Background: Current phenotyping of chronic rhinosinusitis (CRS) into CRS with nasal polyps and without nasal polyps may not adequately reflect the pathophysiologic diversity within CRS.

This is the first European international multicentre prevalence study of CRS. In this multicentre survey of adults in Europe, about one in ten participants had CRS with marked geographical variation. Smoking was associated with having CRS in all parts of Europe.

Geographical variation in the prevalence of self-reported asthma was observed across Europe, but overall, self-reported asthma was more common in young adults, women and smokers. In all age groups, men and women, and irrespective of smoking behaviour, asthma was also associated with CRS.

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Background: Chronic rhinosinusitis (CRS) is a common yet under-recognised chronic inflammatory disease of the nose and paranasal sinuses that is classified according to the presence (CRSwNP) or absence (CRSsNP) of nasal polyps.Methods: This paper reports the methodology and descriptive results of the Global Allergy and Asthma European Network (GALEN) rhinosinusitis cohort. We established a large CRS cohort within the GALEN consortium (European FP6 research initiative) to identify inflammatory endotypes, the natural disease course, and its impact on health-related quality of life (HRQoL). Detailed information on the impact of CRS on HRQoL, comorbidity incidence, objective disease measures, and medical and surgical treatments were collected.Results: This multicentre cross-sectional case-control study recruited 935 adults (869 eligible for analysis: 237 CRSsNP; 445CRSwNP; 187 controls [reference group]). Comorbidities such as asthma, allergy, eczema, food allergy, urticaria, and chronic obstructive pulmonary disease were significantly more frequent in CRS patients. Nasal corticosteroids, antibiotics, and oral corticosteroids were the most common treatments. Significantly more CRSwNP patients reported previous sinonasal surgery. Conclusions:This study provides detailed information that facilitates studying CRS and its main phenotypes. However, patient distribution of this study does not necessarily reflect disease distribution in the general population.

Objective: To describe predictors of return to work after spinal cord injury (SCI), in particular the physical intensity of the pre-injury job. Study design: Survey. Setting: Patients' home. Methods: We interviewed 234 persons with a spinal cord injury (SCI) between 18 and 65 years of age and who were gainfully employed at the time of the injury. Possible predictors were tested with logistic regression analyses. Results: After the SCI, only 37% of the persons were gainfully employed. People with heavy and strenuous physical work pre-injury regained work in only 25%, respectively 21%. Being male (Odds Ratio (OR) 3.70), light to moderate physical job pre-injury (OR 3.16), high Barthel Index (OR 2.76), high educational level (OR 2.12) and education post-injury (OR 2.14) were signi®cant predictors for returning to gainful work after injury. Many unemployed persons thought they were capable of working. Conclusions: Only a minority returned to gainful employment after SCI even to a physically less demanding job. In addition to intensive inpatient re-education, long-term support in job seeking is very important, including switching to a less demanding job. Spinal Cord (2000) 38, 51 ± 55

We report for the first time that SE-IgE is common in the general population throughout Europe and that its risk factors differ from those of IgE against aeroallergens. This is the first study to show that SE-IgE is significantly and independently associated with asthma in the general population.

103Sinusitis 104 105 Conflicts of interest 106Jan Lötvall has received consultancy and speaker fees from AstraZeneca, GlaxoSmithKline, MSD/Merck, 107Novartis, and Schering-Plough. 109Author contributions 110PT, RN, RH, and DJ analyzed the data and wrote the manuscript. WF, CB, PB and DJ conceived and supervised 111 the study. All authors collected data and critically revised the manuscript. 113Body word count: 2673 114Page 3 of 17 Allergy 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 118in epidemiological studies, the definition is based on symptoms only. We aimed to assess the reliability and 119validity of a symptom based definition of CRS using data from the GA2LEN European survey. 120Methods: On two separate occasions, 1700 subjects from 11 centers provided information on symptoms of CRS, 121allergic rhinitis and asthma. CRS was defined by the epidemiological EP3OS symptom criteria. The difference in 122prevalence of CRS between two study points, the standardized absolute repeatability and the chance corrected 123 repeatability (kappa) were determined. In two centers 342 participants underwent nasal endoscopy. The 124 association of symptom-based CRS with endoscopy and self-reported doctor-diagnosed CRS was assessed. 125Results: There was a decrease in prevalence of CRS between the two study phases, and this was consistent 126across all centers (-3.0%, 95% CI: -5.0 to -1.0%, I 2 =0 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 160Study design 161In a first cross-sectional phase (the GA²LEN Survey), 11 participating centers sent a questionnaire by mail to a 162 random sample of at least 3000 subjects aged 15 to 75 years, with up to three attempts to elicit a response. 163Samples were identified by random sampling from a population based local sampling frame. 164The questionnaire was newly developed for the diagnosis of chronic rhinosinusitis ( (Table 1); additionally, subjects were asked if a doctor had ever told whether the subject had CRS 167(further referred to as 'self-reported doctor-diagnosed CRS'). Asthma was defined as reporting 'having ever had 168 asthma' and at least one of the following symptoms in the last 12 months: 1) wheeze or whistling in the chest; or 1692) waking up with chest tightness, shortness of breath or an attack of coughing. Allergic rhinitis was defined by 170 the self reported history of 'nasal allergy'. 171In a second phase (the GA²LEN Survey Follow-Up), each center invited 120 randomly selected subjects with 172 asthma, 120 with CRS, 40 with asthma and CRS and 120 with neither asthma or CRS for a clinical study visit 173with further investigations among which a questionnaire including the same questions as those describ...