard deviation for SNOT-22 was: males CRSsNP 41.1 (21.0), CRSwNP 41.7 (20.5); females CRSsNP 49.6 (19.7), CRSwNP 49.5 (22.9). In the nasal domain, those with CRSwNP scored more highly than those with CRSsNP; for males 18.1 (8.1) vs. 15.9 (7.9); for females 19.6 (8.0) vs 16.7 (7.5). CONCLUSIONS Patients with CRSwNPs report higher symptom scores in the nasal domain of SNOT-22 than those with CRSsNPs with women in both subgroups reporting higher total scores than men.
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Affiliation(s)
- S Erskine
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Hopkins
- ENT Department, Guy s and St Thomas NHS Foundation Trust, London, UK
| | - N Kumar
- ENT Department, Writington, Wigan and Lee NHS Foundation Trust, Wigan, UK
| | - J Wilson
- Head and Neck Surg. Institute of Health and Society, Newcastle University, Newcastle, UK
| | - A Clark
- Norwich Medical School, University of East Anglia, Norwich, UK
| | - A Robertson
- ENT Department, Southern General Hospital, Glasgow, UK
| | - N Kara
- ENT Department, Darlington Memorial Hospitals NHS Foundation Trust, Darlington, UK
| | - V Sunkaraneni
- ENT Department, Royal Surrey County Hospital, Surrey, UK
| | - S Anari
- ENT Department, Heart of England NHS Foundation Trust, Birmingham, UK
| | - C Philpott
- Norwich Medical School, University of East Anglia, Norwich, UK
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Hopkins C, Philpott C, Crowe S, Reagan S, Degun A, Papachristou I, Schilder A. Identifying the most important outcomes for systematic reviews of interventions for rhinosinusitis in adults: working with Patients, Public and Practitioners. Rhinology 2016. [DOI: 10.4193/rhin15.199] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Philpott C, Erskine S, Hopkins C, Coombes E, Kara N, Sunkareneni V, Anari S, Salam M, Farboud A. A case-control study of medical, psychological and socio-economic factors influencing the severity of chronic rhinosinusitis. Rhinology 2016. [DOI: 10.4193/rhin15.272] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Whitcroft K, Merkonidis C, Cuevas M, Haehner A, Philpott C, Hummel T. Intranasal sodium citrate solution improves olfaction in post-viral hyposmia. Rhinology 2016. [DOI: 10.4193/rhin16.054] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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31
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Erskine S, Hopkins C, Kumar N, WIlson J, Clark A, Robertson A, Kara N, Sunkaraneni V, Anari S, Philpott C. A cross sectional analysis of a case-control study about quality of life in CRS in the UK; a comparison between CRS subtypes. Rhinology 2016. [DOI: 10.4193/rhin15.361] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Abstract
OBJECTIVES To assess the compliance of clinical commissioning groups (CCGs) in England with the ENT-UK rhinosinusitis commissioning guide produced in collaboration with the Royal College of Surgeons England and the National Institute of Clinical Excellence. We also aimed to assess the ease of accessibility of data from CCGs. DESIGN Audit of compliance of English CCGs with the ENT-UK rhinosinusitis commissioning guide. SETTING CCGs in England PARTICIPANTS A total of 58 of the 221 CCGs in England were included and chosen because they were the first CCGs authorised by NHS England, or alternately, the CCGs forecasted to have a deficit in their first year of operation. Their websites were reviewed; when information was not easily accessible, a freedom of information request was submitted to the relevant CCG. MAIN OUTCOME MEASURES Compliance with commissioning guidelines for rhinosinusitis. RESULTS Thirteen percent of CCGs had restrictive referral criteria in place, largely unrelated to published evidence-based guidance. The routine use of multiple courses of oral steroids, prescription of antibiotics, CT scanning within primary care, and delaying referral for a year, prior to referral to a specialist were recommended against published advice. CONCLUSIONS Restricting access to surgery may contribute to poorer outcomes and a decrease in the patient's quality of life. This is against the NHS constitution and is open to legal challenge. We encourage all ENT surgeons to review policies of their local CCG and engage with commissioners to ensure that their patients have evidence-based care.
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Affiliation(s)
| | - C Philpott
- James Paget University Hospital, Great Yarmouth, UK.,Norwich Medical School, University of East Anglia, Norwich, UK
| | - C Hopkins
- Guys and St Thomas' Hospital, London, UK.,King's College, London, UK
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Carter A, Jackson R, Philpott C, Hopkins C. Current practice in septal surgery and adjunctive turbinate reduction - A multisite experience in 226 consecutive cases. Clin Otolaryngol 2016; 42:762-764. [PMID: 27206311 DOI: 10.1111/coa.12680] [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] [Accepted: 05/17/2016] [Indexed: 11/28/2022]
Affiliation(s)
- A Carter
- Royal National Throat Nose and Ear Hospital, London, UK
| | - R Jackson
- James Paget University Hospital, Great Yarmouth, Norfolk, UK
| | - C Philpott
- James Paget University Hospital, Great Yarmouth, Norfolk, UK
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Melanson S, Dehnel M, Potkins D, Theroux J, Hollinger C, Martin J, Philpott C, Stewart T, Jackle P, Williams P, Brown S, Jones T, Coad B, Withington S. A negative ion source test facility. Rev Sci Instrum 2016; 87:02B109. [PMID: 26931991 DOI: 10.1063/1.4932320] [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] [Indexed: 06/05/2023]
Abstract
Progress is being made in the development of an Ion Source Test Facility (ISTF) by D-Pace Inc. in collaboration with Buckley Systems Ltd. in Auckland, NZ. The first phase of the ISTF is to be commissioned in October 2015 with the second phase being commissioned in March 2016. The facility will primarily be used for the development and the commercialization of ion sources. It will also be used to characterize and further develop various D-Pace Inc. beam diagnostic devices.
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Affiliation(s)
- S Melanson
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - M Dehnel
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - D Potkins
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - J Theroux
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - C Hollinger
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - J Martin
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - C Philpott
- Buckley Systems Ltd., 6 Bowden Road, Mount Wellington, Auckland 1060, New Zealand
| | - T Stewart
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - P Jackle
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
| | - P Williams
- Buckley Systems Ltd., 6 Bowden Road, Mount Wellington, Auckland 1060, New Zealand
| | - S Brown
- Buckley Systems Ltd., 6 Bowden Road, Mount Wellington, Auckland 1060, New Zealand
| | - T Jones
- Buckley Systems Ltd., 6 Bowden Road, Mount Wellington, Auckland 1060, New Zealand
| | - B Coad
- Buckley Systems Ltd., 6 Bowden Road, Mount Wellington, Auckland 1060, New Zealand
| | - S Withington
- D-Pace, Inc., P.O. Box 201, Nelson, British Columbia V1L 5P9, Canada
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Bernic A, Dessouky O, Philpott C, Morris S, Hopkins C. Cost-Effective Surgical Intervention in Chronic Rhinosinusitis. Curr Otorhinolaryngol Rep 2015. [DOI: 10.1007/s40136-015-0077-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Blackshaw H, Philpott C, Bhutta M, Cooper S, Schilder A. Getting involved in ENT clinical research in the UK; how can the NIHR Clinical Research Network help? Clin Otolaryngol 2014; 39:328-33. [DOI: 10.1111/coa.12318] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- H. Blackshaw
- evidENT, Ear Institute; University College London; London UK
| | - C. Philpott
- Norwich Medical School; University of East Anglia; Norwich UK
| | - M.F. Bhutta
- evidENT, Ear Institute; University College London; London UK
| | - S. Cooper
- NIHR Clinical Research Network Coordinating Centre; Leeds UK
| | - A.G.M. Schilder
- evidENT, Ear Institute; University College London; London UK
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Ashworth P, Mercer L, Patil S, Trinidade A, Philpott C. Epistaxis Secondary to an Oncocytoma of the Anterior Skull Base. Skull Base Surg 2012. [DOI: 10.1055/s-0032-1313946] [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: 10/28/2022]
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39
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Neumann C, Tsioulos K, Merkonidis C, Salam M, Clark A, Philpott C. Validation study of the “Sniffin’ Sticks” olfactory test in a British population: a preliminary communication. Clin Otolaryngol 2012; 37:23-7. [PMID: 22433135 DOI: 10.1111/j.1749-4486.2012.02431.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- C Neumann
- James Paget University Hospitals NHS Foundation Trust, Norfolk, UK.
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Abstract
We describe a case of intracranial dural IH initially diagnosed as a primary skull vault lesion hemangioma due to associated focal hyperostosis. Histopathologic examination of the dural component confirmed IH. The case is discussed in the context of IH within the neural axis.
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Affiliation(s)
- C Philpott
- Department of Radiology, Royal Children’s Hospital Melbourne, Australia.
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Philpott C, Gaskin J, McClelland L, Goodenough P, Clark A, Robinson A, Murty G. The Leicester semi-automated olfactory threshold test--a psychophysical olfactory test for the 21st century. Rhinology 2009; 47:248-253. [PMID: 19839245 DOI: 10.4193/rhin08.232] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [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
OBJECTIVE Develop a useful and cost-effective olfactometer for routine clinical use by providing a standardised threshold test for patients with olfactory disorders presenting in the ENT clinic. METHOD OF STUDY A prospective study of olfactory thresholds in 48 healthy volunteers on 2 consecutive occasions, undergoing quantitative testing with an olfactometer. Further studies of 10 subjects performing 20 tests and 100 subjects performing a single test were performed. An olfactometer was designed to deliver a semi-automated threshold test for an odour. It contains 8 logarithmic dilutions of an odour along with a control valve operated by software from a laptop computer. Common potential variables for olfactory threshold testing were considered including peak inspiratory flow rate. The odours used were phenethyl alcohol (PEA) and eucalyptol (EUC). Subjects were asked to perform 2 tests within 1 month of each other and the mean threshold score for each was calculated to derive a test-retest score. MAIN RESULTS Consistent olfactory thresholds for PEA were achieved with a mean concentration of 10-4. Test-retest reliability score (r(x)) for the olfactometer was r(x) = 0.78 (95% CI 0.67 to 0.89). PRINCIPAL CONCLUSIONS The Leicester Olfactometer provides a simple and cost-effective method of reliably assessing olfactory thresholds in the outpatient clinic.
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Affiliation(s)
- C Philpott
- St Paul's Sinus Centre, Vancouver, Canada
| | - J Gaskin
- Department of Otorhinolaryngology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - L McClelland
- Department of Otorhinolaryngology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
| | - P Goodenough
- Department of Medical Physics, University of Leicester, Leicester, United Kingdom
| | | | | | - G Murty
- Department of Otorhinolaryngology, University Hospitals of Leicester NHS Trust, Leicester, United Kingdom
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Deng Y, Kim Y, Philpott C. Ubiquitin‐dependent trafficking of Arn1, the ferrichrome transporter of Saccharomyces cerevisiae. FASEB J 2007. [DOI: 10.1096/fasebj.21.5.a244-b] [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: 11/11/2022]
Affiliation(s)
- Yi Deng
- Liver Diseases Section, NIDDK, NIH10 Center DriveBldg. 10, Rm 9B‐16BethesdaMD20892
| | - Youngwoo Kim
- Developmental and Molecular BiologyGeorgetown University3900 Reservoir RoadWashington, DC2000
| | - Caroline Philpott
- Liver Diseases Section, NIDDK, NIH10 Center DriveBldg. 10, Rm 9B‐16BethesdaMD20892
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Mukhopadhyay B, Shakoury‐Elizeh M, Philpott C. Identification of Uga3 as an iron‐regulated transcription factor controlling the activity of the GABA shunt in Saccharomyces cerevisiae. FASEB J 2007. [DOI: 10.1096/fasebj.21.6.a1042-c] [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: 11/11/2022]
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45
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Daniel M, Vaghela H, Philpott C, Thomas R, Gannon M, Spencer H, Haggard M. Does the benefit of adenoidectomy in addition to ventilation tube insertion persist long-term? Clin Otolaryngol 2006. [DOI: 10.1111/j.1365-2273.2006.01341_5.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [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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46
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Sharma A, Philpott C, Pope L, McKiernan D. Methicillin resistant Staphylococcus aureus: is it a problem for nasal surgery? J Laryngol Otol 2006; 121:415-8. [PMID: 17040604 DOI: 10.1017/s0022215106002763] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/20/2006] [Indexed: 11/06/2022]
Abstract
Methicillin resistant Staphylococcus aureus (MRSA) is becoming ever more prevalent in the UK, and the proportion of MRSA to methicillin sensitive Staphylococcus aureus (MSSA) seems to be increasing. New strains of MRSA are ever developing resistance to antibiotic treatment, increasing morbidity and mortality of infection. Staphylococcus aureus is part of the normal flora of the nose, and MRSA colonizes the nose in infection. However, nasal surgery is rarely complicated by staphylococcal infections, and MRSA infection following nasal surgery is rare. The authors present a literature review of MRSA infection, its relation to the nasal cavity, and infection following nasal surgery.
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Affiliation(s)
- A Sharma
- Department of Ear, Nose and Throat Surgery, Addenbrooke's NHS Trust, Cambridge and West Suffolk NHS Trust, Bury St. Edmunds, UK.
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Philpott C. Investigative Rhinology. J R Soc Med 2004. [DOI: 10.1258/jrsm.97.9.453-b] [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: 11/18/2022] Open
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Philpott C, Goodenough P, Passant C, Robertson A, Murty G. The effect of temperature, humidity and peak inspiratory nasal flow on olfactory thresholds. ACTA ACUST UNITED AC 2004; 29:24-31. [PMID: 14961848 DOI: 10.1111/j.1365-2273.2004.00760.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [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: 11/27/2022]
Abstract
Temperature, humidity and nasal peak inspiratory flow rate (PIFR) are potential variables in the quantitative measurement of olfactory thresholds in the clinic. To date, these variables have not been properly evaluated with respect to olfactory perception, and therefore the aim of this study was to determine their effect on the thresholds. These variables were measured on 10 occasions in 10 subjects over a 10-week period. The results obtained were then subjected to statistical analysis using a linear mixed-effect model. This demonstrated that olfactory thresholds are sufficiently independent of room temperature, peak humidity and nasal PIFR in a routine outpatient clinic environment in normal subjects, with no evidence of any statistically significant influence by these variables.
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Affiliation(s)
- C Philpott
- Department of Otorhinolaryngology, Leicester Royal Infirmary, University Hospitals of Leicester NHS Trust, University of Leicester, Leicester, UK.
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49
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Ardon O, Bussey H, Philpott C, Ward DM, Davis-Kaplan S, Verroneau S, Jiang B, Kaplan J. Identification of a Candida albicans ferrichrome transporter and its characterization by expression in Saccharomyces cerevisiae. J Biol Chem 2001; 276:43049-55. [PMID: 11562378 DOI: 10.1074/jbc.m108701200] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Saccharomyces cerevisiae can accumulate iron through the uptake of siderophore-iron. Siderophore-iron uptake can occur through the reduction of the complex and the subsequent uptake of iron by the high affinity iron transporter Fet3p/Ftr1p. Alternatively, specific siderophore transporters can take up the siderophore-iron complex. The pathogenic fungus Candida albicans can also take up siderophore-iron. Here we identify a C. albicans siderophore transporter, CaArn1p, and characterize its activity. CaARN1 is transcriptionally regulated in response to iron. Through expression studies in S. cerevisiae strains lacking endogenous siderophore transporters, we demonstrate that CaArn1p specifically mediates the uptake of ferrichrome-iron. Iron-ferrichrome and gallium-ferrichrome, but not desferri-ferrichrome, could competitively inhibit the uptake of iron from ferrichrome. Uptake of siderophore-iron resulting from expression of CaARN1 under the control of the MET25-promoter in S. cerevisiae was independent of the iron status of the cells and of Aft1p, the iron-sensing transcription factor. These studies demonstrate that the expression of CaArn1p is both necessary and sufficient for the nonreductive uptake of ferrichrome-iron and suggests that the transporter may be the only required component of the siderophore uptake system that is regulated by iron and Aft1p.
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Affiliation(s)
- O Ardon
- Department of Pathology, School of Medicine, University of Utah, Salt Lake City, Utah 84132, USA
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50
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Abstract
A prospective study of septicaemia, with special reference to central venous catheter (CVC)-related septicaemia, was performed over a nine-month period in paediatric cancer patients undergoing anti-neoplastic therapy. A total of 142 patients with 153 CVCs were included in the study. Seventy-two episodes of septicaemia were detected in 66 patients; overall, 46% of patients developed one or more episodes of septicaemia. Thirty-nine (54%) of these episodes occurring in 34 patients were CVC-related. Twenty-one (29%) of the episodes occurring in twenty patients were probably unrelated to CVCs and 12 (17%) episodes in 12 patients were of uncertain source. A total of 22932 CVC days were studied. The rate of CVC-related septicaemia was 1.7 episodes/1000 catheter days. Gram-positive organisms were commonest, causing 34 (87%) episodes of CVC-related septicaemia. Twenty-five (71%) of 35 evaluable episodes were successfully treated with antibiotics without CVC removal. Two patients died, CVC related sepsis probably contributing to death, and one patient suffered prolonged morbidity associated with CVC sepsis. Gram-negative organisms were the commonest cause of CVC-unrelated septicaemia, being implicated in 13 (62%) episodes.
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Affiliation(s)
- I Das
- Department of Microbiology, Birmingham Children's Hospital, UK
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