Chronic Rhinosinusitis with Nasal Polyps in Older Adults: Clinical Presentation, Pathophysiology, and Comorbidity

AbstractPurpose of ReviewChronic rhinosinusitis and nasal polyps (CRSwNP) is a common condition that significantly affects patients ’ life. This work aims to provide an up-to-date overview of CRSwNP in older adults, focusing on its aging-related clinical presentations, pathophysiology, and comorbidity associations including asthma.Recent FindingsRecent large population-based studies using nasal endoscopy have shown that CRSwNP is a mostly late-onset disease. Age-related changes in physiologic functions, including nasal epithelial barrier dysfunction, may underlie the incidence and different clinical presentations of CRSwNP in older adults. However, there is still a paucity of evidence on the effect of aging on phenotypes and endotypes of CRSwNP. Meanwhile, late-onset asthma is a major comorbid condition in patients with CRSwNP; they frequently present with type 2 inflammatory signatures that are refractory to conventional treatments when they are comorbid. However, as they are more commonly non-atopic, causative factors other than classical atopic sensitization, such asStaphylococcus aureusspecific IgE sensitization, are suggested to drive the type 2 inflammation. There are additional comorbidity associations in older patients with CRSwNP, including those with chronic otitis media and head and neck malignancy.SummaryAge is a major determinant for the incidence and clinical presentations of CRSwNP. Given the heterogeneity in phenotypes and endotypes, longitudinal investi...
Source: Current Allergy and Asthma Reports - Category: Allergy & Immunology Source Type: research

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CONCLUSIONS: Immunohistochemistry seems to be a promising option not only in clinical recognition, but also in the selection and monitoring of treatment effects. However, these methods have not yet recommended for routine clinical use. PMID: 33032462 [PubMed - as supplied by publisher]
Source: Scandinavian Journal of Gastroenterology - Category: Gastroenterology Tags: Scand J Gastroenterol Source Type: research
Boosting the sensitivity of in vitroβ-lactam allergy diagnostic tests. Chem Commun (Camb). 2020 Oct 14;56(80):11973-11976 Authors: Peña-Mendizabal E, Morais S, Maquieira Á Abstract The synthesis of structurally new haptens and the development of suitable antigens are essential for boosting the sensitivity of drug allergy diagnostic testing. Unprecedented structural antigens for benzylpenicillin and amoxicillin are characterised and evaluated in a cohort of 70 subjects with a turnkey solution based on consumer electronics. PMID: 33033809 [PubMed - in process]
Source: Chemical Communications - Category: Chemistry Authors: Tags: Chem Commun (Camb) Source Type: research
Publication date: October 2020Source: Brain, Behavior, and Immunity, Volume 89Author(s): Xiaoqin Liu, Trine Munk-Olsen, Clara Albiñana, Bjarni J. Vilhjálmsson, Emil M. Pedersen, Vivi Schlünssen, Marie Bækvad-Hansen, Jonas Bybjerg-Grauholm, Merete Nordentoft, Anders D. Børglum, Thomas Werge, David M. Hougaard, Preben B. Mortensen, Esben Agerbo
Source: Brain, Behavior, and Immunity - Category: Neurology Source Type: research
ConclusionThe COMQ-12 could be a useful tool to differentiate chronic otitis media with or without cholesteatoma.
Source: European Archives of Oto-Rhino-Laryngology - Category: ENT & OMF Source Type: research
Publication date: Available online 9 October 2020Source: The Journal of Allergy and Clinical Immunology: In PracticeAuthor(s): Manuel Jorge Rial, Marcela Valverde, Victoria del Pozo, Francisco Javier González-Barcala, Carlos Martínez-Rivera, Xavier Muñoz, José María Olaguibel, Vicente Plaza, Elena Curto, Santiago Quirce, Pilar Barranco, Javier Domínguez-Ortega, Joaquin Mullol, César Picado, Antonio Valero, Irina Bobolea, Ebymar Arismendi, Paula Ribó, Joaquín Sastre
Source: The Journal of Allergy and Clinical Immunology: In Practice - Category: Allergy & Immunology Source Type: research
Purpose of Study: Explore the perceptions of primary care physicians (PCPs) from community health care centers (CHCs) in Franklin County, Ohio, regarding factors that contribute to their inability to consistently provide sustainable asthma management services to their uninsured patient population. Primary Practice Setting: Asthmatic patients are not consistently receiving sustainable asthma management in CHCs in Ohio. Primary care physicians in CHCs play a pivotal role in closing health care gaps for asthmatic patients. To minimize the barriers that impede the efforts of PCPs to control asthma for their uninsured pati...
Source: Professional Case Management - Category: Health Management Tags: Articles Source Type: research
CONCLUSION: Our study provides additional evidence to help design allergy interventions. PMID: 33031690 [PubMed - as supplied by publisher]
Source: Puerto Rico Health Sciences Journal - Category: International Medicine & Public Health Tags: P R Health Sci J Source Type: research
Refractory otitis media (OM) in adults is challenging as misdiagnosis can lead to permanent sensorineural hearing loss. OM in the presence of peripheral eosinophilia and atopic history should warrant alternative treatment rather than antibiotics and topical steroids.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: M358 Source Type: research
Abstract The relationship between otitis media with effusion (OME) and chronic rhinosinusitis with nasal polyposis (CRSwNP) remains unclear. We conducted a cross-sectional study of 80 consecutively presenting patients-42 males and 38 females, aged 15 to 76 years (median: 48)-who were diagnosed with CRSwNP. Our aim was to ascertain the prevalence of OME in CRSwNP patients, to determine whether the severity of CRSwNP affected OME, and to identify risk factors for OME in CRSwNP patients. The severity of CRSwNP was assessed on the basis of nasal symptoms, endoscopic nasal examinations, and Lund-Mackay staging scores. ...
Source: Ear, Nose and Throat Journal - Category: ENT & OMF Authors: Tags: Ear Nose Throat J Source Type: research
Allergic rhinitis (AR) is a condition with a significant impact on patient's quality of life. Sex differences in the prevalence and clinical presentation of rhinitis have been reported in multiple studies. Additionally, it has comorbidities with asthma, atopic dermatitis, rhinosinusitis, otitis media, anosmia, nasal polyps and lower airway infection. As a complex phenotype, AR is affected by both genetic and environmental factors. Recent literature has focused on difference in the genomic architecture of asthma for the two sexes by considering gene-sex interaction, whereas AR has been neglected.
Source: Annals of Allergy, Asthma and Immunology - Category: Allergy & Immunology Authors: Tags: Letters Source Type: research
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