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Introduction Bacterial biofilms have been implicated in the pathogenesis of Chronic Rhinosinusitis (CRS). This thesis consists of a number of separate studies. The results of each study were designed to help provide an evolution of knowledge that could be applied to our subsequent investigations on the topic of bacterial biofilms and chronic rhinosinusitis. In vitro studies were utilized to document the capacity of CRS bacteria to form biofilms as well as to investigate the efficacy of various antimicrobials at high concentrations. Additionally, an in vivo sheep model was developed to examine different biofilm detection techniques. Finally, a study of CRS patients was conducted to investigate the incidence of biofilm related sinus disease. Methods Our in vitro studies used 96 well crystal violet microtiter plate assays to determine the biofilm growth characteristics of S.aureus isolated from patients with CRS. Established biofilms were then subjected various antimicrobial agents, and the degree of biofilm reduction calculated to examine their potential for sinus biofilm treatment. A sheep sinusitis model involved performing endoscopic sinus surgery, occlusion of frontal sinus ostia and the introduction of bacteria. Mucosal specimens were subsequently examined for the presence of bacterial biofilms using transmission electron microscopy (TEM), scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). CSLM was also used in a prospective study to document the presence bacterial biofilms on the mucosa of patients with CRS compared to controls. Results The findings of in vitro experiments revealed that not all isolates were capable of forming biofilms. Of the antibiotics tested, only Mupirocin was capable of reducing biofilm mass by 90% in all isolates. The animal model showed considerable variation in biofilm detection rates. The CSLM biofilm detection rate was 100% in obstructed sinuses with bacteria introduced, whereas TEM detected only 66%. Both these objective measures failed to identify biofilms in control groups. SEM found biofilms in all experimental groups including controls. CSLM analysis of CRS patients found Bacterial biofilms in 44% and no biofilms in controls. Conclusion The demonstration of biofilms in the sheep model for sinusitis and biofilms on the mucosal specimens of patients with CRS, and the ability of bacteria in CRS to form biofilms in vitro, further supports the hypothesis that biofilms play a role in the pathogenesis of CRS. CSLM is the modality of choice in documenting the presence of bacterial biofilms on sinus mucosal surfaces due to the inherent flaws of sampling error and subjectivity of TEM and SEM. Finally, CRS is a multi-factorial disease, topical Mupirocin via nasal irrigation may be a therapeutic option in patients with likely S.aureus biofilms. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367183 / Thesis (M.S.) - University of Adelaide, School of Medicine, 2009

Introduction Bacterial biofilms have been implicated in the pathogenesis of Chronic Rhinosinusitis (CRS). This thesis consists of a number of separate studies. The results of each study were designed to help provide an evolution of knowledge that could be applied to our subsequent investigations on the topic of bacterial biofilms and chronic rhinosinusitis. In vitro studies were utilized to document the capacity of CRS bacteria to form biofilms as well as to investigate the efficacy of various antimicrobials at high concentrations. Additionally, an in vivo sheep model was developed to examine different biofilm detection techniques. Finally, a study of CRS patients was conducted to investigate the incidence of biofilm related sinus disease. Methods Our in vitro studies used 96 well crystal violet microtiter plate assays to determine the biofilm growth characteristics of S.aureus isolated from patients with CRS. Established biofilms were then subjected various antimicrobial agents, and the degree of biofilm reduction calculated to examine their potential for sinus biofilm treatment. A sheep sinusitis model involved performing endoscopic sinus surgery, occlusion of frontal sinus ostia and the introduction of bacteria. Mucosal specimens were subsequently examined for the presence of bacterial biofilms using transmission electron microscopy (TEM), scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). CSLM was also used in a prospective study to document the presence bacterial biofilms on the mucosa of patients with CRS compared to controls. Results The findings of in vitro experiments revealed that not all isolates were capable of forming biofilms. Of the antibiotics tested, only Mupirocin was capable of reducing biofilm mass by 90% in all isolates. The animal model showed considerable variation in biofilm detection rates. The CSLM biofilm detection rate was 100% in obstructed sinuses with bacteria introduced, whereas TEM detected only 66%. Both these objective measures failed to identify biofilms in control groups. SEM found biofilms in all experimental groups including controls. CSLM analysis of CRS patients found Bacterial biofilms in 44% and no biofilms in controls. Conclusion The demonstration of biofilms in the sheep model for sinusitis and biofilms on the mucosal specimens of patients with CRS, and the ability of bacteria in CRS to form biofilms in vitro, further supports the hypothesis that biofilms play a role in the pathogenesis of CRS. CSLM is the modality of choice in documenting the presence of bacterial biofilms on sinus mucosal surfaces due to the inherent flaws of sampling error and subjectivity of TEM and SEM. Finally, CRS is a multi-factorial disease, topical Mupirocin via nasal irrigation may be a therapeutic option in patients with likely S.aureus biofilms. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367183 / Thesis (M.S.) - University of Adelaide, School of Medicine, 2009

Introduction Bacterial biofilms have been implicated in the pathogenesis of Chronic Rhinosinusitis (CRS). This thesis consists of a number of separate studies. The results of each study were designed to help provide an evolution of knowledge that could be applied to our subsequent investigations on the topic of bacterial biofilms and chronic rhinosinusitis. In vitro studies were utilized to document the capacity of CRS bacteria to form biofilms as well as to investigate the efficacy of various antimicrobials at high concentrations. Additionally, an in vivo sheep model was developed to examine different biofilm detection techniques. Finally, a study of CRS patients was conducted to investigate the incidence of biofilm related sinus disease. Methods Our in vitro studies used 96 well crystal violet microtiter plate assays to determine the biofilm growth characteristics of S.aureus isolated from patients with CRS. Established biofilms were then subjected various antimicrobial agents, and the degree of biofilm reduction calculated to examine their potential for sinus biofilm treatment. A sheep sinusitis model involved performing endoscopic sinus surgery, occlusion of frontal sinus ostia and the introduction of bacteria. Mucosal specimens were subsequently examined for the presence of bacterial biofilms using transmission electron microscopy (TEM), scanning electron microscopy (SEM) and confocal scanning laser microscopy (CSLM). CSLM was also used in a prospective study to document the presence bacterial biofilms on the mucosa of patients with CRS compared to controls. Results The findings of in vitro experiments revealed that not all isolates were capable of forming biofilms. Of the antibiotics tested, only Mupirocin was capable of reducing biofilm mass by 90% in all isolates. The animal model showed considerable variation in biofilm detection rates. The CSLM biofilm detection rate was 100% in obstructed sinuses with bacteria introduced, whereas TEM detected only 66%. Both these objective measures failed to identify biofilms in control groups. SEM found biofilms in all experimental groups including controls. CSLM analysis of CRS patients found Bacterial biofilms in 44% and no biofilms in controls. Conclusion The demonstration of biofilms in the sheep model for sinusitis and biofilms on the mucosal specimens of patients with CRS, and the ability of bacteria in CRS to form biofilms in vitro, further supports the hypothesis that biofilms play a role in the pathogenesis of CRS. CSLM is the modality of choice in documenting the presence of bacterial biofilms on sinus mucosal surfaces due to the inherent flaws of sampling error and subjectivity of TEM and SEM. Finally, CRS is a multi-factorial disease, topical Mupirocin via nasal irrigation may be a therapeutic option in patients with likely S.aureus biofilms. / http://proxy.library.adelaide.edu.au/login?url= http://library.adelaide.edu.au/cgi-bin/Pwebrecon.cgi?BBID=1367183 / Thesis (M.S.) - University of Adelaide, School of Medicine, 2009

Tez (Tıpta Uzmanlık) - Süleyman Demirel Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, 2001. / Bibliyografya var.

Tez (Tıpta Uzmanlık)--Süleyman Demirel Üniversitesi, Tıp Fakültesi, Kulak Burun Boğaz Anabilim Dalı, 2004. / Bibliyografya var.

Σκοπός της παρούσας μελέτης ήταν η διερεύνηση της εξωκυττάριας συγκέντρωσης και του βαθμού διεισδυτικότητας των νεότερων μακρολίδων στο υγρό περιεχόμενο του ιγμορείου άντρου, εντός των πρώτων 24 ωρών από την χορήγηση σε ασθενείς με οξεία παραρρινοκολπίτιδα, χρησιμοποιώντας ως μοντέλα την κλαριθρομυκίνη και αζιθρομυκίνη. Σε 36 ασθενείς με οξεία ιγμορίτιδα συλλέχθηκαν δείγματα υγρού από το ιγμόρειο άντρο και ορού αίματος 2,4,6,8 και 12 ώρες ή 2,6,12 και 24 ώρες μετά την χορήγηση τριών δόσεων ρ.ο. κλαριθρομυκίνης 500 mg δις ημερησίως ή δύο δόσεων ρ.ο. αζιθρομυκίνης 500 mg άπαξ ημερησίως αντίστοιχα. Οι συγκεντρώσεις των φαρμάκων στα δυο βιολογικά υγρά προσδιορίσθηκαν με την υγρή χρωματογραφία υψηλής απόδοσης με φθοριομετρική ανίχνευση, ενώ επίσης εκτιμήθηκε το pH σε όλα τα δείγματα υγρού παραρρίνιων. Η μέση συγκέντρωση κλαριθρομυκίνης στο υγρό παραρρίνιων κόλπων ήταν σημαντικά υψηλότερη από την αντίστοιχη της αζιθρομυκίνης (2,47 mg/l έναντι 0,65 mg/l), ενώ ο μέσος βαθμός διεισδυτικότητας στο υγρό του ιγμόρειου άντρου,εκφρασμένος ως η αναλογία των συγκεντρώσεων φαρμάκου στον ιστό και στον ορό αίματος, ήταν παρόμοια για τα δύο αντιβιοτικά (115 % και 120% αντίστοιχα). Σε ασθενείς με οξεία παραρρινοκολπίτιδα, η κλαριθρομυκίνη και η αζιθρομυκίνη παρουσιάζουν επαρκή διεισδυτικότητα στο υγρό του ιγμόρειου άντρου για την εκρίζωση στελεχών streptococcus pneumoniae ευαίσθητων στην ερυθρομυκίνη. Με βάση τις συγκρίσιμες δραστικότητες τους in vitro, την επίδραση του pH του υγρού του ιγμόρειου άντρου και το προφίλ διεισδυτικότητας στο συγκεκριμένο υγρό, συμπεραίνουμε ότι ανάμεσα στα ευαίσθητα στην ερυθρομυκίνη στελέχη streptococcus pneumoniae, η κλαριθρομυκίνη θα πλεονεκτούσε σε σχέση με την αζιθρομυκίνη στην εκρίζωση των στελεχών χαμηλής αντίστασης. / The aim of this study was to investigate the extracellular concentration and the degree of sinus fluid penetration of newer macrolides, during the first 24-48 hours of treatment in patients with acute bacterial rhinosinusitis (ABRS), choosing clarithromycin and azithromycin as model antibiotics. An open, noninterventional pharmacokinetic study was performed at a tertiary teaching hospital. In 36 outpatients with ABRS, sinus fluid aspirates and serum samples were collected 2, 4, 6, 8 and 12 hours or 2, 6, 12 and 24 hours after the administration of three doses of oral clarithromycin, 500mg, twice daily or two doses of oral azithromycin, 500 mg, once daily, respectively. Drug concentrations were determined in both matrices by high-performance liquid chromatography (HPLC) with fluorometric detection ,and the pH was estimated for all sinus fluid samples. The average clarithromycin sinus fluid concentration was found to be significantly higher than the corresponding azithromycin concentration (2.47mg/L versus 0.65 mg/L), while the extent of the average sinus fluid penetration, expressed by the ratio of drug concentration in tissue versus serum, was similar for both drugs (115% and 120% respectively). In patients with ABRS, clarithromycin and azithromycin, present adequate penetration into sinus fluid to eradicate erythromycin-sensitive strains of S. pneumoniae. Considering their comparative in vitro activity, the sinus fluid pH effect and their sinus fluid penetration profile, we may conclude that among the erythromycin-resistant S. pneumoniae strains, clarithromycin might be advantageous over azithromycin in eradicating some of the low-level resistant strains.

Thesis (M.Tech.: Homoeopathy)-Dept of. Homoeopathy, Durban Institute of Technology,2004 xiv, 74 leaves : ill. ; 30 cm / The purpose of this double blind placebo-controlled study was to determine the efficacy of Natura Homoeopathic Laboratory’s Nasosinus (Hepar sulphuris calcareum D3, Nux vomica D3 and Pulsatilla pratensis D3) in the treatment of acute sinusitis, in terms of patients’ perception of response to treatment.

Submitted by CAMILA SA DE MELO CAMPOS (camilasacampos@hotmail.com) on 2018-05-13T22:14:55Z No. of bitstreams: 1 dissertaçao camila final - Copia.pdf: 691249 bytes, checksum: 98d49f1fc447ac06d4713fdb6c720790 (MD5) / Approved for entry into archive by Sulamita Selma C Colnago null (sulamita@btu.unesp.br) on 2018-05-14T17:32:14Z (GMT) No. of bitstreams: 1 campos_csm_me_bot.pdf: 691249 bytes, checksum: 98d49f1fc447ac06d4713fdb6c720790 (MD5) / Made available in DSpace on 2018-05-14T17:32:14Z (GMT). No. of bitstreams: 1 campos_csm_me_bot.pdf: 691249 bytes, checksum: 98d49f1fc447ac06d4713fdb6c720790 (MD5) Previous issue date: 2018-04-27 / CAMPOS, C. S. M. 2018. Avaliação da incidência e evolução das manifestações das doenças nasais em pacientes portadores de fibrose cística. 2018. Dissertação (Mestrado) – Faculdade de Medicina de Botucatu, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2018. Introdução: A fibrose cística é uma doença originada da mutação do gene responsável pela codificação da proteína CFTR. A ausência ou defeito dessa proteína leva a um transporte irregular de sal e água em células mucosas respiratórias e de glândulas exócrinas podendo resultar em diversas manifestações clínicas. As alterações otorrinolaringológicas frequentes são rinossinusite crônica e polipose nasal. Objetivo: Avaliar a incidência e a evolução de doenças nasais em pacientes portadores de fibrose cística com exame videonasolaringoscópico documentado em prontuário do período de agosto de 2015 a agosto de 2017. Casuística e Métodos: Realizou-se a coleta de dados de 65 pacientes acompanhados no ambulatório de fibrose cística do Hospital das Clínicas de Botucatu. Foram incluídos os pacientes que possuíam exames videonasolaringoscópicos realizados durante o período de acompanhamento e que concordaram em participar do estudo. Realizou-se um estudo de coorte com avaliação dos dados epidemiológicos, presença de comorbidades, achados nos exames videonasolaringoscópicos, positivação de cultura de orofaringe e resposta ao tratamento clínico. Resultados: Foram analisados 51 pacientes. A mutação delta F508 esteve presente em 20 pacientes. As comorbidades avaliadas foram: bronquiectasias (n= 39), pneumonia (n= 29), íleo meconial ao nascimento (n=9), hepatopatia (n= 22) e insuficiência pancreática (n= 32). Nos exames videonasolaringoscópicos encontramos: 19 pacientes com pólipos nasais (37,2%), destes, treze tiveram resposta positiva com o tratamento com corticoide tópico nasal. Doze pacientes possuiam hipertrofia adenoideana (23,5%), oito pacientes tinham secreção purulenta em cavidades nasais (15,7%), 40 pacientes possuíam alteração na mucosa nasal. O microorganismo mais frequente nas culturas de orofaringe foi a Pseudomonas aeruginosa (72,5%). Não encontramos relação entre a presença de pólipos nasais e complicações pulmonares; entre a positivação da cultura de orofaringe para Pseudomonas aeruginosa e presença de pólipos nasais; e entre as complicações pulmonares e a positivação de cultura de orofaringe para Pseudomonas aeruginosa. Conclusão: A incidência de polipose nasal observada neste estudo foi de 37,2%. O exame videonasolaringoscópico permite a detecção precoce da polipose nasal nesta população. / CAMPOS, C.S.M. 2018. Evaluation of the incidence and evolution of the manifestations of nasal diseases in patients with cystic fibrosis. 2018. Thesis (Master) – Botucatu Medical School, Universidade Estadual Paulista “Júlio de Mesquita Filho”, Botucatu, 2018. Introduction: Cystic fibrosis is a disease originated from the mutation of the gene responsible for the coding of the CFTR protein. The absence or defect of this protein leads to an irregular transport of salt and water in respiratory mucous cells and exocrine glands, resulting in several clinical manifestations. Frequent otorhinolaryngological changes are chronic rhinosinusitis and nasal polyps. Objective: To evaluate the incidence and evolution of nasal diseases in patients with cystic fibrosis with a videonasolaryngoscopic exam documented in medical records from August 2015 to August 2017. Casuistry and Methods: Data were collected from 65 patients followed in the cystic fibrosis outpatient clinic Botucatu Medical School. Patients who had videonasolaryngoscopic examinations performed during the follow-up period and who agreed to participate in the study were included. A cohort study was conducted with epidemiological data, presence of comorbidities, findings in videonasolaryngoscopic examinations, oropharyngeal culture positivity and response to clinical treatment. Results: Fifty-one patients were analyzed. The delta F508 mutation was present in 20 patients. The comorbidities evaluated were: bronchiectasis (n = 39), pneumonia (n = 29), meconium ileus at birth (n = 9), liver disease (n = 22) and pancreatic insufficiency (N=32) . In the videonasolaringoscopic exams we found: 19 patients with nasal polyps (37.2%), of whom thirteen had a positive response to nasal topical corticosteroid treatment. Twelve patients had adenoid hypertrophy (23.5%), eight patients had purulent secretion in nasal cavities (15.7%), and 40 patients had alterations in the nasal mucosa. The most frequent microorganism in oropharynx cultures was Pseudomonas aeruginosa (72.5%). We did not find a relation between the presence of nasal polyps and pulmonary complications; between the positivity of the oropharynx culture for Pseudomonas aeruginosa and the presence of nasal polyps; and between pulmonary complications and the positivity of oropharynx culture for Pseudomonas aeruginosa.Conclusion: The incidence of nasal polyposis observed in this study was 37.2%. The videonasolaringoscopic examination allows the early detection of nasal polyposis in this population.

No description available.