Sinusitis, NIAID Fact Sheet
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Rhinitis and Sinusitis
Glendale Animal Hospital 623-934-7243 www.familyvet.com Rhinitis and Sinusitis (Inflammation of the Nose and Sinuses) Basics OVERVIEW Rhinitis—inflammation of the lining of the nose Sinusitis—inflammation of the sinuses The nasal cavity communicates directly with the sinuses; thus inflammation of the nose (rhinitis) and inflammation of the sinuses (sinusitis) often occur together (known as “rhinosinusitis”) “Upper respiratory tract” (also known as the “upper airways”) includes the nose, nasal passages, throat (pharynx), and windpipe (trachea) “Lower respiratory tract” (also known as the “lower airways”) includes the bronchi, bronchioles, and alveoli (the terminal portion of the airways, in which oxygen and carbon dioxide are exchanged) SIGNALMENT/DESCRIPTION OF PET Species Dogs Cats Breed Predilections Short-nosed, flat-faced (known as “brachycephalic”) cats are more prone to long-term (chronic) inflammation of the nose (rhinitis), and possibly fungal rhinitis Dogs with a long head and nose (known as “dolichocephalic dogs,” such as the collie and Afghan hound) are more prone to Aspergillus (a type of fungus) infection and nasal tumors Mean Age and Range Cats—sudden (acute) viral inflammation of the nose and sinuses (rhinosinusitis) and red masses in the nasal cavity and throat (known as “nasopharyngeal polyps”) are more common in young kittens (6–12 weeks of age) Congenital (present at birth) diseases (such as cleft palate) are more common in young pets Tumors/cancer and dental disease—are more common in older pets Foreign -
Bronchiolitis
6 Sand Hill Road, Suite 102 Flemington, NJ 08822 PHONE 908-782-6700 FAX 908-788-5861 hunterdonpediatrics.org BRONCHIOLITIS Bronchiolitis is an infection of the small breathing tubes (bronchioles) that lead to the lung. Bronchiolitis is not the same as bronchitis, which is an infection in the large breathing tubes (bronchi). Bronchiolitis is usually seen in infants and young toddlers. It is not usually seen in older children or adults. A virus causes bronchiolitis. The most common virus is RSV (respiratory syncytial virus). Since RSV infection does not usually result in immunity, people can get it again; however, beyond the age of two, RSV usually causes just a bad cold. RSV is very contagious and spreads rapidly through childcare groups and families from October through April. Some studies suggest that babies who get RSV are more likely to have asthma in the future. Also, people with asthma who get RSV infection may trigger an asthma attack. Babies with RSV have severe nasal congestion, usually followed by a worsening cough. There may be a mild fever at the beginning of the illness. Signs of trouble with RSV include: ● Poor feeding/decreased urine output ● Rapid breathing ● Grunting sound with breathing ● Tightening of chest or stomach muscles with breathing ● Wheezing (high pitched whistling sound with breathing out) ● Blue tint around mouth or fingers/toes ● Fever lasting more than two days, or over 104 The vast majority of patients with bronchiolitis recover well. Certain children are especially likely to have trouble with bronchiolitis: ● Infants under two months of age ● Infants who were premature and have not reached their “due date” yet ● Patients with lung diseases like cystic fibrosis or bronchopulmonary dysplasia (BPD) ● Patients with severe heart disease ● Patients with AIDS or other immunity problems ● Patients on chemotherapy or with organ transplants Treatment for bronchiolitis is mostly supportive; that is, treatment is aimed at helping the patient breathe better. -
Rhinotillexomania in a Cystic Fibrosis Patient Resulting in Septal Perforation Mark Gelpi1*, Emily N Ahadizadeh1,2, Brian D’Anzaa1 and Kenneth Rodriguez1
ISSN: 2572-4193 Gelpi et al. J Otolaryngol Rhinol 2018, 4:036 DOI: 10.23937/2572-4193.1510036 Volume 4 | Issue 1 Journal of Open Access Otolaryngology and Rhinology CASE REPORT Rhinotillexomania in a Cystic Fibrosis Patient Resulting in Septal Perforation Mark Gelpi1*, Emily N Ahadizadeh1,2, Brian D’Anzaa1 and Kenneth Rodriguez1 1 Check for University Hospitals Cleveland Medical Center, USA updates 2Case Western Reserve University School of Medicine, USA *Corresponding author: Mark Gelpi, MD, University Hospitals Cleveland Medical Center, 11100 Euclid Avenue, Cleveland, OH 44106, USA, Tel: (216)-844-8433, Fax: (216)-201-4479, E-mail: [email protected] paranasal sinuses [1,4]. Nasal symptoms in CF patients Abstract occur early, manifesting between 5-14 years of age, and Cystic fibrosis (CF) is a multisystem disease that can have represent a life-long problem in this population [5]. Pa- significant sinonasal manifestations. Viscous secretions are one of several factors in CF that result in chronic sinona- tients with CF can develop thick nasal secretions con- sal pathology, such as sinusitis, polyposis, congestion, and tributing to chronic rhinosinusitis (CRS), nasal conges- obstructive crusting. Persistent discomfort and nasal man- tion, nasal polyposis, headaches, and hyposmia [6-8]. ifestations of this disease significantly affect quality of life. Sinonasal symptoms of CF are managed medically with Digital manipulation and removal of crusting by the patient in an attempt to alleviate the discomfort can have unfore- topical agents and antibiotics, however surgery can be seen damaging consequences. We present one such case warranted due to the chronic and refractory nature of and investigate other cases of septal damage secondary to the symptoms, with 20-25% of CF patients undergoing digital trauma, as well as discuss the importance of sinona- sinus surgery in their lifetime [8]. -
The Common Cold.Pdf
PATIENT TEACHING AID The Common Cold PERFORATION ALONG TEAR Everyone has experienced the misery of the common Rhinovirus Infection cold. A cold causes familiar symptoms such as a runny nose, sore throat, congestion, postnasal drip, and cough. For most sufferers, these symptoms are annoying, but not serious. Cold symptoms gradually improve and disappear over 7 to 10 days without complications. Colds are viral infections, so treatment with an antibiotic is not helpful. The best treatment for a cold is rest, fluids, and nonprescription medicines to help relieve symptoms. Although there is no vaccine to prevent colds, the spread of cold viruses can be slowed by frequent hand washing and avoiding close contact with those suffering from a cold. ILLUSTRATION: KRISTEN WIENANDT MARZEJON 2016 MARZEJON WIENANDT KRISTEN ILLUSTRATION: Copyright Jobson Medical Information LLC, 2016 continued MEDICAL PATIENT TEACHING AID Antibiotics Should Not Be Used to Treat a Cold Colds are caused by a variety of viruses, most commonly rhinoviruses. These viruses are highly contagious, and they are spread through the air or when someone is in contact with an infected person or contaminated object. There is no good evidence that exposure to cold or being overheated © Jobson Medical Information LLC, 2016 LLC, Information Medical Jobson © increases the risk of contracting a cold. Although most Wash your hands thoroughly and frequently colds occur in the winter months, some viruses that cause to prevent the spread of cold viruses. colds are more common in the fall or spring. Infants and young children are more prone to colds, as are people with weakened immunity. -
SEPTOPLASTY SURGICAL INFORMED CONSENT the Nasal
.SEPTOPLASTY SURGICAL INFORMED CONSENT The nasal septum is the wall inside your nose that divides it into two separate nasal passages. It is made of cartilage and bone. In a healthy nose, there is usually nearly equal airflow on both sides. Sometimes, the nasal septum is crooked or twisted. This condition is called a deviated nasal septum, and it can be caused by trauma to the nose, or patients can be born this way. The primary problem with a deviated nasal septum is nasal blockage, either on one or both sides. This nasal blockage can also contribute to nosebleeds, sinus infections, and often worsens obstructive sleep apnea. Occasionally, a deviated septum can be associated with a specific type of headache. A deviated septum can be surgically repaired with an operation called a septoplasty. This is typically done through a closed approach, which takes about one hour. More complicated or severely deviated septa may require an open approach, which can take up to 2-3 hours. In either case, septoplasty surgery is done under general anesthesia. It is an outpatient procedure so patients will be discharged home the same day. Some patients have multiple causes of nasal obstruction. Aside from a deviated septum, other reasons for a stuffy nose include chronic sinusitis, turbinate hypertrophy, nasal polyps, or nasal valve collapse. In these cases, septoplasty surgery may be performed in conjunction with other procedures such as endoscopic sinus surgery, turbinate reduction, or insertion of alar batten or spreader grafts. These procedures are discussed in their own individual sections on our website. Your physician will discuss what surgery is most appropriate for you. -
Allergic/Non-Allergic Rhinitis
Tips to Remember: Rhinitis Do you have a runny or stuffy nose that doesn't seem to go away? If so, you may have rhinitis, which is an inflammation of the mucous membranes of the nose. Rhinitis is one of the most common allergic conditions in the United States, affecting about 40 million people. It often coexists with other allergic disorders, such as asthma. It is important to treat rhinitis because it can contribute to other conditions such as sleep disorders, fatigue and learning problems. There are two general types of rhinitis: Allergic rhinitis is caused by substances called allergens. Allergens are often common, usually harmless substances that can cause an allergic reaction in some people. Causes • When allergic rhinitis is caused by common outdoor allergens, such as airborne tree, grass and weed pollens or mold, it is called seasonal allergic rhinitis, or "hay fever." • Allergic rhinitis is also triggered by common indoor allergens, such as animal dander (dried skin flakes and saliva), indoor mold or droppings from cockroaches or dust mites. This is called perennial allergic rhinitis. Symptoms • Sneezing • Congestion • Runny nose • Itchiness in the nose, roof of the mouth, throat, eyes and ears Diagnosis If you have symptoms of allergic rhinitis, an allergist/immunologist can help determine which specific allergens are triggering your reaction. He or she will take a thorough health history, and then test you to determine if you have allergies. Skin tests or Blood (RAST) tests are the most common methods for determining your allergic triggers. Treatment Once your allergic triggers are determined, your physician or nurse will work with you to develop a plan to avoid the allergens that trigger your symptoms. -
(RSV) Infection? an Analysis Using the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) RSV Database
Does Ribavirin Impact on the Hospital Course of Children With Respiratory Syncytial Virus (RSV) Infection? An Analysis Using the Pediatric Investigators Collaborative Network on Infections in Canada (PICNIC) RSV Database Barbara J. Law, MD*; Elaine E. L. Wang, MDCM‡; Noni MacDonald, MD§; Jane McDonald, MDi; Simon Dobson, MD¶; Francois Boucher, MD#; Joanne Langley, MD**; Joan Robinson, MD‡‡; Ian Mitchell, MD§§; and Derek Stephens MSc‡ ABSTRACT. Objectives. To determine the relation- 20.6%, 20.9%, 15.5%, 15.2%, and 13.3%, respectively. ship between receipt of aerosolized ribavirin and the Across the subsets ribavirin use ranged from 36% to 57% hospital course of high-risk infants and children with of ventilated patients and 6% to 39% of nonventilated respiratory syncytial virus (RSV) lower respiratory infec- patients. For nonventilated patients in each subset the tion (LRI). median RSV-attributable hospital length of stay (RSV- Methods. The 1993–1994 Pediatric Investigators Col- LOS) was 2 to 3 days longer for ribavirin recipients and laborative Network on Infections in Canada (PICNIC) the duration of hypoxia was significantly increased. Du- RSV database consists of prospectively enrolled children ration of intensive care unit (ICU) stay was also increased with acute RSV LRI, admitted to nine Canadian pediatric for all ribavirin-treated subgroups except those with tertiary care centers. After excluding cases with compro- CHD. In contrast, for ventilated patients, ribavirin ther- mised immunity and/or nosocomial infection, subsets apy was -
Anorexia/Cachexia Heart Failure Symptom Management Guideline for Adults, Age 19 and Older in British Columbia
Anorexia/Cachexia Heart Failure Symptom Management Guideline For adults, age 19 and older in British Columbia What is anorexia? Anorexia is a syndrome characterized by some or all of the following symptoms: loss of appetite, nausea, early satiety, weakness, fatigue, food aversion, and significant physical and/or psychological symptoms. Causes of anorexia are multifactorial and include fatigue, dyspnea, medication side-effects, nausea, depression, anxiety and sodium restricted diets, which may all be found in patients with heart failure. What is cachexia? Cachexia is a syndrome characterized by severe body weight, fat and muscle loss and increased protein catabolism due to underlying disease. The prevalence of cachexia is 16–42% in the heart failure population and is associated with a 50%, 18 month mortality risk independent of variables such as ejection fraction, age and functional ability. How is cachexia diagnosed? Chronic condition with >5% weight loss in <12 months; or body mass index (BMI) <20kg/m2; and 3 out of 5 additional criteria: 1) Fatigue, 2) Decreased muscle strength, 3) Anorexia, 4) Low muscle mass, 5) Abnormal biochemistry *Blood testing to diagnose cachexia in advanced stages of disease is not advocated. Reminder: Malnutrition also affects prognosis in patients with heart failure and is often found in early transitions of the disease. However this symptom management guideline will focus on the assessment and treatment of anorexia and cachexia. Approach to Managing Anorexia/Cachexia Assessment History: When did weight loss begin? How much weight was lost? Obtain baseline (dry) weight. How is [the patients] appetite? What do they eat or drink on a typical day? How has weight loss affected mood? Ask about: nausea, early satiety, dyspnea, poor oral hygiene, dysphagia, malabsorption, bowel habits. -
SINUSITIS AS a CAUSE of TONSILLITIS. by BEDFORD RUSSELL, F.R.C.S., Surgeon-In-Charge, Throat Departmentt, St
Postgrad Med J: first published as 10.1136/pgmj.9.89.80 on 1 March 1933. Downloaded from 80 POST-GRADUATE MEDICAL JOURNAL March, 1933 Plastic Surgery: A short course of lecture-demonstrations is being arranged, to be given at the Hammersmith Hospitar, by Sir Harold Gillies, Mr. MacIndoe and Mr. Kilner. Details will be circulated shortly. Technique of Operations: A series of demonstrations is being arranged. Details will be circulated shortly. Demonstrations in (Advanced) Medicine and Surgeryi A series of weekly demonstrations is being arranged. Details will be circulated shortly. A Guide Book, giving details of how to reach the various London Hospitals by tube, tram, or bus, can be obtained from the Fellowship. Price 6d. (Members and Associates, 3d.). SINUSITIS AS A CAUSE OF TONSILLITIS. BY BEDFORD RUSSELL, F.R.C.S., Surgeon-in-Charge, Throat Departmentt, St. Bart's Hospital. ALTHOUGH the existence of sinus-infection has long since been recognized, medical men whose work lies chiefly in the treatment of disease in the nose, throat and ear are frequently struck with the number of cases of sinusitis which have escaped recognition,copyright. even in the presence of symptoms and signs which should have given rise at least to suspicion of such disease. The explanation of the failure to recognize any but the most mlianifest cases of sinusitis lies, 1 think, in the extreme youth of this branch of medicine; for although operations upon the nose were undoubtedly performed thousands of years ago, it was not uintil the adoption of cocaine about forty years ago that it was even to examine the nasal cavities really critically. -
Influenza (PDF)
INFLUENZA Outbreaks of influenza, or “flu”, typically occur every winter. Colds may occur at any time of year with seasonal peaks occurring in fall and spring. Influenza is a respiratory illness usually caused by infection with one of two influenza viruses – influenza A or influenza B. Outbreaks of influenza (flu) typically occur every winter. Influenza is characterized by an abrupt onset of fever, chills, headache, body aches, and lack of energy accompanied by respiratory symptoms, most frequently cough and sore throat. Most people are largely recovered in one week, although many feel fatigued for several weeks. Serious complications of flu, such as pneumonia, however, can occur, especially if the body’s defenses are weakened by age or disease. Influenza is spread by inhaling the influenza virus which is usually carried on tiny, invisible water droplets in the air generated by coughs and sneezes. Hand-to-hand contact as well as contact with infected secretions on a hard surface may also cause transmission of the virus. Each year influenza viruses change and new vaccines are made to combat the particular strains that are expected to cause illness that year. The flu vaccine may reduce the chance of getting the flu by 60-80%, and lessen the severity of illness in the person who does get the flu. According to the Centers for Disease Control (CDC), everyone 6 months or order should get a yearly flu vaccine. The following people are at high risk for complications of flu and are especially urged to get vaccinated: Individuals with chronic heart or lung problems that have required regular medical follow-up or hospitalization during the last year. -
Bronchiolitis
Bronchiolitis What is bronchiolitis? Bronchiolitis is a viral infection of the lungs that usually affects infants. There is swelling in the smaller airways or bronchioles of the lung, which causes coughing and wheezing. Bronchiolitis is the most common reason for children under 1 year old to be admitted to the hospital. What are the symptoms of bronchiolitis? The following are the most common symptoms of bronchiolitis. However, each child may experience symptoms differently. Symptoms may include: Runny nose or nasal congestion Fever Cough Changes in breathing patterns (wheezing and breathing faster or harder are common) Decreased appetite Fussiness Vomiting What causes bronchiolitis? Bronchiolitis is a common illness caused by different viruses. The most common virus causing this infection is Respiratory Syncytial Virus (RSV). However, many other viruses can cause bronchiolitis including: Influenza, Parainfluenza, Rhinovirus, Adenovirus, and Human metapneumovirus. Initially, the virus causes an infection in the upper airways, and then spreads downward into the lower airways of the lungs. The virus causes swelling of the airways. Mucus is also produced in the airways. This narrowing of the airways can make it difficult for your child to breath, eat, or nurse. How is bronchiolitis diagnosed? Bronchiolitis is usually diagnosed on the history and physical examination of the child. Antibiotics are not helpful in treating viruses and are not needed to treat bronchiolitis. Because there is no cure for the disease, the goal of treatment is to make your child comfortable and to support their symptoms. This treatment may include suctioning to keep the airways clear, extra oxygen if the blood oxygen levels are low, or hydration if your child is not able to feed well. -
New Medical Treatments for Nasal Polyps
New Medical Treatments for Nasal Polyps February 7, 2020 Brian Modena, MD, MSc 1 Disclosures Research support: NHLBI‐Supported Researcher Self Care Catalysts: architect of Health StorylinesTM app Personal Fees: AstraZeneca, GSK, Regeneron, Sanofi 42nd Annual Pulmonary and Allergy Update Objectives 1. Discuss the epidemiology, biology, pathophysiology, and symptoms of CRS with nasal polyposis (CRSwNP). 2. Review treatment guidelines and recommendations for CRSwNP. 3. Review the many scoring systems used to evaluate CRSwNP. 4. Discuss in detail the Phase II and Phase III clinical trials using biologics for treatment of CRSwNP. Nasal Polyposis Epidemiology Prevalence = ~4%1; (CRS = ~11‐12%)2 Costs: Genetic inheritance = ~14% 2 Increases with age; peak ~50 years CRS = ~$8 billion/year Caucasians = Th2‐driven inflammation. Per patient per year: $13,000; Male to female = 2:1 $26,000 if surgery performed. Asians = Th1‐driven inflammation. Association with allergic rhinitis is weak. Surgeries/year = ~500,000 Disease Prevalence estimates 1. Hastan, Fokkens, et al, 2011 Allergic rhinitis Adult: 0.1%; Children 1.5%1 2. Lange, Holst, et al., Clin Otolaryngol 2013. 3. Mygind. JACI. 1990 Dec;86(6 Pt 1):827‐9. Asthma 5‐22% 4. Schleimer RP. Annu Rev Pathol. 2017;12:331‐57. 5. Hunter TD, DeConde AS, Manes RP. J Med Econ. 2018;21(6):610‐5. CRS 20‐25%1‐4 6. Palmer JN, Messina JC, Biletch R, et al. Allergy Asthma Proc. 2018;39:1‐9. NSAID intolerance 36‐72% 7. Pearlman AN, Chandra RK, Chang D, et al. Am J Rhinol Allergy. 2009;23(2):145‐8. NSAID intolerance and asthma 80% 8.