Acute bacterial rhinosinusitis is the mucosal inflammation of the nose and paranasal sinuses caused by bacteria lasting ≥10 days for up to 4 weeks with no clinical improvement, severe signs or symptoms [eg high fever (39°C), purulent nasal discharge, facial pain] of ≥3-4 consecutive days, and worsening of symptoms within 10 days after initial improvement.
It is often preceded by a viral upper respiratory tract infection, rhinitis or other conditions that impair local or systemic immune function (eg nonallergic rhinitis, dental infection, mechanical obstruction of the nose, cystic fibrosis, ciliary dysfunction, immunodeficiency that impair the sinus drainage).
Signs and symptoms are nonspecific and typically difficult to differentiate from viral upper respiratory tract infection.
There is fever with nasal obstruction/congestion or anterior and/or posterior purulent drainage, with or without facial pressure/pain/fullness and reduction/loss of smell. Streptococcus pneumoniae and unencapsulated strains of Haemophilus influenzae cause half of acute rhinosinusitis cases.
Dupilumab significantly improves all disease components of severe, uncontrolled chronic rhinosinusitis with nasal polyps (CRSwNP) — a primarily type 2 inflammatory condition — compared with placebo when both are added to standard of care. Furthermore, the treatment benefit extends to even patients with comorbid nonsteroidal anti-inflammatory drug-exacerbated respiratory disease (NSAID-ERD), according to a pooled analysis of the LIBERTY NP SINUS-24 and -52* trials presented at ERS 2019.
A large number of patients who present at outpatient clinics with symptoms of acute respiratory infections (ARIs) during influenza seasons are prescribed antibiotics despite not needing them, a finding that highlights the overuse of antibiotics in ARIs, a recent study showed.
Children who undergo adenoidectomy, tonsillectomy, or both (adenotonsillectomy) within the first 9 years of life may have an elevated long-term risk of respiratory, allergic, or infectious diseases, results from a Denmark-based study show.
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Routinely used for treating cardiovascular diseases, statins have been shown to benefit other conditions, and new evidence suggests that using the drug at high intensity reduces the risk of hip or knee replacement, an effect that may be specific to rheumatoid arthritis.
Having migraine during midlife appears to be associated with a higher risk of developing dementia in later life, according to a large population-based longitudinal Danish study presented at the AHS* 2020 Virtual Meeting, indicating that migraine may be a risk factor for dementia.
Upadacitinib may be a suitable treatment for patients with active psoriatic arthritis (PsA) who have insufficient response to non-biologic disease-modifying anti-rheumatic drugs (non-bDMARDs), according to results of the phase III SELECT-PsA-1* trial presented at EULAR 2020.