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Recurrent ENT infections in children – is it a sign of primary immunodeficiency disease?

ENT clinicians often come across children with recurrent ear, sinus and pulmonary infections. These recurrent infections, albeit common in childhood, can represent an early sign of primary immunodeficiency diseases (PIDD). PIDD is an underdiagnosed group of genetic disorders involving absent...

CRSwNP and smell – is it just the obstruction?

Anosmia and hyposmia are symptoms of CRS both with and without nasal polyps and can significantly affect quality of life. The nature of anosmia/hyposmia is thought to be both sensory-neural and conductive. These authors studied a mouse model in which...

A trial of house dust mite sublingual tablet in children with allergic rhinitis

The house dust mite (HDM) is one of the commonest causative agents in allergic rhinitis (AR), affecting patients across all demographics. Recently, sublingual immunotherapy (SLIT) has been shown in clinical trials and meta-analysis to be effective compared to placebo in...

Recurrent seroma in cochlear implanted patients

Little is known about why some patients experience recurrent seromas over the implant package and in the absence of any cause, antibiotics are frequently prescribed as a precaution to protect the implant from infection. A tertiary referral centre selected five...

The hippo and the nose

Chronic rhinosinusitis with nasal polyps (CRSwNP) leads to histological changes including thickening of the basilar membrane and epithelial proliferation. Molecular mechanisms underlying these changes are still not fully clear. A signalling pathway called the hippo with Yes‐associated protein (YAP) as...

Allergic rhinitis, the usual suspects

Allergic rhinitis (AR) is characterised by allergen binding to IgE on mast cells and basophils and subsequent histamine, prostaglandine D2 (PGD2) and cysteinyl leukotrienes (cysLTs) release causing early-phase response. This is followed by late-phase response mediated by eosinophils. Other cells,...

The polyp shrinker

Inflammatory markers, including T2 cells beta common (βc) cytokines IL-3, IL5 and granulocyte-macrophage colony-stimulating factor (GM-CSF), are known to play an important role in chronic rhinosinusitis with nasal polyps (CRSwNP). CSL311, a monoclonal antibody (mAb), was developed to target human...

An advance in imaging for sinonasal tumours?

Benign sinonasal growths are incredibly common, and malignant sinonasal growths thankfully rare. We know that malignant tumours often present late, and the imaging can sometimes be misleading, so the authors here compare using diffusion weighted imaging (DWI), dynamic contrast enhanced...

Does pollution worsen inflammatory nasal problems?

This ambitious study, conducted over a period of four years, assessed 27,863 patients and compared levels of allergic rhinitis (AR) or chronic rhinosinusitis (CRS) with the levels of air pollution recorded, as assessed by levels of particulate matter (PM10). They...

A new treatment for smell loss?

It has been well established that smell training can be effective in the recovery of smell function post Covid-19 infection, and many other treatment modalities have been assessed. There have been limited studies to date evaluating the effects of dietary...

Not the answer yet, but it may be in the future

AI is certainly a topical issue these days and radiomics refers to techniques which allow the extraction of quantitative features from medical imaging to produce large data sets for clinical problem solving. This paper looks at CT imaging of the...

Early recognition aiding better prognosis?

As we are all aware, acute invasive fungal rhinosinusitis (AIFR) is a life-threatening disease which typically affects immunocompromised patients. It is diagnosed via typical signs, symptoms and presentation but gold standard is by biopsy of tissues demonstrating infiltration fungal hyphae....