Entering a new era of Predictive Medicine in Rhinology

Hellings, Peter

doi:10.4193/rhin18.402

Cited by 4 publications

(4 citation statements)

References 11 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Predicting the development and prognosis of chronic rhinosinusitis with nasal polyps (CRSwNP) remains a real challenge . In Western countries, there are more cases of eosinophilic CRSwNP (sustained by T‐helper 2 inflammation) than of the non‐eosinophilic variant, whereas in Asia, the 2 histotypes seem to be equally represented .…”

mentioning

confidence: 99%

Histopathological and hematological changes in recurrent nasal polyposis

Brescia

Alessandrini

Zanotti

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

Background There is a dearth of information regarding the histological and hematological differences between primary and recurrent chronic rhinosinusitis with nasal polyps (CRSwNP). The present study analyzed the histological changes in recurrent CRSwNP in terms of eosinophilic infiltrate, subepithelial edema, goblet cell hyperplasia, and basement membrane thickness. Blood levels of eosinophils and basophils were also measured prior to surgery on both primary and recurrent disease. Methods Thirty‐two consecutive adult patients with nasal polyposis treated with primary surgery who subsequently underwent revision surgery were retrospectively enrolled. Results At primary surgery, a significant positive correlation (all p < 0.05) emerged between all histopathological parameters, and between tissue eosinophil and blood eosinophil counts. A positive correlation between subepithelial edema scores and blood basophil levels (p < 0.025) also came to light. At revision surgery, only basement membrane thickness correlated positively with: (1) tissue eosinophil count; and (2) goblet cell hyperplasia (both p = 0.001). In recurrent disease, there was again a positive correlation between eosinophil counts in tissue and blood (p < 0.05). The mean tissue eosinophil count in recurrent CRSwNP was significantly lower than in the primary disease (p < 0.001). Conclusion Our preliminary results support the hypothesis that tissue remodeling due to surgical and medical treatments for CRSwNP is a dynamic process involving important differences in tissue eosinophil counts between primary and recurrent CRSwNP. How tissue remodeling evolves after CRSwNP treatment warrants further investigation, not only in larger series of patients, but also after stratifying patients by the time elapsing since their treatment.

show abstract

mentioning

confidence: 99%

Histopathological and hematological changes in recurrent nasal polyposis

Brescia

Alessandrini

Zanotti

et al. 2019

Int Forum Allergy Rhinol

View full text Add to dashboard Cite

show abstract

“…The patient‐centered strategies that can maximize population compliance within an active OA setting to more predictably reach treatment endpoints need to be developed and integrated within clinical best practice standards. Population compliance can be significantly enhanced through the future integration of precision health concepts within the spectrum of sino‐allergy disease, a center‐of‐excellence model that combines disease prediction and prevention, classification, treatment, and monitoring in an integrated clinical best practice of measurable outcomes …”

Section: Discussionmentioning

confidence: 99%

“…Population compliance can be significantly enhanced through the future integration of precision health concepts within the spectrum of sino-allergy disease, a center-of-excellence model that combines disease prediction and prevention, classification, treatment, and monitoring in an integrated clinical best practice of measurable outcomes. [61][62][63]…”

Section: Future Value-based Healthcare: Sino-allergy Medical Homementioning

confidence: 99%

Contemporary analysis of otolaryngic allergy

et al. 2019

View full text Add to dashboard Cite

Objectives Investigate the current trends in otolaryngic allergy (OA). Study Design Cross‐sectional survey. Methods Survey of active AAOA membership. Results Response rate was 27.3%. Regional response distribution rates were proportional to the AAOA membership distribution within the United States (R2 = 0.95; P < 0.001), with no significant regional response bias demonstrated (P = 0.428). Self‐reported duration to OA competency was 5.8 years. Physicians reporting OA competency were more likely to be board‐certified (P < 0.001) and have AAOA fellowship status (P < 0.001). The AAOA was reported to be the most valuable educational resource toward achieving OA competency, with residency training being least valuable (P < 0.001). 91.5% of respondents’ practices offered OA services. Subcutaneous injections predominated at twice the utilization of sublingual immunotherapy. Allergy immunotherapy tablets were rarely utilized. Home allergy shots were offered by 45.2% of respondents. In‐office immunotherapy vial compounding was preferred (95.8%) to third‐party vendors. 94% of AAOA respondents identified patient compliance to be an issue within OA. Non‐inhalant allergy service integration included food allergy (63.5%), asthma (44.9%), allergic fungal sinusitis (43.8%), penicillin allergy (18%), stinging insect allergy (12.6%), and aspirin desensitization (3.9%). Conclusion Reported duration to OA competency after residency was surprisingly long. Further investigation of current and future educational/clinical training is warranted given clinical integration reported for OA. Otolaryngology is in the unique position to develop a comprehensive sino‐allergy evidence‐based strategy integrating the extensive diagnostic and medical treatment arms alongside the surgical expertise of the specialty within a clinical sino‐allergy home concept. Level of Evidence 5 Laryngoscope, 130:283–289, 2020

show abstract

“…Given the expansion of therapeutic options for CRS beyond surgery and corticosteroids (CS), 11,12 patients with CRS might benefit from a more personal approach, with preventive actions, participation in the elaboration of and decision on the therapeutic plan and with information on the prediction of success of each of the proposed treatment options. In that context, the principles of precision medicine are implemented in CRS care 13 and applicable to all patients without major efforts from the physician or additional costs. 14 In the context of endoscopic sinus surgery, significant progress has been made over the past 2 decades with better and optimized instruments, better postoperative care with a more personalized follow-up and drug-eluting stents, and a 3-dimensional navigation system for image-guided surgery.…”

Section: Strengthsmentioning

confidence: 99%

SWOT Analysis of Chronic Rhinosinusitis Care Anno 2022

Hellings

2022

The Journal of Allergy and Clinical Immunology: In Practice

View full text Add to dashboard Cite

Entering a new era of Predictive Medicine in Rhinology

Cited by 4 publications

References 11 publications

Histopathological and hematological changes in recurrent nasal polyposis

Histopathological and hematological changes in recurrent nasal polyposis

Contemporary analysis of otolaryngic allergy

SWOT Analysis of Chronic Rhinosinusitis Care Anno 2022

Contact Info

Product

Resources

About