scholarly journals Rhinology in review: from COVID-19 to biologicals

2021 ◽  
Vol 0 (0) ◽  
pp. 0-0
Author(s):  
W.J. Fokkens ◽  
B.N. Landis ◽  
C. Hopkins ◽  
S. Reitsma ◽  
A.R. Sedaghat
Keyword(s):  
Meta Analysis ◽  
Large Body ◽  
Olfactory Dysfunction ◽  
Upper Respiratory Tract ◽  
Chronic Rhinitis ◽  
The Mean ◽  
Upper Respiratory ◽  
Definition Of ◽  
Tract Infections

We look back at the end of what soon will be seen as an historic year, from COVID-19 to real-world introduction of biologicals influencing the life of our patients. This review describes the important findings in Rhinology over the past year. A large body of evidence now demonstrates loss of sense of smell to be one of the most common symptoms of COVID-19 infection; a meta-analysis of 3563 patients found the mean prevalence of self-reported loss to be 47%. A number of studies have now shown long-term reduced loss of smell and parosmia. Given the high numbers of people affected by COVID-19, even with the best reported recovery rates, a significant number worldwide will be left with severe olfactory dysfunction. The most prevalent causes for olfactory dysfunction, besides COVID-19 and upper respiratory tract infections in general, are trauma and CRSwNP. For these CRSwNP patients a bright future seems to be starting with the development of treatment with biologics. This year the Nobel prize in Medicine 2021 was awarded jointly to David Julius and Ardem Patapoutian for their discoveries of receptors for temperature and touch which has greatly enhanced our understanding of nasal hyperreactivity and understanding of intranasal trigeminal function. Finally, a new definition of chronic rhinitis has been proposed in the last year and we have seen many papers emphasizing the importance of endotyping patients in chronic rhinitis and rhinosinusitis in order to optimise treatment effect.

Effects of procalcitonin testing on antibiotic use and clinical outcomes in patients with upper respiratory tract infections. An individual patient data meta-analysis

2017 ◽  
Vol 56 (1) ◽  
Author(s):  
Jonas Odermatt ◽  
Natalie Friedli ◽  
Alexander Kutz ◽  
Matthias Briel ◽  
Heiner C. Bucher ◽  
...  
Keyword(s):  
Respiratory Tract ◽  
Antibiotic Therapy ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Antibiotic Exposure ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Restricted Activity ◽  
Tract Infections

AbstractBackground:Several trials found procalcitonin (PCT) helpful for guiding antibiotic treatment in patients with lower respiratory tract infections and sepsis. We aimed to perform an individual patient data meta-analysis on the effects of PCT guided antibiotic therapy in upper respiratory tract infections (URTI).Methods:A comprehensive search of the literature was conducted using PubMed (MEDLINE) and Cochrane Library to identify relevant studies published until September 2016. We reanalysed individual data of adult URTI patients with a clinical diagnosis of URTI. Data of two trials were used based on PRISMA-IPD guidelines. Safety outcomes were (1) treatment failure defined as death, hospitalization, ARI-specific complications, recurrent or worsening infection at 28 days follow-up; and (2) restricted activity within a 14-day follow-up. Secondary endpoints were initiation of antibiotic therapy, and total days of antibiotic exposure.Results:In total, 644 patients with a follow up of 28 days had a final diagnosis of URTI and were thus included in this analysis. There was no difference in treatment failure (33.1% vs. 34.0%, OR 1.0, 95% CI 0.7–1.4; p=0.896) and days with restricted activity between groups (8.0 vs. 8.0 days, regression coefficient 0.2 (95% CI –0.4 to 0.9), p=0.465). However, PCT guided antibiotic therapy resulted in lower antibiotic prescription (17.8% vs. 51.0%, OR 0.2, 95% CI 0.1–0.3; p<0.001) and in a 2.4 day (95% CI –2.9 to –1.9; p<0.001) shorter antibiotic exposure compared to control patients.Conclusions:PCT guided antibiotic therapy in the primary care setting was associated with reduced antibiotic exposure in URTI patients without compromising outcomes.

scholarly journals Immunological Outcomes of Bovine Colostrum Supplementation in Trained and Physically Active People: A Systematic Review and Meta-Analysis

Nutrients ◽  
2020 ◽  
Vol 12 (4) ◽  
pp. 1023
Author(s):  
Natalia Główka ◽  
Krzysztof Durkalec-Michalski ◽  
Małgorzata Woźniewicz
Keyword(s):  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Bovine Colostrum ◽  
Upper Respiratory Tract ◽  
Physically Active ◽  
Active Population ◽  
Upper Respiratory ◽  
Randomised Controlled ◽  
Tract Infections ◽  
Active Adults

Bovine colostrum (BC) is a promising natural product applied to improve immunological functions. However, there is very little evidence on the true benefits of BC treatment on the immune function of trained and physically active people; moreover, there is no consensus on the supplementation strategy. For this reason, the aim of this meta-analysis was to quantify the effects of BC supplementation on immunological outcomes in physically active people. Data from 10 randomised controlled trials (RCTs) investigating the effect of BC supplementation in athletes and physically active adults were analysed, involving 239 participants. The results show that BC supplementation has no or a fairly low impact on improving the concentration of serum immunoglobulins (IgA, IgG), lymphocytes and neutrophils, and saliva immunoglobulin (IgA) in athletes and physically active participants. Previous research has shown BC to reduce upper respiratory tract infections; nevertheless, there is a gap of scientific knowledge on the mechanisms underlying these effects. Future RCTs are needed to focus on finding these mechanisms, as well as on preparing a clear consensus on a BC supplementation strategy in trained athletes and the physically active population.

scholarly journals Probiotics Effect on the Immune System

2020 ◽  
Author(s):  
Jonathan Cho Kin Ng
Keyword(s):  
Immune System ◽  
Respiratory Tract Infections ◽  
Average Duration ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

Background: Probiotics can provide health benefits to an individual by regulation of the immune system. Many clinical trials have found that probiotics can prevent upper respiratory tracts infections. Aim: To perform a systematic review and meta-analysis of available trials to investigate the effectiveness of probiotics in the prevention of upper respiratory tract infections in individuals of all ages. Conclusion: Probiotics were found to be better in reducing the number of participants who experienced acute URTI, the average duration per episode of acute URTI, use of antibiotics in URTI related cases and absence due to URTI. Side effects were found to be minor, making probiotics a good candidate for clinical use. This shows that probiotics are effective in preventing acute URTIs. However, due to limited studies and small sample size, the results are subjected to bias and should be interpreted with care.

Safety and Tolerability of 60 Weeks' Extended Efalizumab Therapy in Patients with Chronic Moderate to Severe Plaque Psoriasis

2007 ◽  
Vol 13a (1) ◽  
pp. 28-33
Author(s):  
Alice B. Gottlieb ◽  
Tiffani K. Hamilton ◽  
Ivor Caro ◽  
Peter Compton ◽  
Craig L. Leonardi
Keyword(s):  
Safety Profile ◽  
Respiratory Tract Infections ◽  
Safety Data ◽  
Acute Type ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections ◽  
Term Maintenance ◽  
Common Infections

The chronic nature of psoriasis calls for long-term maintenance of control; thus, it is important to understand the long-term safety profile of effective therapies. We present long-term safety data for the T-cell inhibitor efalizumab in the treatment of moderate to severe psoriasis. To further assess the safety profile of efalizumab over extended therapy periods, we evaluated pooled results from 1,004 patients enrolled in two studies where patients were to be treated for 60 weeks. The most frequently observed adverse events (AEs) were acute-type AEs, predefined as headache, fever, chills, nausea, vomiting and myalgia occurring within 48 hours of efalizumab dosing. The rate of infection was comparable to rates reported in other efalizumab trials. The most common infections were colds and upper respiratory tract infections. The incidence of malignancy was <1% in any 12-week period. These studies demonstrate that the safety profile for efalizumab is maintained for up to 60 weeks.

scholarly journals Effectiveness of honey for symptomatic relief in upper respiratory tract infections: a systematic review and meta-analysis

2020 ◽  
pp. bmjebm-2020-111336 ◽  
Author(s):  
Hibatullah Abuelgasim ◽  
Charlotte Albury ◽  
Joseph Lee
Keyword(s):  
Systematic Review ◽  
Antimicrobial Resistance ◽  
Respiratory Tract ◽  
Respiratory Tract Infections ◽  
Meta Analysis ◽  
Symptomatic Relief ◽  
Upper Respiratory Tract Infections ◽  
Upper Respiratory Tract ◽  
Upper Respiratory ◽  
Tract Infections

BackgroundAntibiotic over prescription for upper respiratory tract infections (URTIs) in primary care exacerbates antimicrobial resistance. There is a need for effective alternatives to antibiotic prescribing. Honey is a lay remedy for URTIs, and has an emerging evidence base for its use. Honey has antimicrobial properties, and guidelines recommended honey for acute cough in children.ObjectivesTo evaluate the effectiveness of honey for symptomatic relief in URTIs.MethodsA systematic review and meta-analysis. We searched Pubmed, Embase, Web of Science, AMED, Cab abstracts, Cochrane Library, LILACS, and CINAHL with a combination of keywords and MeSH terms.ResultsWe identified 1345 unique records, and 14 studies were included. Overall risk of bias was moderate. Compared with usual care, honey improved combined symptom score (three studies, mean difference −3.96, 95% CI −5.42 to −2.51, I2=0%), cough frequency (eight studies, standardised mean difference (SMD) −0.36, 95% CI −0.50 to −0.21, I2=0%) and cough severity (five studies, SMD −0.44, 95% CI −0.64 to −0.25, I2=20%). We combined two studies comparing honey with placebo for relieving combined symptoms (SMD −0.63, 95% CI −1.44 to 0.18, I2=91%).ConclusionsHoney was superior to usual care for the improvement of symptoms of upper respiratory tract infections. It provides a widely available and cheap alternative to antibiotics. Honey could help efforts to slow the spread of antimicrobial resistance, but further high quality, placebo controlled trials are needed.PROSPERO registration NoStudy ID, CRD42017067582 on PROSPERO: International prospective register of systematic reviews (https://www.crd.york.ac.uk/prospero/).

scholarly journals Probiotics Effect on the Immune System

2020 ◽  
Author(s):  
Jonathan Cho Kin Ng
Keyword(s):  
Immune System ◽  
Respiratory Tract Infections ◽  
Average Duration ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Small Sample ◽  
Upper Respiratory Tract ◽  
System P ◽  
Upper Respiratory ◽  
Tract Infections

Background: Probiotics can provide health benefits to an individual by regulation of the immune system. Many clinical trials have found that probiotics can prevent upperrespiratory tracts infections.Aim: To perform a systematic review and meta-analysis of available trials to investigate the effectiveness of probiotics in the prevention of upper respiratory tract infections in individuals of all ages.Conclusions: Probiotics were found to be better in reducing the number of participants who experienced acute URTI, the average duration per episode of acute URTI, use of antibiotics in URTI related cases and absence due to URTI. Side effects were found to be minor, making probiotics a good candidate for clinical use. This shows that probiotics are effective in preventing acute URTIs. However, due to limited studies and small sample size, the results are subjected to bias and should be interpreted with care.

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