International Consensus Statement on Rhinology and Allergy: Rhinosinusitis

Background: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR‐RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR‐RS‐2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence‐based findings of the document. Methods: ICAR‐RS presents over 180 topics in the forms of evidence‐based reviews with recommendations (EBRRs), evidence‐based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. Results: ICAR‐RS‐2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence‐based management algorithm is provided. Conclusion: This ICAR‐RS‐2021 executive summary provides a compilation of the evidence‐based recommendations for medical and surgical treatment of the most common forms of RS

Lidar com a doença mental - a pluralidade de sistemas de cuidados e de itinerários terapêuticos: análise comparativa de dois estudos efectuados junto de duas populações residentes em Portugal Dealing with mental illness - the plurality of care systems and of therapeutic itineraries: a comparative analysis of two studies carried out in Portugal

Vários estudos apontam para a pluralidade dos sistemas de cuidados para lidar com a doença e neles integram o sistema profissional, popular e alternativo (inclui o complementar e o tradicional). Qual a sua configuração particular em cada sistema cultural é a questão norteadora das duas pesquisas efectuadas. O objectivo deste artigo é o de perceber como se lida com a doença mental, analisando os itinerários terapêuticos que se constroem entre sistemas de cuidados plurais, caracterizando em particular o recurso à medicina tradicional. A análise dos dois estudos (um efectuado na região Norte, outro em Lisboa) permitiu-nos interpretar essas práticas e problematizar os factores socioculturais que determinam e explicam as configurações encontradas. Ambas as pesquisas se enquadram numa metodologia qualitativa. Centrámos a pesquisa na análise dos discursos que obtivemos através de entrevistas semidiretivas, descrevendo-os, interpretando-os e comparando-os. Os resultados apontam para uma pluralidade de itinerários terapêuticos, que se tecem em torno de discursos públicos e privados, onde os sistemas explicativos do recurso à medicina ou às práticas tradicionais encontram sentidos, também eles plurais. As pessoas podem recorrer a estes sistemas de formas diversas, usando um só ou combinando mais do que um, de modo simultâneo ou sequencial, conforme o contexto e as necessidades sentidas face à doença ou ao sofrimento mental. É no espaço de impotência e "incompetência" da medicina "sábia" que se desenvolvem outros sistemas terapêuticos, que é necessário conhecer, pelos resultados que alcançam e pelo seu poder heurístico de explicação da sociedade e da cultura.<br>Several studies point to the plurality of care systems to deal with illness. They can be organized into professional, popular and alternative systems (the latter includes the complementary and the traditional ones). What the particular setup is in each cultural system is the core question of both the empirical studies we report. The purpose of this article is to understand how lay people deal with mental illness, examining the therapeutic itineraries that are constructed between plural care systems, featuring in particular the use of traditional medicine. The analysis of the two studies (one carried out in the north region and the other in Lisbon) allowed us to interpret these practices and discuss the social and cultural factors that determine and explain the settings that were found. Both researches fit into a qualitative methodology. In-depth, semi-structured interviews were performed and were analyzed using discourse analysis to describe and interpret data. The results point to a plurality of therapeutic itineraries, built around public and private speeches, where the explanatory systems underlying the use of official medicine and/or traditional practices found plural meanings. People may use these systems in several forms, using one or combining more than one, simultaneously or sequentially, depending on the context and on the needs they feel to face both illness and mental suffering. It is in between the space of the impotence and 'incompetence' of the 'wise' medicine that other therapeutic systems develop. It is important to understand those systems because of their achievements and their heuristic power to explain society and culture