Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report

xlomafota13 shared this article with you from Inoreader Metal Allergy in Tracheostomy Tube Placement Resulting in Complete Subglottic Stenosis: A Case Report Via otol rhinol Ann Otol Rhinol Laryngol. 2022 Jan 6:34894211070135. doi: 10.1177/00034894211070135. Online ahead of print. ABSTRACT OBJECTIVES: Metal hypersensitivity reaction to surgical implants is a well- known phenomenon that is associated with pain, swelling, inflammation, and decreased efficacy of the implant. We present a unique case of a patient with placement a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. METHODS: The patient was a 33-ye ar old, severely atopic woman with history of asthma exacerbations requiring several intubations for acute respiratory failure with several subsequent tracheal dilations with steroid injections, and eventual tracheostomy placement with a metal Jackson tracheostomy tube that led to expeditious total subglottic stenosis. RESULTS: Initial intervention included performing an airway evaluation, CO2 laser, and steroid injection of the area of complete subglottic stenosis. Follow up several months later revealed little improvement in level of tracheal narrowing proximal to the tracheostomy tube. Patient did not have shortness of breath but continued to be aphonic. Cricotracheal versus tracheal resection have been proposed but surgical morbidity was deemed too high due to patient's obesity. CONCLUSIONS: Metal hypersensitivity reactions are well known phenomena as it relates to surgical implants in other surgical specialties but are seldom reported within the ear, nose and throat literature. Oftentimes, it takes astute observation to diagnose and establish a connection. Prompt recognition and treatment can be acquired from interdisciplinary collaboration with allergy. PMID:34991357 | DOI:10.1177/00034894211070135 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Management strategies for chronic rhinosinusitis with nasal polyps

xlomafota13 shared this article with you from Inoreader Management strategies for chronic rhinosinusitis with nasal polyps Via hno HNO. 2022 Jan 7. doi: 10.1007/s00106-021-01127-9. Online ahead of print. ABSTRACT Chronic rhinosinusitis with (CRwNP) or without (CRsNP) nasal polyps can have a great impact on quality of life. Typical symptoms include nasal obstruction, olfactory dysfunction, nasal discharge, and facial pain or pressure. Diagnostic gold standard is nasal endoscopy followed by CT scan of the paranasal sinuses. Besides first-line treatment with topical or systemically applied glucocorticoids, nasal rinsing, and surgical therapy, monoclonal antibodies have been approved in Germany since 2019. PMID:34994808 | DOI:10.1007/s00106-021-01127-9 View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Induction and generalization of nocebo effects on itch

xlomafota13 shared this article with you from Inoreader Induction and generalization of nocebo effects on itch Via Experimental Dermatology Abstract Nocebo effects, i.e., negative treatment outcomes due to negative expectancies, can increase itch. Moreover, indirect evidence has shown that nocebo hyperknesis can generalize to another itch modality. Knowledge on response generalization can help to prevent and decrease negative effects. The aims of this study were to investigate 1) the efficacy of inducing nocebo effects on cowhage-evoked itch via verbal suggestions and 2) whether these effects can generalize to 2a) mechanically evoked touch and 2b) mechanically evoked itch. Forty-four healthy participants watched a video suggesting that a nocebo solution increases cowhage-evoked itch and that a control solution does not affect itch. Subsequently, cowhage, mechanical itch, and mechanical touch stimuli were applied. Nocebo effects were measured as the difference in both mean and peak of the outcomes itch and urge to scratch between nocebo and control trials. Main analyses revealed significant nocebo effects on mean and peak itch for all stimuli. For urge to scratch, a significant nocebo effect was only observed for mechanical touch (peak). As mechanical stimuli did not induce pure sensations as planned, post-hoc sensitivity analyses were run for mechanical stimuli that individually induced either touch or itch at baseline. These analyses showed similar results for generalization to mechanical itch, but generalization to mechanical touch was nonsignificant. This study showed that merely verbal suggestion can induce nocebo effects on cowhage-evoked itch and that these effects can generalize to another itch modality. Future studies may examine how to prevent negative experiences from generalizing to subsequent encounters. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.