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4,467 results on '"Wormald, P. J."'

1. Characterising the allergic fungal rhinosinusitis microenvironment using full‐length 16S rRNA gene amplicon sequencing and fungal ITS sequencing.

Author

Connell, J. T., Bouras, G., Yeo, K., Fenix, K., Cooksley, C., Bassiouni, A., Vreugde, S., Wormald, P. J., and Psaltis, A. J.

Subjects
ALLERGIC fungal sinusitis, HAEMOPHILUS influenzae, STREPTOCOCCUS pneumoniae, NASAL polyps, ASPERGILLUS
Abstract

Introduction: Allergic fungal rhinosinusitis (AFRS) is a severe phenotype of chronic rhinosinusitis with nasal polyposis (CRSwNP), characterised by localised and exaggerated type 2 inflammation. While fungal antigenic stimulation of unregulated Th2‐mediated inflammation is the core pathophysiological mechanism, the direct and synergistic role of bacteria in disease modification is a pervasive hypothesis. We set out to define the microenvironment of AFRS to elucidate virulent organisms that may be implicated in the pathophysiology of AFRS. Methodology: We undertook a cross‐sectional study of AFRS patients and non‐fungal CRSwNP patients. Demographics, disease severity, culture and microbiome sequences were analysed. Multimodality microbiome sequencing included short‐read next‐generation sequencing (NGS) on the Illumina Miseq (16S rRNA and ITS) and full‐length 16S rRNA sequencing on the Oxford Nanopore Technologies GridION (ONT). Results: Thirty‐two AFRS and 29 non‐fungal CRSwNP patients (NF) were included in this study. Staphylococcus aureus was the dominant organism cultured and sequenced in both AFRS and NF groups (AFRS 27.54%; NF 18.04%; p =.07). Streptococcus pneumoniae (AFRS 12.31%; NF 0.98%; p =.03) and Haemophilus influenzae (AFRS 15.03%; NF 0.24%; p =.005) were significantly more abundant in AFRS. Bacterial diversity (Shannon's index) was considerably lower in AFRS relative to NF (AFRS 0.6; NF 1.0, p =.008). Aspergillus was the most cultured fungus in AFRS (10/32, 31.3%). The AFRS sequenced mycobiome was predominantly represented by Malassezia (43.6%), Curvularia (18.5%) and Aspergillus (16.8%), while the NF mycobiome was nearly exclusively Malassezia (84.2%) with an absence of Aspergillus or dematiaceous fungi. Conclusion: A low diversity, dysbiotic microenvironment dominated by Staphylococcus aureus, Streptococcus pneumoniae and Haemophilus influenzae characterised the bacterial microbiome of AFRS, with a mycobiome abundant in Malassezia, Aspergillus and Curvularia. While Staphylococcus aureus has been previously implicated in AFRS through enterotoxin superantigen potential, Streptococcus pneumoniae and Haemophilus influenzae are novel findings that may represent alternate cross‐kingdom pathophysiological mechanisms. [ABSTRACT FROM AUTHOR]

Published
2024
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4. Position paper on olfactory dysfunction: 2023

Author

Whitcroft, K L, primary, Altundag, A, additional, Balungwe, P, additional, Boscolo-Rizzo, P, additional, Douglas, R, additional, Enecilla, M L B, additional, Fjaeldstad, A W, additional, Fornazieri, M A, additional, Frasnelli, J, additional, Gane, S, additional, Gudziol, H, additional, Gupta, N, additional, Haehner, A, additional, Hernandez, A K, additional, Holbrook, E H, additional, Hopkins, C, additional, Hsieh, J W, additional, Huart, C, additional, Husain, S, additional, Kamel, R, additional, Kim, J K, additional, Kobayashi, M, additional, Konstantinidis, I, additional, Landis, B N, additional, Lechner, M, additional, Macchi, A, additional, Mazal, P P, additional, Miri, I, additional, Miwa, T, additional, Mori, E, additional, Mullol, J, additional, Mueller, C A, additional, Ottaviano, G, additional, Patel, Z M, additional, Philpott, C, additional, Pinto, J M, additional, Ramakrishnan, V R, additional, Roth, Y, additional, Schlosser, R J, additional, Stjärne, P, additional, Van Gerven, L, additional, Vodicka, J, additional, Welge-Luessen, A, additional, Wormald, P J, additional, and Hummel, T, additional

Published
2023
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6. Mental workload during endoscopic sinus surgery is associated with surgeons’ skill levels

Author

Suzuki, Masanobu, primary, Miyaji, Kou, additional, Matoba, Kotaro, additional, Abe, Takashige, additional, Nakamaru, Yuji, additional, Watanabe, Ryosuke, additional, Suzuki, Takayoshi, additional, Nakazono, Akira, additional, Konno, Atsushi, additional, Hinder, Dominik, additional, Psaltis, A. J., additional, Wormald, P. J., additional, and Homma, Akihiro, additional

Published
2023
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7. A Participatory Evaluation of the Use of Social Networking Tools in a High School Math Class

Author

Wormald, Randy J.

Abstract

As we move into the 21st century, the needs of our students are more variable than ever. There has been a proliferation of social networking usage in society yet there has been little use of those emerging tools in schools as a means to enhance student learning. It is a common practice in school districts to block social networking sites and online collaborative tools (Cramer & Hayes, 2010; National School Boards Association, 2007; Toppo, 2011). This study explored the benefits of employing social networking tools into a math class in a rural high school to determine levels of engagement, motivation, and perceived educational advantages. This qualitative study was investigated through the lenses of student engagement theory, online learning theory and guided social constructivism. Participatory evaluation guided this collaborative research project that allowed participants (the teacher and his students) to be researchers and take ownership of their learning. A two-week unit was taught implementing social networking tools as the main instructional methodology to high school freshmen in an algebra II class. The teacher led his students in focus groups to reflect on their learning experience and inform future implementation of the social networking tools for learning. Following the first unit reflection, a second unit was implemented using the social networking tools again, but utilizing suggested revisions as identified by the teacher and his students. This study has the potential to inform the literature on the acceptance of using social networking tools for instructional use. Keywords: student engagement, motivation, social networking, math, constructivism [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]

Published
2012

15. Optimising Aerosol Delivery for Maxillary Sinus Deposition in a Post-FESS Sinonasal Cavities

Author

Vahaji, Sara, Shang, Y, Zhang, Y, Wong, E, Rezk, A, Yeo, L, Vreugde, S, Wormald, P-J, Singh, N, Inthavong, K, Vahaji, Sara, Shang, Y, Zhang, Y, Wong, E, Rezk, A, Yeo, L, Vreugde, S, Wormald, P-J, Singh, N, and Inthavong, K

Abstract

Optimal management of chronic rhinosinusitis (CRS) endotypes includes post-operative application of topical formulations. There is little evidence regarding the ideal aerosol delivery characteristics and techniques to achieve the most efficient deposition on affected sinus mucosa. Nebulisers provide an alternative to nasal sprays by producing smaller particle sizes at lower velocities. We applied a reverse-particle-tracking simulation using computational fluid dynamics (CFD) to evaluate the ideal aerosol characteristics from a nebuliser to target the post-operative maxillary sinus mucosa. A CT scan of a CRS patient was used to create a pre-operative and virtual post-operative model. Particles of diameter 2 to 30 µm were tracked through the sinonasal cavity at 5, 10 and 15 L min–1 flow rates using CFD. Reverse particle simulations demonstrated that the optimised combination of parameters were 20 µm particles, delivered at 5 m s–1 (or 14 microns, delivered at 15 m s–1) at an inhalation rate of 5 L min–1, released from a nozzle in an elliptical oblique-superior direction into the superior half of the nasal valve significantly improved the maximum deposition efficiency (from 3% up to 55%) in the post-operative maxillary sinus mucosa. The nebulised spray (without optimisation) demonstrated negligible particle deposition within the sinuses of the pre-op model, while it increased marginally in the post-op model for smaller diameter particles at lower inhalation rates. The ideal combination of parameters to achieve targeted medication deposition on specific sinus mucosal surfaces can guide the development of new nasal drug delivery devices that produce the desired deposition regions for clinical applications in post-operative CRS patients.

Published
2021

17. Overcoming bacteriophage insensitivity in Staphylococcus aureus using clindamycin and azithromycinat subinhibitory concentrations.

Author

Liu, S, Zhao, Y, Hayes, A, Hon, K, Zhang, G, Bennett, C, Hu, H, Finnie, J, Morales, S, Shearwin, L, Psaltis, AJ, Shearwin, K, Wormald, P-J, Vreugde, S, Liu, S, Zhao, Y, Hayes, A, Hon, K, Zhang, G, Bennett, C, Hu, H, Finnie, J, Morales, S, Shearwin, L, Psaltis, AJ, Shearwin, K, Wormald, P-J, and Vreugde, S

Abstract

BACKGROUND: Staphylococcus aureus is a pathogen of major concern in both acute infections and chronic conditions such as chronic rhinosinusitis (CRS). Bacteriophage (phage) therapy has recently regained interest for its potential to treat infections caused by antibiotic resistant strains including Methicillin Resistant Staphylococcus aureus (MRSA). However, bacteria can adapt and become resistant to phages. The aim of this study is to determine the potential for antibiotics to overcome phage resistance. METHODS: The susceptibility of S. aureus clinical isolates (CIs) to phages J-Sa36, Sa83 and Sa87 alone or in combination with protein synthesis inhibitor (PSI) antibiotics clindamycin, azithromycin and erythromycin was assessed using plaque spot assays, minimum inhibitory concentration (MIC) assays, double layer spot assays and resazurin assays. The safety and efficacy of subinhibitory PSI antibiotics in combination with phage was tested in a Sprague Dawley rat model of sinusitis infected with a phage resistant S. aureus CI. RESULTS: All three antibiotics at subinhibitory concentrations showed synergy when combined with all 3 phages against S. aureus CIs in planktonic and biofilm form and could sensitize phage-resistant S. aureus to promote phage infection. The combination of topical subinhibitory clindamycin or azithromycin and phage was safe and could eradicate S. aureus sinonasal biofilms in vivo. CONCLUSION: Subinhibitory concentrations of PSI antibiotics could sensitize phage-resistant S. aureus and MRSA strains to phages in vitro and in vivo. This data supports the potential use of phage-PSI antibiotic combination therapies, in particular for difficult-to-treat infections with phage-resistant S. aureus and MRSA strains.

Published
2021

18. Corynebacterium accolens Has Antimicrobial Activity against Staphylococcus aureus and Methicillin-Resistant S. aureus Pathogens Isolated from the Sinonasal Niche of Chronic Rhinosinusitis Patients

Author

Menberu, MA, Liu, S, Cooksley, C, Hayes, AJ, Psaltis, AJ, Wormald, P-J, Vreugde, S, Menberu, MA, Liu, S, Cooksley, C, Hayes, AJ, Psaltis, AJ, Wormald, P-J, and Vreugde, S

Abstract

Corynebacterium accolens is the predominant species of the healthy human nasal microbiota, and its relative abundance is decreased in the context of chronic rhinosinusitis (CRS). This study aimed to evaluate the antimicrobial potential of C. accolens isolated from a healthy human nasal cavity against planktonic and biofilm growth of Staphylococcus aureus (S. aureus) and methicillin-resistant S. aureus (MRSA) clinical isolates (CIs) from CRS patients. Nasal swabs from twenty non-CRS control subjects were screened for the presence of C. accolens using microbiological and molecular techniques. C. accolens CIs and their culture supernatants were tested for their antimicrobial activity against eight S. aureus and eight MRSA 4CIs and S. aureus ATCC25923. The anti-biofilm potential of C. accolens cell-free culture supernatants (CFCSs) on S. aureus biofilms was also assessed. Of the 20 nasal swabs, 10 C. accolens CIs were identified and confirmed with rpoB gene sequencing. All isolates showed variable antimicrobial activity against eight out of 8 S. aureus and seven out of eight MRSA CIs. Culture supernatants from all C. accolens CIs exhibited a significant dose-dependent antibacterial activity (p < 0.05) against five out of five representative S. aureus and MRSA CIs. This inhibition was abolished after proteinase K treatment. C. accolens supernatants induced a significant reduction in metabolic activity and biofilm biomass of S. aureus and MRSA CIs compared to untreated growth control (p < 0.05). C. accolens exhibited antimicrobial activity against S. aureus and MRSA CIs in both planktonic and biofilm forms and holds promise for the development of innovative probiotic therapies to promote sinus health.

Published
2021

20. Fluticasone Propionate Suppresses Poly(I:C)-Induced ACE2 in Primary Human Nasal Epithelial Cells

Author

Nakazono, Akira, primary, Nakamaru, Yuji, additional, Ramezanpour, Mahnaz, additional, Kondo, Takeshi, additional, Watanabe, Masashi, additional, Hatakeyama, Shigetsugu, additional, Kimura, Shogo, additional, Honma, Aya, additional, Wormald, P. J., additional, Vreugde, Sarah, additional, Suzuki, Masanobu, additional, and Homma, Akihiro, additional

Published
2021
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23. Prevention of adhesions post-abdominal surgery: Assessing the safety and efficacy of Chitogel with Deferiprone in a rat model

Author

Vediappan, Rajan Sundaresan, primary, Bennett, Catherine, additional, Cooksley, Clare, additional, Finnie, John, additional, Trochsler, Markus, additional, Quarrington, Ryan D., additional, Jones, Claire F., additional, Bassiouni, Ahmed, additional, Moratti, Stephen, additional, Psaltis, Alkis J., additional, Maddern, Guy, additional, Vreugde, Sarah, additional, and Wormald, P. J., additional

Published
2021
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38. The Use of Postoperative Antibiotics Following Endoscopic Sinus Surgery for Chronic Rhinosinusitis: A Systematic Review and Meta-analysis.

Author

Swords, Chloe E., Wong, Jeremy J., Stevens, Kara N., Psaltis, Alkis J., Wormald, Peter J., and Tan, Neil C.-W.

Subjects
ENDOSCOPIC surgery, PATIENT reported outcome measures, ANTIBIOTICS, SINUSITIS, RANDOMIZED controlled trials
Abstract

Background: Endoscopic sinus surgery is performed for medically recalcitrant chronic rhinosinusitis. There is no universally accepted strategy regarding post-operative antibiotics despite the high rates of usage worldwide. The aim of this study was to analyse patient-reported and objective outcomes behind antibiotic use following endoscopic sinus surgery. Methods: A search of electronic databases was performed. Eligible randomised controlled trials (RCTs) and observational trials were included. The primary outcome was patient reported outcome measures. Secondary outcomes were local infections, endoscopy scores and adverse events. Meta-analysis was performed. Results: Of 1045 publications identified, 7 were included in the qualitative synthesis and 5 RCTs were included in meta-analysis. Antibiotic regimens varied between studies in terms of antibiotic selection, timing commenced and duration of use. Meta-analysis suggested no significant difference between placebo and antibiotics in patient reported outcome measures (standardised mean difference (SMD) –0.215, 95% confidence interval (CI) –0.637 to 0.207) or endoscopic scores (SMD –2.86, 95% CI –0.846 to 0.273). There was no consistent definition in reporting of infection; therefore, this outcome cannot be comprehensively considered. No severe adverse events were attributable to antibiotics. Conclusions: From the studies analysed, there is no level 1 evidence to suggest that antibiotics improved patient outcomes following sinus surgery. However, there was significant heterogeneity in outcome measures and no clear data exists regarding the effects of antibiotics on postoperative infections. The available evidence at present is not enough to make a recommendation in either direction. Further designed larger RCTs are required to investigate these questions in more detail. [ABSTRACT FROM AUTHOR]

Published
2021
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41. Positioning the principles of precision medicine in care pathways for allergic rhinitis and chronic rhinosinusitis – A EUFOREA-ARIA-EPOS-AIRWAYS ICP statement

Author

Hellings, P. W., Fokkens, W. J., Bachert, C., Akdis, C. A., Bieber, T., Agache, I., Bernal-Sprekelsen, M., Canonica, G. W., Gevaert, P., Joos, G., Lund, V. J., Muraro, A., Onerci, M., Zuberbier, T., Pugin, B., Seys, S. F., Bousquet, Jean, ARIA and EPOS working groups, Akdis, M., Alobid, I., Ankri, J., Annesi-Maesano, I., Ansotegui, I. J., Anto, Josep M., Arnavielhe, S., Arshad, S. H., Asarnoj, A., Avolio, F., Baiardini, I., Barbagallo, Carlo M., Barbara, Cristina, Baroody, F., Bateman, E. D., Bedbrook, Anna, Beghé, B., Bel, E. H., Bennoor, K. S., Benson, M., Bergmann, K. C., Bewick, M., Białoszewski, A. Z., Bindslev-Jensen, C., Bjermer, L., Blain, Hubert, Blasi, F., Boner, A. L., Bonini, M., Bonini, S., Bosnic-Anticevitch, S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, Rodolphe, Braido, F., Briggs, A. H., Brightling, C. E., Brozek, J. L., Bucca, C., Buhl, R., Bunu, C., Burte, E., Bush, A., Caballero-Fonseca, F., Caimmi, D. P., Calderon, M. A., Camargos, P. A. M., Camuzat, Thierry, Cardona, V., Carlsen, K. H., Carr, W., Carreiro-Martins, P., Carriazo, A. M., Casale, T. B., A.M, Cepeda Sarabia, Cervin, A., Cesari, M., Chatzi, L., Chavannes, Niels H., Chiron, R., Pérez, T. Chivato, Chkhartishvili, E., Chuchalin, Alexander G., Chung, K. F., Ciprandi, G., Cohen, N., Diaz, S. Conzález, Cox, L., Crooks, George, Cruz, A. A., Custovic, Adnan, Dahl, R., Dahlen, S. E., Darsow, U., Carlo, G. De, Keenoy, E. De Manuel, Sousa, J. Correia de, Vries, Elisabeth G. E. de, Dedeu, Antoni, Deleanu, D., Demoly, Pascal, Denburg, J. A., Devillier, P., Didier, A., Dinh-Xuan, A. T., Dokic, D., Douagui, H. B., Douglas, R., Dray, G., Toit, G. Du, Dubakiene, R., Durham, S. R., Dykewicz, M. S., Eklund, P., El-Gamal, Y., Ellers, E., Emuzyte, R., Farrell, J., Fink-Wagner, A., Fiocchi, A., Fletcher, M., Fonseca, J. A., Forastiere, F., Gaga, M., Gamkrelidze, A., Gemicioǧlu, B., Georgalas, C., Gereda, J. E., Goossens, H., Grisle, I., Guldemond, N. A., Gutter, Z., Guzmán, M. A., Haahtela, T., Harvey, R., Heinrich, J., Hellquist-Dahl, B., Hopkins, C., Horak, F., Hourihane, J. O. B., Humbert, M., Hyland, M. E., Iaccarino, G., Illario, M., Jares, E. J., Jeandel, Claude, Johnston, S. L., Jonquet, Olivier, Jung, K. S., Just, J., Jutel, M., Kaidashev, I. P., Kalayci, O., Kalogjera, L., Kalyoncu, A. F., Kardas, P., Keil, T., Keith, P. K., Kerkhof, M., Kern, B., Kerstjens, H. A. M., Khaitov, M. R., Khaltaev, N., Klimek, L., Kogevinas, M., Kolek, V., Koppelman, G. H., Kowalski, M. L., Kuitunen, M., Kull, I., Kuna, P., Kvedariene, V., Lambrecht, B., Larenas-Linnemann, D., Lau, S., Laune, D., Le, Tuyen D., Li, J., Lieberman, P., Lipworth, B. J., Carlsen, K. C. Lodrup, Louis, R., Lupinek, C., MacNee, W., Magard, Y., Magnan, A., Mahboub, B., Maier, D., Majer, I., Malva, J., Manning, P. J., Marshall, G. D., Masjedi, M. R., Mathieu-Dupas, E., Maurer, M., Mavale-Manuel, S., Melén, E., Gomes, Elisabete Melo, Meltzer, E. O., Mercier, Jacques, Merk, H., Miculinic, N., Mihaltan, F., Milenkovic, B., Millot-Keurinck, J., Mohammad, Y., Momas, I., Almeida, M. Morais, Mosges, R., Mullol, J., Murray, R., Naclerio, R. N., Nadif, R., Namazova-Baranova, L., Neffen, H., Nekam, K., Nieto, A., Niggemann, B., Nogueira-Silva, L., Nogues, M., Nyembue, T. D., O'Hehir, R. E., Ohta, K., Okamoto, Y., Okubo, K., Olive-Elias, M., Ouedraogo, S., Paggiaro, P. L., Pali-Schöll, I., Palkonen, S., Panzner, P., Papadopoulos, N. G., Papi, A., Park, H. S., Passalacqua, G., Pawankar, R., Pedersen, S., Pereira, A. M., Pfaar, O., Picard, R., Pigearias, B., Pin, I., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Postma, D. S., Potter, P., Poulsen, L. K., Price, D., Rabe, K. F., Raciborski, F., Riechelmann, H., Robalo-Cordeiro, C., Roberts, G., Rodenas, F., Rodriguez-Mañas, L., Rolland, C., Rodriguez, M. Roman, Romano, A., Rosado-Pinto, J., Rosario, N. A., Rottem, M., Ryan, D., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schlosser, R., Schmid-Grendelmeier, P., Schunemann, H. J., Scichilone, N., Senior, B., Serrano, E., Sheikh, A., Shields, K. M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Smit, H. A., Sole, D., Sooronbaev, T., Spranger, O., Stellato, C., Stelmach, R., Sterk, P. J., Strandberg, T., Sunyer, Jordi, Thijs, C., Thomas, M., Todo-Bom, A., Tomazic, P. V., Toskala, E., Triggiani, M., Valenta, R., Valero, A. L., Valiulis, A., Valovirta, E., Eerd, M. van, Ganse, E. van, Hage, M. van, Wick, R. G. van, Vandenplas, O., Varona, L. L., Vazankari, T., Vellas, B., Ventura, M. T., Vezzani, G., Viegi, Giovanni, Voegels, R., Vontetsianos, T., Wagenmann, M., Wahn, U., Walker, S., Wang, D. Y., Wang, Ya Xing, Werfel, T., Whalley, B., Wickman, M., Williams, D. M., Williams, S., Wilson, N., Wormald, P. J., Wright, J., Yawn, B. P., Yiallouros, Panayiotis K., Yorgancioglu, A., Young, I., Yusuf, O. M., Zaidi, A., Zar, H. J., Zernotti, M. E., Zhang, L., Zhong, N., Zidarn, M., Adult Psychiatry, Ear, Nose and Throat, AII - Inflammatory diseases, AII - Amsterdam institute for Infection and Immunity, Pulmonology, Other departments, Hellings, P. W., Fokkens, W. J., Bachert, C., Akdis, C. A., Bieber, T., Agache, I., Bernal-Sprekelsen, M., Canonica, G. W., Gevaert, P., Joos, G., Lund, V., Muraro, A., Onerci, M., Zuberbier, T., Pugin, B., Seys, S. F., Bousquet, J., Aberer, W., Akdis, M., Alobid, I., Ankri, J., Annesi-Maesano, I., Ansotegui, I. J., Anto, J. M., Arnavielhe, S., Arshad, H., Asarnoj, A., Avolio, F., Baiardini, I., Barbagallo, M., Barbara, C., Baroody, F., Bateman, E. D., Bedbrook, A., Beghe, B., Bel, E. H., Bennoor, K. S., Benson, M., Bergmann, K. C., Bewick, M., Bialoszewski, A. Z., Bindslev-Jensen, C., Bjermer, L., Blain, H., Blasi, F., Boner, A. L., Bonini, M., Bonini, S., Bosnic-Anticevich, S., Bosse, I., Bouchard, J., Boulet, L. P., Bourret, R., Bousquet, P. J., Braido, F., Briggs, A. H., Brightling, C. E., Brozek, J., Bucca, C., Buhl, R., Bunu, C., Burte, E., Bush, A., Caballero-Fonseca, F., Caimmi, D. P., Calderon, M. A., Camargos, P. A., Camuzat, T., Cardona, V., Carlsen, K. H., Carr, W., Carreiro-Martins, P., Carriazo, A. M., Casale, T., Cepeda Sarabia, A. M., Cervin, A., Cesari, M., Chatzi, L., Chavannes, N. H., Chiron, R., Chivato, T., Chkhartishvili, E., Chuchalin, A. G., Chung, K. F., Ciprandi, G., Cohen, N., Conzalez Diaz, S., Cox, L., Crooks, G., Cruz, A. A., Custovic, A., Dahl, R., Dahlen, S. E., Darsow, U., De Carlo, G., De Manuel Keenoy, E., de Sousa, J. C., De Vries, G., Dedeu, T., Deleanu, D., Demoly, P., Denburg, J. A., Devillier, P., Didier, A., Dinh-Xuan, A. T., Dokic, D., Douagui, H., Douglas, R., Dray, G., Du Toit, G., Dubakiene, R., Durham, S. R., Dykewicz, M. S., Eklund, P., El-Gamal, Y., Ellers, E., Emuzyte, R., Farrell, J., Fink Wagner, A., Fiocchi, A., Fletcher, M., Fonseca, J., Forastiere, F., Gaga, M., Gamkrelidze, A., Gemicioglu, B., Georgalas, C., Gereda, J. E., Goossens, H., Grisle, I., Guldemond, N. A., Gutter, Z., Guzman, M. A., Haahtela, T., Harvey, R., Heinrich, J., Hellquist-Dahl, B., Hopkins, C., Horak, F., Hourihane, J. O., Humbert, M., Hyland, M., Iaccarino, G., Illario, M., Jares, E. J., Jeandel, C., Johnston, S. L., Jonquet, O., Jung, K. S., Just, J., Jutel, M., Kaidashev, I. P., Kalayci, O., Kalogjera, L., Kalyoncu, A. F., Kardas, P., Keil, T., Keith, P. K., Kerkhof, M., Kern, B., Kerstjens, H. A., Khaitov, M., Khaltaev, N., Klimek, L., Kogevinas, M., Kolek, V., Koppelman, G. H., Kowalski, M., Kowalski, M. L., Kuitunen, M., Kull, I., Kuna, P., Kvedariene, V., Lambrecht, B., Larenas-Linnemann, D., Lau, S., Laune, D., Le, L. T., Li, J., Lieberman, P., Lipworth, B., Lodrup Carlsen, K. C., Louis, R., Lund, V. J., Lupinek, C., Macnee, W., Magar, Y., Magnan, A., Mahboub, B., Maier, D., Majer, I., Malva, J., Manning, P., Marshall, G. D., Masjedi, M. R., Mathieu-Dupas, E., Maurer, M., Mavale-Manuel, S., Melen, E., Melo-Gomes, E., Meltzer, E. O., Mercier, J., Merk, H., Miculinic, N., Mihaltan, F., Milenkovic, B., Millot-Keurinck, J., Mohammad, Y., Momas, I., Morais-Almeida, M., Mosges, R., Mullol, J., Murray, R., Naclerio, R., Nadif, R., Namazova-Baranova, L., Neffen, H., Nekam, K., Nieto, A., Nogues, M., Nyembue, T. D., O'Hehir, R. E., Ohta, K., Okamoto, Y., Okubo, K., Olive-Elias, M., Ouedraogo, S., Paggiaro, P., Pali-Scholl, I., Palkonen, S., Panzner, P., Papadopoulos, N. G., Papi, A., Park, H. S., Passalacqua, G., Niggemann, B., Nogueira-Silva, L., Pereira, A. M., Pfaar, O., Picard, R., Pigearias, B., Pin, I., Plavec, D., Pohl, W., Popov, T. A., Portejoie, F., Postma, D., Potter, P., Poulsen, L. K., Price, D., Rabe, K. F., Raciborski, F., Riechelmann, H., Robalo-Cordeiro, C., Roberts, G., Rodenas, F., Rodriguez-Manas, L., Rolland, C., Roman Rodriguez, M., Romano, A., Rosado-Pinto, J., Rosario, N., Rottem, M., Ryan, D., Samolinski, B., Sanchez-Borges, M., Sastre-Dominguez, J., Scadding, G. K., Schlosser, R., Schmid-Grendelmeier, P., Schunemann, H. J., Scichilone, N., Senior, B., Serrano, E., Sheikh, A., Shields, M., Simons, F. E. R., Siroux, V., Sisul, J. C., Skrindo, I., Smit, H. A., Sole, D., Sooronbaev, T., Spranger, O., Stellato, C., Stelmach, R., Sterk, P. J., Strandberg, T., Sunyer, J., Thijs, C., Thomas, M., Todo-Bom, A., Tomazic, P. V., Toskala, E., Triggiani, M., Valenta, R., Valero, A., Valiulis, A., Valovirta, E., van Eerd, M., van Ganse, E., van Hage, M., van Wick, R. G., Vandenplas, O., Varona, L. L., Vazankari, T., Vellas, B., Ventura, M. T., Vezzani, G., Viegi, G., Voegels, R., Vontetsianos, T., Wagenmann, M., Wahn, U., Walker, S., Wang, D. 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[0000-0002-8339-9285], Custovic, Adnan [0000-0001-5218-7071], Hellings, P.W., Fokkens, W.J., Akdis, C.A., Canonica, G.W., Seys, S.F., Ansotegui, I.J., Anto, J.M., Bateman, E.D., Beghé, B., Bel, E.H., Bennoor, K.S., Bergmann, K.C., Bialoszewski, A.Z., Boner, A.L., Boulet, L.P., Bousquet, P.J., Briggs, A.H., Brightling, C.E., Caimmi, D.P., Calderon, M.A., Camargos, P.A., Carlsen, K.H., Carriazo, A.M., Cepeda Sarabia, A.M., Chavannes, N.H., Chuchalin, A.G., Chung, K.F., Conzález Diaz, S., Cruz, A.A., Dahlen, S.E., de Sousa, J.C., Denburg, J.A., Dinh-Xuan, A.T., Durham, S.R., Dykewicz, M.S., Gemicioğlu, B., Gereda, J.E., Guldemond, N.A., Guzmán, M.A., Hourihane, J.O., Jares, E.J., Johnston, S.L., Jung, K.S., Kaidashev, I., Kalyoncu, A.F., Keith, P.K., Kerstjens, H.A., Koppelman, G.H., Kowalski, M.L., Le, L.T., Lodrup Carlsen, K.C., Lund, V.J., MacNee, W., Marshall, G.D., Masjedi, M.R., Melén, E., Meltzer, E.O., Mösges, R., Nyembue, T.D., O'Hehir, R.E., Pali-Schöll, I., Papadopoulos, N.G., Park, H.S., Pawankar, R., Pedersen, S., Pereira, A.M., Popov, T.A., Poulsen, L.K., Rabe, K.F., Rodriguez-Mañas, L., Scadding, G.K., Schunemann, H.J., Simons, F.E.R., Sisul, J.C., Smit, H.A., Solé, D., Sterk, P.J., Tomazic, P.V., van Wick, R.G., Varona, L.L., Ventura, M.T., Wang, D.Y., Williams, D.M., Wormald, P.J., Yawn, B.P., Yiallouros, P.K., Yusuf, O.M., Zar, H.J., and Zernotti, M.E.

Subjects
allergic rhinitis, integrated care pathway, precision medicine, rhinosinusitis, Allergy, Rhinosinusitis, Disease, Allergic rhinitis, 0302 clinical medicine, QUALITY-OF-LIFE, Medicine, Immunology and Allergy, 030223 otorhinolaryngology, Sinusitis, NASAL POLYPOSIS, Rhinitis, Precision medicine, 3. Good health, Algorithm, REAL-LIFE, IMPACT OUTCOMES, ARIA and EPOS working groups, 1107 Immunology, DISEASES, GA(2)LEN, Disease Progression, allergic rhiniti, Life Sciences & Biomedicine, ENDOSCOPIC SINUS SURGERY, Algorithms, Human, Integrated care pathway, Adult, Chronic Disease, Humans, Precision Medicine, Rhinitis, Allergic, Young Adult, Immunology, medicine.medical_specialty, rhinosinusiti, PHENOTYPES, VALIDATION, 03 medical and health sciences, Therapeutic approach, Allergic, Patient satisfaction, Quality of life (healthcare), Patient participation, IMMUNOTHERAPY, Intensive care medicine, Asthma, Science & Technology, business.industry, medicine.disease, Sinusiti, SEVERITY, 030228 respiratory system, 3121 General medicine, internal medicine and other clinical medicine, Physical therapy, ASTHMA, business
Abstract

Precision medicine (PM) is increasingly recognized as the way forward for optimizing patient care. Introduced in the field of oncology, it is now considered of major interest in other medical domains like allergy and chronic airway diseases, which face an urgent need to improve the level of disease control, enhance patient satisfaction and increase effectiveness of preventive interventions. The combination of personalized care, prediction of treatment success, prevention of disease and patient participation in the elaboration of the treatment plan is expected to substantially improve the therapeutic approach for individuals suffering from chronic disabling conditions. Given the emerging data on the impact of patient stratification on treatment outcomes, European and American regulatory bodies support the principles of PM and its potential advantage over current treatment strategies. The aim of the current document was to propose a consensus on the position and gradual implementation of the principles of PM within existing adult treatment algorithms for allergic rhinitis (AR) and chronic rhinosinusitis (CRS). At the time of diagnosis, prediction of success of the initiated treatment and patient participation in the decision of the treatment plan can be implemented. The second-level approach ideally involves strategies to prevent progression of disease, in addition to prediction of success of therapy, and patient participation in the long-term therapeutic strategy. Endotype-driven treatment is part of a personalized approach and should be positioned at the tertiary level of care, given the efforts needed for its implementation and the high cost of molecular diagnosis and biological treatment. © 2017 EAACI and John Wiley and Sons A/S. Published by John Wiley and Sons Ltd. 72 9 1297 1305

Published
2017

42. Sub-Inhibitory Clindamycin and Azithromycin reduce S. aureus Exoprotein Induced Toxicity, Inflammation, Barrier Disruption and Invasion

Author

Hu, H, Ramezanpour, M, Hayes, AJ, Liu, S, Psaltis, AJ, Wormald, P-J, Vreugde, S, Hu, H, Ramezanpour, M, Hayes, AJ, Liu, S, Psaltis, AJ, Wormald, P-J, and Vreugde, S

Abstract

BACKGROUND: Chronic rhinosinusitis (CRS) is defined as a chronic inflammation of the nose and paranasal sinus mucosa associated with relapsing infections-particularly with S. aureus. Long-term treatments with protein synthesis inhibitor antibiotics have been proposed to reduce inflammation in the context chronic severe inflammatory airway pathologies, including CRS. This study assessed the effect of subinhibitory clindamycin and azithromycin on S. aureus exoprotein induced inflammation, toxicity and invasiveness. METHODS: S. aureus ATCC51650 and two clinical isolates grown in planktonic and biofilm form were treated with subinhibitory clindamycin and azithromycin. Exoproteins were collected and applied to primary human nasal epithelial cells (HNECs) in monolayers and at air-liquid interface. This was followed by lactate dehydrogenase (LDH), enzyme-linked immunosorbent assay (ELISA), Transepithelial Electrical Resistance (TEER) and paracellular permeability assays to assess the effect on cell toxicity, inflammatory cytokine production and mucosal barrier structure and function, respectively. The effect of these treatments was tested as well on the S. aureus invasiveness of HNECs. RESULTS: Subinhibitory clindamycin reduced S. aureus exoprotein production in planktonic and biofilm form, thereby blocking exoprotein-induced toxicity, reversing its detrimental effects on mucosal barrier structure and function and modulating its inflammatory properties. Sub-inhibitory azithromycin had similar effects-albeit to a lesser extent. Furthermore, clindamycin-but not azithromycin-treated S. aureus lost its invasive capacity of HNECs. CONCLUSION: Subinhibitory clindamycin and azithromycin reduce S. aureus exoprotein production, thereby modulating the inflammatory cascade by reducing exoprotein-induced toxicity, inflammation, mucosal barrier disruption and invasiveness.

Published
2019

43. Accuracy of a portable haemoglobinometer in clinical practice

Author

Linegar, A. G., Knottenbelt, J. D., and Wormald, P.-J.

Abstract

The haemoglobin (Hb) levels of 100 blood samples submitted to the haematology laboratory of Groote Schuur Hospital were estimated by 3 clinical observers using the Buffalo Medical Specialties (BMS) portable haemoglobinometer. The average error was between 5% and 6% of the laboratory Hb value (0,6 g/dl). It is concluded that the BMS machine, besides being easy to use and giving a rapid result, is also sufficiently accurate for clinical practice.

Published
2017

45. Staphylococcus aureus from patients with chronic rhinosinusitis show minimal genetic association between polyp and non-polyp phenotypes

Author

Bardy, JJ, Sarovich, DS, Price, EP, Steinig, E, Tong, S, Drilling, A, Ou, J, Vreugde, S, Wormald, P-J, Psaltis, AJ, Bardy, JJ, Sarovich, DS, Price, EP, Steinig, E, Tong, S, Drilling, A, Ou, J, Vreugde, S, Wormald, P-J, and Psaltis, AJ

Abstract

BACKGROUND: Staphylococcus aureus has a high prevalence in chronic rhinosinusitis (CRS) patients and is suggested to play a more etiopathogenic role in CRS patients with nasal polyps (CRSwNP), a severe form of the CRS spectrum with poorer surgical outcomes. We performed a microbial genome-wide association study (mGWAS) to investigate whether S. aureus isolates from CRS patients have particular genetic markers associated with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). METHODS: Whole genome sequencing was performed on S. aureus isolates collected from 28 CRSsNP and 30 CRSwNP patients. A mGWAS approach was employed using large-scale comparative genomics to identify genetic variation within our dataset. RESULTS: Considerable genetic variation was observed, with > 90,000 single nucleotide polymorphisms (SNPs) sites identified. There was little correlation with CRS subtype based on SNPs and Insertion/Delection (Indels). One indel was found to significantly correlate with CRSwNP and occurred in the promoter region of a bacitracin transport system ATP-binding protein. Additionally, two variants of the highly variable superantigen-like (SSL) proteins were found to significantly correlate with each CRS phenotype. No significant association with other virulence or antibiotic resistance genes were observed, consistent with previous studies. CONCLUSION: To our knowledge this study is the first to use mGWAS to investigate the contribution of microbial genetic variation to CRS presentations. Utilising the most comprehensive genome-wide analysis methods available, our results suggest that CRS phenotype may be influenced by genetic factors other than specific virulence mechanisms within the S. aureus genome.

Published
2018

49. Myringoplasty - effects on hearing and contributing factors

Author

Black, J. H. and Wormald, P. J.

Abstract

Indications for myringoplasty are chronic otorrhoea and hearing impairment. Some authors have described poor postoperative hearing results and sensorineural hearing loss associated with the surgery, and question the indication for myringoplasty on an ear with normal hearing « 25 dB). This study of 211 Consecutive myringoplasties performed over 1 year details the 'take rate,' hearing gains and losses, and factors found to influence the above. The take rate of 78% is comparable with figures in the literature. The most significant factors influencing this are the grade of the surgeon and the size of the perforation. The average pre-operative air-bone gap was closed from 23,7 dB to 13,9 dB with a 4,5% incidence of postoperative sensorineural hearing loss. Postoperatively 77,9% of patients had an air-bone gap of less than 20 dB. We conclude that myringoplasty is a beneficial procedure, closing the tympanic membrane and improving the hearing.

Published
2016

50. Quinsy tonsillectomy or interval tonsillectomy - a prospective randomised trial

Author

Fagan, J. J. and Wormald, P. J.

Abstract

Fifty-one patients with peritonsillar abscesses were randomised to undergo either quinsy tonsillectomy (aT) or interval tonsillectomy (IT), and the two groups were compared. The QT group lost fewer (10,3 v. 17,9) working days and less blood during the operation (158,6 ml v. 205,7 ml); haemostasis was easier and the operation was technically simpler in this group. There was no significant difference in length of hospital stay and neither group had intra- or postoperative complications. Only 64% of the IT group returned for tonsillectomy. In this study QT had distinct advantages over drainage and IT in the management of peritonsillar abscesses.

Published
2016

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