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Κυριακή 15 Μαΐου 2022

Intranasal Spray Characteristics for Best Drug Delivery in Patients With Chronic Rhinosinusitis

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Objectives

To determine parameter combinations for effective drug delivery of intranasal spray steroids to the ostiomeatal complex (OMC) and maxillary sinus (MS) in patients with chronic rhinosinusitis (CRS).

Methods

Each patient's sinonasal cavity was reconstructed from computed tomography scans. Intranasal airflow and drug particle transport were simulated using computational fluid dynamic modeling. Airflow simulations were performed at 15 Pascal inhalation pressure. Intranasal spray particles of 1–100 μm were simulated at release speeds of 1, 5, and 10 m/s from 6 release locations (Bottom, Center, Top, Lateral, Lateral-Bottom, and Lateral-Top) at a nozzle insertion depth of 15 mm. Drug delivery simulations were performed in the head tilted forward position.

Results

Maximal OMC deposition was 0.78%–12.44%, while maximal MS deposition was 0.02%–1.03% across all simulations. In general, particles between 6 and 10 μm had the best OMC (at 1 m/s particle velocity) and MS (at 10 m/s particle velocity) deposition. Particles ranging from 21 to 30 μm also had superior OMC deposition. The lateral and lateral-top spray release locations produced maximum OMC deposition, but no one release location demonstrated an increase in MS deposition.

Conclusion

This preliminary study suggests that it is challenging to determine a common set of intranasal spray parameter combinations for effective drug delivery to the OMC and MSs. Although drug particle size and spray particle velocity seem to impact particle deposition patterns, spray release location appears to vary with anatomical differences between subjects, particularly when the MS is the target location for particle deposition. Laryngoscope, 2022

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Ataxia‐telangiectasia after hepatoblastoma: The reverse chronology

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Analgesic effect of auricular point acupressure for acute pain in patients with dementia: study protocol for a randomized controlled trial

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Common and frequent as acute pain is, it is often underestimated and undertreated in older people with dementia in nursing homes and inadequate pain management remains an issue.
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Association of oral bacteria with oral hygiene habits and self‐reported gingival bleeding

alexandrossfakianakis shared this article with you from Inoreader

Abstract

Aims

To describe associations of gingival bacterial composition and diversity with self-reported gingival bleeding and oral hygiene habits in a Norwegian regional-based population.

Material and methods

We explored gingival fluid microbiome composition (16S amplicon sequencing) in 484 adult participants (47% females, median age, 28 years) in the RHINESSA study in Bergen, Norway. We explored bacterial diversity and abundance differences by Community Periodontal Index (CPI) score, self-reported frequency of gingival bleeding and oral hygiene habits.

Results

Gingival bacterial diversity increased with increasing frequency of self-reported gingival bleeding, with higher Shannon diversity index for 'always' β = 0.51 and 'often' β = 0.75 (p < 0.001) compared to 'never' gingival bleeding. Frequent gingival bleeding was associated with higher abundance of several bacteria, such as Porphyromonas endodontalis, Treponema denticola, and Fretibacterium spp, but lower abundance of bacteria within the gram-positive phyla, Firmicutes and Actinobacteria. Flossing and rinsing with mouth wash twice daily was associated with higher total abundance of bacteria in the Proteobacteria phylum, but with lower bacterial diversity compared to those who never flossed or never used mouth wash.

Conclusion

A high frequency of self-reported gingival bleeding was associated with higher bacterial diversity than that found in participants reporting no gingival bleeding, and with higher total abundance of known periodontal pathogens such as Porphyromonas spp, Treponema spp, and Bacteriodes spp.

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