Eosinophilic granulomatosis with polyangiitis (Churg-Strauss, EGPA) is a systemic small-to-medium-sized vasculitis associated with asthma and eosinophilia. Histologically EGPA presents tissue eosinophilia, necrotizing vasculitis, and granulomatous inflammation with eosinophil tissue infiltration. EGPA commonly involves the upper airway and lung parenchyma, peripheral neuropathy, cardiac disorders, and skin lesions. The anti-neutrophil cytoplasmic antibodies (ANCA) are positive in 40% of cases, especially in those patients with clinical signs of vasculitis. The pathogenesis of EGPA is multifactorial. The disease can be triggered by exposure to a variety of allergens and drugs, but a genetic background has also been described, particularly an association with HLA-DRB4. Th2 response is of special importance in the upregulation of different interleukins such as IL-4, IL-13, and IL-5. Th1 and Th17 responses are also of significance. Activated eosinophils have a prolonged survival and probably cause tissue damage by releasing eosinophil granule proteins, while their tissue recruitment can be regulated by chemokines such as eotaxin-3 and CCL17. Humoral immunity is also OPEN ACCESSSinusitis 2016, 1 25 abnormally regulated, as demonstrated by excessive responses of IgG4 and IgE. EGPA has a good respond to glucocorticoids, although the combination of glucocorticoids and immunosuppressants (e.g., cyclophosphamide, azathioprine) is needed in most of cases. Newer treatment options include anti-IL-5 antibodies (mepolizumab), whose efficacy has been described in clinical trials, and anti-CD-20, a B cell-depleting agent (rituximab), reported in several case series.
Download Endoscopic Approaches to the Paranasal Sinuses and Skull Base 1st Edition Pdf For Free https://smtebooks.us/book/11864/endoscopic-approaches-pdf ...the authors do an excellent job of transforming this subject matter into an intelligible and understandable read...The true highlight of this textbook is the focus on the anatomy and anatomical landmarks of each approach...The numerous illustrations are superb...-Annals of Otology, Rhinology & Laryngology Key individuals dedicated to the effective and safe application of skull base surgery techniques over the past 2 decades have provided the foundation for this excellent textbook.-Neurosurgery With the continuing evolution of endoscopic techniques for surgery of lesions of the paranasal sinuses and skull base, and the reduced morbidity associated with this minimally invasive modality, the method has gained widespread use in recent years. This work offers a thorough review of all endoscopic approaches for access to the nose and paranasal sinuses and, through them, to the skull base. Central to this guide is the emphasis on profound knowledge of the complex anatomy in this area, as well as the many vital structures that can be endangered there. To this end, more than 900 full-color images, most photographs from cadaver dissections, are put to brilliant use.
skriver: This atlas offers a complete review of all endoscopic approaches available for the repair of nasoseptal perforations, following damage that may occur through trauma, infection, drug abuse, or as a result of endoscopic skull base surgery. Approaches are explained step by step using brilliant photographs from fresh cadaver dissections. Key Features: Internationally renowned specialists from Europe and the United States as editors and contributors Full-color photos of fresh cadaver dissections illustrate all steps for each approach Specific anatomic landmarks as revealed during each step are detailed, providing confidence in spatial orientation Includes risks and potential complications as well as methods to reduce them Videos of cadaver dissections and live surgery Nasoseptal Perforations: Endoscopic Repair Techniques will be an important resource for residents, fellows, and surgeons in otolaryngology, plastic and reconstructive surgery, and craniomaxillofacial surgery.
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