bluuebunny/crossref_metadata_2025_split huggingface dataset:
A Novel Botulinum Neurotoxin Topical Gel: Treatment of Allergic Rhinitis in Rats and Comparative Safety Profile
Authors: Zhu Zhao , Stone Hongran F. , Thach Thai Q.D. , Garcia Luke , Ruegg Curtis L. 
Published: December 2012

Background Rhinitis affects a significant proportion of adults and children with typically seasonal or chronic symptoms. Botulinum neurotoxin type A (BoNTA) is a well-known cholinergic antagonist widely used in a number of approved neurological and esthetic indications. is study designed to assess the therapeutic effect of RT001, a novel topical gel formulation of BoNTA, in the treatment of allergic rhinitis using a rat model and to compare its safety profile with that of an aqueous formulation of BoNTA complex. Methods A rat model of allergic rhinitis was used involving induction of classic rhinitis signs (sneezing and nasal itch) in addition to nasal inflammatory pathology to assess the degree of therapeutic effect of RT001. Comparative safety of RT001 and BoNTA complex was assessed in guinea pigs based on lethality and body weight gain. Results Clinical signs of rhinitis were significantly (p < 0.01) relieved after a single intranasal administration of RT001 and resolved to normal baseline levels within 5 days after treatment. Mucosal inflammation characterized by edema, congestion, and vascular dilatation along with increased expression of vasoactive intestinal peptide was noted in control animals after allergy induction, whereas 001 treatment resolved inflammation to essentially normal baseline levels. Safety studies in guinea pigs via intranasal dosing revealed ~31-fold greater safety factor for RT001 when compared with BoNTA complex. Conclusion These results suggest that topical intranasal application of RT001 is effective in relief of clinical signs and inflammatory pathology associated with allergic rhinitis in a rodent model and may provide a safe treatment for rhinitis.
Use of Advanced Imaging Technology and Endoscopy for Chronic Rhinosinusitis Varies by Physician Specialty
Authors: Pynnonen Melissa A. , Lin Giant , Dunn Rodney L. , Hollenbeck Brent K. 
Published: December 2012

Background Patients with chronic rhinosinusitis are cared for by multiple specialties. Endoscopy and imaging are important diagnostic tools. However, because physicians vary in their access to imaging and endoscopy, testing may vary across specialties. The purpose of this study is to characterize differences in use of imaging and endoscopy between physician specialties. Methods Using data from the National Ambulatory Medical Care Survey, we identified adult visits with primary, secondary, and tertiary diagnoses of chronic rhinosinusitis from 2005 through 2008. We measured rates of advanced radiographic imaging (CT, MRI, and PET) and office procedures. Logistic regression models were used to assess the bivariate and independent effects of patient, physician, and practice-level factors on use of advanced imaging and office procedures. Results There were nearly 51 million visits for diagnoses coded as chronic rhinosinusitis, representing an average of 12.7 million visits annually. Primary care providers saw the majority of these patients. Otolaryngologists used advanced radiographic imaging at a rate higher n primary care physicians per outpatient visit (16.0% versus 1.93%; p < 0.001). Office procedures, performed almost exclusively (99.2%) by otolaryngologists, were performed at 24.5% of otolaryngology visits. Private insurance was significantly associated with a lower use of advanced radiographic imaging (odds ratio, 0.54; 95% CI, 0.31–0.94) among otolaryngology visits, but no patient or provider-level variables were associated with office procedure use. Conclusion Radiographic imaging and office procedures are used at a higher rate per outpatient visit by otolaryngologists than by primary care providers. Additional studies are needed to identify and characterize factors that contribute to these different rates of use.
Does Oral Prednisolone Increase the Efficacy of Subsequent Nasal Steroids in Treating Nasal Polyposis?
Authors: Kirtsreesakul Virat , Wongsritrang Krongthong , Ruttanaphol Suwalee 
Published: December 2012

Background Although combined oral and nasal steroid therapy is widely used in nasal polyposis, a subset of patients show an unfavorable therapeutic outcome. This study aimed to evaluate whether oral prednisolone produces any additive effects on subsequent nasal steroid therapy and to evaluate if any clinical variables can predict therapeutic outcome. Methods Using a 3:2 randomization ratio, 67 patients with nasal polyposis received 50 mg of prednisolone and 47 patients received placebo daily for 2 weeks, followed by mometasone furoate nasal spray (MFNS) at 200 micrograms twice daily for 10 weeks. Clinical response was evaluated by nasal symptom score (NSS), peak expiratory flow index (PEFI), and total nasal polyps score (TNPS). Potential predictor variables were assessed by clinical history, nasal endoscopy, allergy skin test, and sinus radiography. Results At the end of the 2-week oral steroid phase, the prednisolone group showed significantly greater improvements in all nasal symptoms, nasal airflow, and polyp size than the placebo group. In the nasal steroid phase, while the MFNS maintained the outcome improvements in the prednisolone group, all outcome variables in the placebo group showed continuing improvements. At the end of the nasal steroid phase, there re no significant differences of most outcome improvements between the two groups, except in hyposmia, PEFI, and TNPS (p = 0.049, p = 0.029, and p = 0.005, respectively). In the prednisolone group, patients with polyps grade 3 and endoscopic signs of meatal discharge showed significantly less improvement in total NSS, PEFI, and TNPS than patients with grade 1–2 size and negative metal discharge. Conclusion In the 12-week treatment evaluation of nasal polyposis, pretreatment with oral steroids had no significant advantage for most nasal symptoms other than earlier relief; however, combined oral and nasal steroid therapy more effectively improved hyposmia, polyps size, and nasal airflow. Polyps size grade 3 and/or endoscopic signs of meatal discharge predisposed to a poorer treatment outcome.
The Novel Dry Extract BNO 1011 Stimulates Chloride Transport and Ciliary Beat Frequency in Human Respiratory Epithelial Cultures
Authors: Kreindler James L. , Chen Bei , Kreitman Yael , Kofonow Jennifer , Adams Kelly M. , Cohen Noam A. 
Published: December 2012

Background Herbal remedies predate written history and continue to be used more frequently than conventional pharmaceutical medications. The novel dry extract BNO 1011 is based on a combination of five herbs that is used to treat acute and chronic rhinosinusitis. We evaluated the pharmacologic effects of the novel dry extract BNO 1011 on human respiratory epithelial cultures specifically addressing electrolyte transport and cilia beat frequency (CBF). Methods Well-differentiated human bronchial epithelial cultures grown at an air–liquid interface were treated on the apical or basolateral surface with varying concentrations of dry extract BNO 1011. Changes in transepithelial sodium and chloride transport were determined in Ussing chambers under voltage-clamped conditions. Changes in CBF were determined using the Sissons-Ammons Video Analysis system (Ammons Engineering, Mt. Morris, MI). Results When applied to the apical surface, dry extract BNO 1011 activated forskolin-stimulated chloride secretion and ciliary beat in a dose-dependent fashion. Basolateral application of dry extract BNO 1011 did not alter the measured physiological properties. Conclusion Apical application of dry extract BNO 1011 stimulates both chloride secretion and CBF and therefore may augment mucociliary clearance.
Identifying Intracellular Staphylococcus Aureus in Chronic Rhinosinusitis: A Direct Comparison of Techniques
Authors: Tan Neil C.-W. , Tran Hai Bac , Foreman Andrew , Jardeleza Camille , Vreugde Sarah , Wormald Peter John 
Published: December 2012

Background The emerging concept of intracellular pathogens such as Staphylococcus aureus playing a role in chronic rhinosinusitis (CRS) has led to the development of numerous imaging techniques for their identification. Traditional methods of bacterial culture are not effective at localizing bacteria to the surface or within tissue samples. The aim of this study was to develop and validate a novel imaging technique using confocal scanning laser microscopy (CSLM) coupled with a fluorescence in situ hybridization (FISH) probe and nucleic acid counterstain (propidium iodide [PI]) that allows for simultaneous analysis of S. aureus intracellular status and surface biofilm within whole mucosal samples. Methods A prospective study was performed including 17 patients undergoing endoscopic sinus surgery for CRS. Tissue samples were analyzed with both CSLM-FISH/PI and immunohistochemistry (IHC) for intracellular S. aureus status. Results Using CSLM-FISH/PI intracellular S. aureus was identified in 9/17 (47%) patients and in 7/17 (39%) using IHC. Surface biofilm can be identified with CSLM-FISH/PI in the same piece of tissue; however, deeper imaging to the submucosa is impossible. IHC showed submucosal bacteria in three patients. Conclusion Both CSLM-FISH/PI and IHC are complementary techniques that can be used to identify intracellular S. aureus. CSLM-FISH/PI allows for the simultaneous detection of intracellular status and surface biofilm within the tissue analyzed. IHC has a role in the identification of intracellular and submucosal S. aureus within these tissues. Additional investigation is required to identify the true pathogenic nature of intracellular organisms as well as any relationship to surface biofilm status.
A Time Course Study on the Development of Allergen-induced Nasal Airway Remodeling in a Rat Model
Authors: Chung Young-Jun , Kim Hyo Yeol , Chung Seung-Kyu , Dhong Hun-Jong 
Published: December 2012

Background Only a few studies have investigated the airway remodeling process in allergic rhinitis (AR), and the results reported are conflicting. We established an allergen-induced nasal remodeling model for AR using brown Norway rats and investigated time-dependent histological changes and the reversibility of the epithelial and subepithelial changes. Methods Ovalbumin (OVA)-sensitized rats were exposed to OVA daily and then assigned to one of five groups depending on the duration of the challenge. Groups I, II, III, and IV rats were exposed for 1, 4, 8, and 12 weeks, respectively. Group V rats were exposed for 12 weeks and then protected from challenge for 4 weeks. Matched control rats were exposed to saline. Histological parameters of the nasal mucosa such as epithelial and subepithelial thickness, goblet cell hyperplasia, eosinophil infiltration, submucosal gland hypertrophy, and expression of matrix metalloproteinase-9 (MMP-9) and tissue inhibitor of metalloproteinase-1 (TIMP-1) were compared between groups. Results Repeated challenges for 12 weeks resulted in the characteristic features of nasal airway remodeling. All parameters except epithelial thickness increased markedly. Goblet cell hyperplasia and eosinophil infiltration decreased to control group levels after cessation of challenge for 4 weeks. Subepithelial changes such as subepithelial thickening, submucosal gland hypertrophy, and increased expression of MMP-9 and TIMP-1 were still observed after 4 weeks without challenge. Conclusion Our results indicate that prolonged OVA challenge can induce nasal remodeling. Epithelial changes were minimal or absent after cessation of the challenge, but subepithelial changes were resistant to reversal.
Diagnostic Value of Biopsies in Identifying Cytoplasmic Antineutrophil Cytoplasmic Antibody–negative Localized Wegener's Granulomatosis Presenting Primarily with Sinonasal Disease
Authors: Borner Urs , Landis Basile Nicolas , Banz Yara , Villiger Peter , Ballinari Piero , Caversaccio Marco , Dubach Patrick 
Published: December 2012

Background A substantial proportion of Wegener's disease (WG) patients present with localized disease of the upper airways, i.e., sinonasal and other ear/nose/throat (ENT) symptoms. Because of the oligosymptomatic presentation a timely diagnosis of this potentially fatal disease is challenging. This study evaluates diagnostic peculiarities between WG in its localized and generalized form of the disease. Methods Retrospective analysis was performed of 82 patients with suspected WG manifesting in the ENT region between 1989 and 2009. Comparison was performed of the clinical and laboratory results between patients with localized (n = 15) and generalized stage (n = 16) as well as non-WG patients (n = 50). Results ENT signs and symptoms were subtle, especially in the population presenting with localized disease. Therapy refractory rhinosinusitis or serous otitis media were the most frequent presentations of WG. In testing for localized WG, mucosal biopsy had the highest sensitivity (53%) compared with cytoplasmic antineutrophil cytoplasmic antibodies (c-ANCAs) with a lower sensitivity (47%) but highest specificity (96%) and highest positive predictive value (PPV; 78% versus 73%). Patients with generalized WG typically revealed a pathological urine sediment, hemoptysis, or rheumatological symptoms. In the generalized stage, c-ANCA had the highest sensitivity (81%), specificity (96% versus 95%), and highest PPV (87%). Conclusion Timely diagnosis and treatment of localized WG limited to the ENT region remains problematic. Even with adequate therapy, nearly one-half of patients with sinonasal localization suffer from relapse, at least 1 in 10 will progress to generalized disease, and up to two-thirds may develop permanent tissue damage. Unfortunately, the diagnostic usefulness of c-ANCA is significantly reduced at this early stage compared with cases with generalized disease (p = 0.04). Hence, the relative diagnostic value of mucosal biopsy increases especially for the significant proportion of c-ANCA– localized WG patients (47%). Sinonasal tissue sampling represents a cornerstone for diagnosis, which unlike c-ANCA testing can be repeated in short intervals and is associated with low morbidity.
Efficacy Study of Nasal Irrigation after Radiofrequency Tissue Volume Reduction for Inferior Turbinate Hypertrophy: An Equivalence Randomized Controlled Trial
Authors: Hirunwiwatkul Prakobkiat , Udomchotphruet Panya 
Published: December 2012

Background To determine the benefits of nasal irrigation after radiofrequency tissue volume reduction (RFTVR) for inferior turbinate hypertrophy (ITH) in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry. An equivalence randomized controlled trial was performed at the Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand. Methods Seventy-nine subjects with ITH planned for RFTVR were enrolled consecutively. The intervention was randomized into two groups: with and without nasal saline irrigation. Primary outcome was visual analog scale (VAS; 0–10) of postoperative nasal obstructive symptoms. Rhinorrhea, pain, nasal itching and sneezing, foul odor, bleeding, crusting and discharge, and patient satisfaction were self-assessed by the patients. Findings from endoscopic nasal examination and acoustic rhinometry (total nasal volume and cross-sectional area 2 [CSA2]) were performed before and after the intervention by blinded assessors. Results The study revealed no difference of nasal obstruction and other symptoms between the saline group and the control group on the 1st postoperative week, except nasal itching and sneezing. The saline group had itching and sneezing symptoms lower than the control group on the 5th–7th postoperative day. All patients had minimal or no postoperative nasal bleeding. There were also no differences of satisfaction and acoustic rhinometry findings between both groups. Conclusion The nasal irrigation with normal saline had no additional benefits after RFTVR for ITH in terms of nasal obstructive symptoms, endoscopic nasal findings, and acoustic rhinometry except nasal itching and sneezing symptoms.
Cranial reduction and fixation with a resorbable plate combined with cerebrospinal fluid shunting for difficult-to-manage macrocephaly related to hydrocephalus
Authors: Manwaring Jotham C. , Truong Devon , Deukmedjian Armen R. , Carey Carolyn M. , Storrs Bruce B. , Rodriguez Luis F. , Tetreault Lisa , Tuite Gerald F. 
Published: December 2012

The management of newborns with extreme macrocephaly related to hydrocephalus can be difficult; balancing the treatment of severe cranial deformity with optimal hydrocephalus management can be complicated. Excessive CSF drainage can result in significant suture overlap that leads to difficulties in patient positioning, secondary synostosis, and long-term aesthetic complications. Delayed cranial reduction and remodeling procedures carry significant risk, and the aesthetic outcomes have sometimes been poor.
The authors describe a newborn with severe macrocephaly who underwent shunt placement followed by a limited cranial reduction and fixation procedure using an absorbable plate within the 1st week of life. The procedure produced an immediate intracranial volume reduction of 49%. This novel management strategy facilitated patient positioning, simplified hydrocephalus management, and provided an excellent aesthetic outcome.
Craniocervical arachnoid cyst in a patient with Klippel-Feil syndrome: a unique case
Authors: Khan Imad Saeed , Ahmed Osama , Thakur Jai Deep , Shorter Cedric D. , Guthikonda Bharat 
Published: December 2012

Klippel-Feil syndrome, or brevicollis, is a complex congenital disorder caused by the improper segmentation of the cervical vertebrae. The authors present the very rare case of a patient with Klippel-Feil syndrome who presented with an intradural arachnoid cyst at the craniocervical junction. They also examine possible factors contributing to this association.
A 46-year-old woman presented with complaints of progressively worsening headaches and dizziness of 18 months' duration. She also demonstrated mild bilateral upper-extremity weakness. Magnetic resonance imaging revealed fused cervical vertebrae and a dorsal intradural arachnoid cyst at the craniocervical junction, extending down to the fourth cervical level. Because of worsening myelopathy and the presence of brainstem compression, the patient underwent surgical excision of the arachnoid cyst, which was approached via a midline posterior suboccipital/upper cervical route. An endoscope was introduced through a gap between the occiput and fused upper cervical vertebrae, and the arachnoid cyst was widely fenestrated. Postoperatively, the patient has remained symptom free for more than 2 years with evidence of good radiological decompression.
The authors report a unique association between craniocervical arachnoid cyst and Klippel-Feil syndrome. To their knowledge, no other cases of this association have been reported in the literature. Arachnoid cysts should be part of the differential diagnosis in the presence of worsening myelopathic symptoms or pain in patients with Klippel-Feil syndrome.
Les assemblées de desocupados dans la périphérie sud de Buenos Aires
Authors: Rius Pia V. 
Published: December 2012

Résumé Les organisations des travailleurs desocupados (MTD- Movimiento de Trabajadores Desocupados ) dans la région Sud du Grand Buenos Aires, Argentine, fonctionnent sur la base d’assemblées. La description ethnographique d’une de ces assemblées donne à voir l’articulation entre les prises de décisions et les modalités du vivre ensemble, qui ont autant cours sur la scène publique que dans les coulisses. L’observation des discussions sur la distribution des colis alimentaires permet de saisir comment la crédibilité des délégués et le maintien de la confiance sont mis à l’épreuve par l’exigence de publicité. S’appuyant sur l’assemblée, une critique des politiques sociales voit le jour. On ne peut cependant comprendre les échanges d’arguments au sein des assemblées participatives si on les détache des pratiques locales : relations de famille et de voisinage, au travail ou lors des mobilisations, interactions avec les autorités locales.
Mobiliser et mettre en scène des « leaders »
Authors: Balazard Hélène 
Published: December 2012

Résumé Construite sur le modèle du Broad based community organizing initié par Saul Alinsky, London Citizens représente un large éventail d’organisations – congrégations religieuses, établissements scolaires, syndicats et autres associations – qui cherchent à faire entendre leur voix et promouvoir le rôle de la « société civile » dans la gouvernance londonienne. Cet article analyse la genèse d’une campagne au sein de l’organisation. Grâce à une approche ethnographique, il interroge comment London Citizens concilie la participation la plus large possible de ses membres aux décisions collectives et la recherche d’efficacité et de visibilité dans l’arène publique. La formation de « leaders » – de la discussion à la prise de décision, en passant par la performance théâtrale lors des assemblées et autres actions collectives –, élément central du community organizing , n’est pas sans poser des tensions qui sont analysées dans cet article.
Comment la cartographie méconnaît les habitants
Authors: Charles Julien 
Published: December 2012

Résumé Cette contribution entend rendre compte de l’engagement des participants dans un dispositif participatif mis en place en Belgique dans le cadre d’un Plan communal de mobilité. Une attention particulière est accordée aux attentes normatives qui imprègnent les modalités d’organisation des réunions, à la façon dont celles-ci évoluent au fil des rencontres et aux équipements qui soutiennent la mémoire des participants. À cet égard, nous indiquerons ce que requiert la cartographie, qui occupe une place centrale dans ce dispositif, et la dynamique de formatage qui en résulte. Sur ce fond, on tentera de rendre compte d’un phénomène régulièrement observé dans ce type de réunions : la progressive désertion des participants.
Cachez ce politique que je ne saurais voir !
Authors: Carrel Marion , Talpin Julien 
Published: December 2012

Résumé Cet article analyse les enjeux de compétition sociale et politique dans deux conseils de quartier à Roubaix, l’un marqué par l’entre-soi et une « efficacité » en continuité avec l’action municipale, l’autre par des critiques et conflits de légitimité. Alors que le politique y est constamment dénié, l’observation de deux disputes – autour de la présence de Roms dans un quartier de la ville et de l’abstention record aux élections régionales – indique que des discussions politiques peuvent émerger, à condition que leurs membres ne soient pas suspectés d’intentions partisanes. En d’autres termes, l’ethnographie donne à voir le paradoxe selon lequel les conseillers de quartier doivent ne pas politiser la discussion pour la politiser.