Background
In this prospective, multicenter, randomized, controlled, double‐blind study, we investigated the impact of a mobile patient engagement application on health outcomes and quality of life ...in allergic rhinitis (AR) and asthma patients.
Methods
In total, 327 patients with diagnoses of persistent AR or mild‐to‐severe persistent asthma were randomized into 2 intervention groups and 2 control groups upon their admission at outpatient clinics. The intervention groups (POPET‐AR and POPET‐Asthma) received a mobile phone application (“physician on call patient engagement trial” POPET), enabling them to communicate with their physician, and record their health status and medication compliance. The AR groups completed the Rhinitis Quality of Life Questionnaire (RQLQ) at initiation and at the first month of the study. The asthma groups completed the Asthma Control Test (ACT) at initiation and at the third month of the study.
Results
The POPET‐AR group showed better clinical improvement than the control group in terms of the overall RQLQ score as well in measures of general problems, activity, symptoms other than nose/eye, and emotion domains (p < 0.05). In the POPET‐Asthma group, more patients (49%) achieved a well‐controlled asthma score (ACT > 19) compared with the control group (27%); this was statistically significant (p < 0.05).
Conclusion
Use of a mobile engagement platform, such as POPET, can have a significant impact on health outcomes and quality of life in both AR and asthma, potentially decreasing the number of hospital admissions, repeat doctor visits, and losses in productivity. Improvements were seen in domains related to activity, productivity, perception of disease, and emotion.
Nasal tip sutures: Techniques and indications Cingi, Cemal; Muluk, Nuray Bayar; Ulusoy, Seçkin ...
American journal of rhinology & allergy,
2015 Nov-Dec, 2015-11-00, 20151101, Volume:
29, Issue:
6
Journal Article
Peer reviewed
The surgical anatomy of the nasal tip is determined by intrinsic factors, such as the nasal tip volume, shape, definition, and symmetry. These factors are intimately related to the morphology of the ...lower lateral cartilages. Tip sutures reduce the need for grafts and allow the surgeon to manipulate the tip with a high degree of precision and better long-term clinical outcomes. In this review, we evaluated common nasal tip suture techniques to clarify the similarities and differences among them.
The following nasal tip suture techniques were investigated: medial crural fixation suture, middle crura suture, transdomal (dome creating, dome binding, domal definition) suture, interdomal suture, lateral crural mattress suture, columella septal suture, intercrural suture, tip rotation suture, craniocaudal transdomal suture, lateral crural spanning suture, suspension suture, tongue-in-groove technique, and lateral crural steal.
Tip sutures increase tip projection, narrow the tip, provide stabilization, and provide tip rotation. The sutures may be used separately or together.
Nasal tip sutures have long been used as noninvasive suture techniques. Each suture technique has unique benefits, and various key points must be considered when using these techniques.
Septoplasty in children Cingi, Cemal; Muluk, Nuray Bayar; Ulusoy, Seckin ...
American journal of rhinology & allergy,
2016 Mar-Apr, 2016-03-00, 20160301, Volume:
30, Issue:
2
Journal Article
Peer reviewed
Physicians have long had concerns about the potential harmful effects of pediatric septoplasties on the nasoseptal growth process because septal cartilage is important for the growth and development ...of the face.
In this review article, pediatric septoplasty and its indications are discussed, together with a literature survey. In addition, overviews of development of the nasal skeleton from neonate to adult, nasal growth, and cartilaginous septum are presented. Important issues and comments on pediatric septoplasties are provided.
During septoplasty procedures, elevation of the mucoperichondrium unilaterally or bilaterally does not negatively affect growth of the face. Stabilization of the septum may be easier when mucosal elevation is performed unilaterally. The nasal floor mucosa should not be elevated so to avoid damage to the incisive nerves. Corrections and limited excisions may be done from the cartilaginous septum. Separation of the septal cartilage from the perpendicular plate, especially at the dorsal part, should not be performed because this area is important for the length and height of the nasal septum and nasal dorsum. Incisions or excisions should not be performed through the growing and supporting zones, especially at the sphenoethmoid dorsal zone.
If there are severe breathing problems related to the septal deviation, septoplasty should be performed. In the majority of cases, septal surgery may be conducted in 6-year-old children. However, if necessary, septal surgery may be performed in younger children and even at birth.
The most common reason for failure in dacryocystorhinostomy has been proven to be the granuloma or membranous obstruction of scar tissue formation on lacrimal opening in the nasal cavity during the ...healing process. In this article, the authors suggest an easy maneuver to avoid the risk of scarring and collapsing of the knot in bony window by using a piece of an aspiration catheter. Using this easy maneuver, the authors can manage to reduce the risk of scarring and stenosis, and when the authors take out the tubes after 2 months, removing the silicone tube was easier with our technique. Moreover with the present technique the authors observed there was no embedding of the knot in the scar.
The olfactory system is affected by the nutritional balance and chemical state of the body, serving as an internal sensor. All bodily functions are affected by energy loss, including olfaction; ...hunger can alter odour perception.
In this study, we investigated the effect of fasting on olfactory perception in humans, and also assessed perceptual changes during satiation.
The “Sniffin’ Sticks” olfactory test was applied after 16h of fasting, and again at least 1h after Ramadan supper during periods of satiation. All participants were informed about the study procedure and provided informed consent. The study protocol was approved by the local Ethics Committee of Gaziosmanpaşa Taksim Education and Research Hospital (09/07/2014 no: 60). The study was conducted in accordance with the basic principles of the Declaration of Helsinki.
This prospective study included 48 subjects (20 males, 28 females) with a mean age of 33.6±9.7 (range 20–72) years; their mean height was 169.1±7.6 (range 150.0–185.0)cm, mean weight was 71.2±17.6 (range 50.0–85.0)kg, and average BMI was 24.8±5.3 (range 19.5–55.9). Scores were higher on all items pertaining to olfactory identification, thresholds and discrimination during fasting vs. satiation (p<0.05). Identification (I) results: Identification scores were significantly higher during the fasting (median=14.0) vs. satiation period (median=13.0). Threshold (T) results: Threshold scores were significantly higher during the fasting (median=7.3) vs. satiation period (median=6.2). Discrimination (D) results: Discrimination scores were significantly higher during the fasting (median=14.0) vs. satiation period (median=13.0). The total TDI scores were 35.2 (fasting) vs. 32.6 (satiation). When we compared fasting threshold value of >9 and ≤9, the gap between the fasting and satiety thresholds was significantly greater in >9 (p<0.05).
Olfactory function improved during fasting and declined during satiation. The olfactory system is more sensitive, and more reactive to odours, under starvation conditions, and is characterised by reduced activity during satiation. This situation was more pronounced in patients with a better sense of smell. Olfaction-related neurotransmitters should be the target of further study.
O sistema olfatório é afetado pelo equilíbrio nutricional e estado químico do corpo, que serve como um sensor interno. Todas as funções corporais são afetadas pela perda de energia, incluindo o olfato; a fome pode alterar a percepção do odor.
Neste estudo, investigamos o efeito do jejum sobre a percepção olfativa em seres humanos, e também avaliamos as mudanças de percepção durante a saciedade.
O teste olfatório Sniffin Sticks foi aplicado após 16 horas de jejum e novamente pelo menos 1 hora após a ceia do Ramadã durante os períodos de saciedade. Todos os participantes foram informados sobre os procedimentos do estudo e forneceram o consentimento informado. O protocolo do estudo foi aprovado pelo Comitê de Ética local do Gaziosmanpaşa Taksim Education e Research Hospital (2014/09/07 n° 60). O estudo foi conduzido de acordo com os princípios básicos da Declaração de Helsinki.
Foram incluídos 48 pacientes (20 homens, 28 mulheres) com idade média de 33,6±9,7 (variação 20-72) anos; a altura média deles era de 169,1±7,6 (variação 150,0-185,0) cm, o peso médio era de 71,2±17,6 (variação de 50,0-85,0) kg e IMC médio era de 24,8±5,3 (variação de 19,5-55,9). Os escores foram maiores em todos os itens correspondentes à identificação olfativa, limiares e discriminação durante jejum vs. saciedade (p<0,05). Resultados da identificação (I): os escores de identificação foram significativamente maiores durante o jejum (mediana=14,0) vs. período de saciedade (mediana=13,0). Resultados limiares (T): os escores limiares foram significativamente maiores durante o jejum (mediana=7,3) vs. período de saciedade (mediana=6,2). Resultados de discriminação (D): os escores de discriminação foram significativamente maiores durante o jejum (mediana=14,0) vs. período de saciedade (mediana=13,0). Os escores totais de TDI foram de 35,2 (jejum) vs. 32,6 (saciedade). Quando comparamos o valor do limiar de jejum de >9 e ≤9, a diferença entre os limiares de jejum e de saciedade foi significativamente maior em >9 (p < 0,05)
A função olfatória melhorou durante o jejum e diminuiu durante a saciedade. O sistema olfatório é mais sensível e mais reativo aos odores em condições de fome e é caracterizado por atividade reduzida durante a saciedade. Esta situação foi mais pronunciada em pacientes com um melhor sentido olfativo. Os neurotransmissores relacionados com o olfato devem ser alvo de um estudo mais aprofundado.
We investigated the effects of lateral osteotomy on nasal sound intensity levels in 34 patients who underwent rhinoplasty. Four groups were evaluated: group 1, preoperative rhinoplasty with lateral ...osteotomy (Preop-RPwithLO); group 2, postoperative rhinoplasty with lateral osteotomy (Postop-RPwithLO); group 3, preoperative rhinoplasty without lateral osteotomy (Preop-RPwithoutLO); and group 4, postoperative rhinoplasty without lateral osteotomy (Postop-RPwithoutLO). By sound analysis, low-frequency (Lf; 500-1000 Hz), medium-frequency (Mf; 1-2 kHz), and high-frequency (Hf; 2-4 and 4-6 kHz) nasal sound intensities were defined. Mf-left values of Postop-RPwithLO were significantly lower than those of Preop-RPwithLO, and Mf-left values of Postop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Preop-RPwithoutLO. Hf-right values of Preop-RPwithoutLO were significantly higher than those of Postop-RPwithLO and Postop-RPwithoutLO. Hf-total values of Postop-RPwithoutLO were significantly lower than those of Preop-RPwithoutLO. Nasal airway width decreased and nasal sounds, especially Mf sound intensities, increased in the nonlateral osteotomy group (group 4). When lateral osteotomy is performed, the nasal air passage may be adjusted as required by the surgeon, the air passage in the nasal valve region may not be narrowed, and nasal sound intensities may decrease. During postoperative follow-ups, increased Mf and Lf nasal sound intensities should be considered for the narrowness of the nasal passage and lower patency of the nasal cavities. Nasal sound analysis is a noninvasive technique and can also be used to evaluate nasal patency in septoplasty and rhinoplasty patients and children and for cases in which official reports are needed in addition to acoustic rhinometry measurements.
Background
Although the effectiveness of allergen monotherapy immunotherapy for allergic rhinitis (AR) has been well established by many prior studies, other aspects of immunotherapy are still ...incompletely documented by high‐quality studies. The many published papers describe various results. The aim of the present study was to conduct a meta‐analysis on the effectiveness of allergen immunotherapy.
Methods
A total of 56 homogeneous studies were included in the analysis. The inclusion criteria used to select articles were as follows: (1) placebo‐controlled clinical trials; (2) the use of immunotherapy; (3) participants and/or physicians were or were not blinded to immunotherapy or placebo assignment (single‐blinding, double‐blinding, or no‐blinding studies); and (4) randomization or not of those in the immunotherapy and placebo groups.
Results
Between 2003 and 2013, 114 placebo‐controlled clinical trials were reported in Medline. Studies describing recovery rates in immunotherapy and placebo groups numbered 56. The distribution of such works was homogeneous (heterogeneity chi‐square = 16.11; degrees of freedom df = 55; p = 1.000). The extent of recovery in immunotherapy groups was 53.671‐fold greater than in placebo groups (Mantel‐Haenszel M‐H pooled risk ratio RR = 53.671; 95% confidence interval CI, 36.981 to 77.893; z = 20.96; p < 0.001).
Conclusion
Our meta‐analysis suggests that immunotherapy is associated with a recovery rate 53.671‐fold that of placebo.
In the present study, we investigated the outcomes of sublingual immunotherapy (SLIT) in house dust mite-induced allergic rhinitis (HDM-AR) patients. In this prospective, multicentric study, 186 ...patients with AR who had positive skin prick test results for HDMs were included. The patients were administered SLIT using Staloral 300 for 1 year. Evaluation of the patients regarding symptom scores, clinical findings and Rhinitis Quality of Life Questionnaire (RQLQ) scores was performed at baseline, and then at 6 and 12 months of therapy. Our results showed that, for all of the evaluated items (symptom scores, clinical findings and RQLQ scores), 12-month values were significantly lower than those at 6 months and baseline. Similarly, 6-month values were significantly lower than those at baseline. There were no complications in any of our patients. SLIT for HDM-AR is a treatment modality that can be used safely. We obtained better results than expected, and the treatment showed a positive psychological effect; the patients believed that SLIT was the final step of treatment and, which made them feel better.
The aesthetic importance of the eyebrow has been highlighted for centuries. In this paper, we investigated ideal eyebrow. Eyebrows and eyelids, varies among different races, ages and genders. It is ...considered to be of primary importance in facial expression and beauty. We present one form of the ideal eyebrow aesthetic and discuss methods of optimising surgical results. For the modern acceptable concept of the ideal brow, the medial brow should begin on the same vertical plane as the lateral extent of the ala and the inner canthus and end laterally at an oblique line drawn from the most lateral point of the ala through the lateral canthus. The medial and lateral ends of the brow lie approximately at the same horizontal level. The apex lies on a vertical line directly above the lateral limbus. Individual perceptions and expectations also differ from person to person. The brow should over lie the orbital rim in males and be several millimetres above the rim in female. Male tend to have a heavier, thicker brow with a little arch present. There are some pitfalls in brow aesthetics. Overelevation creates an unnatural, surprised and unintelligent look which is the most common surgical mistake in brow lifting. Medial placement of the brow peak would create an undesired ‘surprised’ appearance. Moreover, a low medial brow with a high lateral peak induces an angry look. Overresection of the medial brow depressors may lead to widening and elevation of the medial brow, which creates an insensitive look and can also lead to glabellar contour defects. It is impossible to define an ideal eyebrow that is suitable for every face. However, one must consider previously described criteria and other periorbital structures when performing a brow surgery.
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