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

THE EFFICACY OF CLOVE OIL AGAINST ASPERGILLUS FLAVUS AND AFLATOXINS B1(AFB1) PRODUCTION IN GEORGIA PEANUTS

In Georgia, peanut contamination by Aspergillus spp. causes $25 million loss annually. Aspergillus flavus produces AFB1, a carcinogenic substance affecting humans globally. Recently, there has been considerable interest in biological control against mold. Achar et al. (2020) established that Clove oil reduces AFB1 in peanuts, Variety Tifguard. We now evaluate the effectiveness of Clove oil (EO) in reducing AFB1 in peanuts. AFB1 was first quantified in mycelium and spores using selected ion monitoring (SIM) based liquid chromatography and mass spectrometry method with standard AFB1. Thermo Scientific Vanquish Flex HPLC coupled with Orbitrap Exploris 240 Mass Spectrometer were used for the SIM based LCMS experiments. 100 seeds, GA Greener were then artificially inoculated with 10^6 spores/mL in a flask and incubated for 8 days at 28°C. Seeds were exposed to Clove EO by placing 15 treated seeds/ flask containing 0 ppm, 500 ppm, 1000 ppm, 1500 ppm, and 2000 ppm, respectively. Flasks were sealed with parafilm and placed in a shaker incubator at 28°C; 180 rpm for 6 days. Seeds were then plated (5/plate) with moist filter paper and incubated for 8 days at 28°C. Tween 20 served as control. Seeds were air-dried, grinded using a mortar and pestle, quenched in liquid nitrogen, and centrifuged with methanol for AFB1 quantification. The supernatant was vacuum centrifuged and resuspended in 0.1% formic acid for SIM-LCMS experiments. The findings demonstrated that high concentration of Clove EO significantly reduced AFB1in infected peanuts. Surprisingly, the high reduction of AFB1 production was noticed between 0 and 500 ppm of Clove EO, and the reduction slightly increased with higher concentrations, 1000 and 2000 ppm. This demonstrates that Clove oil is most effective at low concentrations at reducing AFB1 in infected peanuts. Future studies will focus on AFB1 production in contaminated peanut seeds exposed to Clove EO in Vivo

Acquired hyperpigmentations

Cutaneous hyperpigmentations are frequent complaints, motivating around 8.5% of all dermatological consultations in our country. They can be congenital, with different patterns of inheritance, or acquired in consequence of skin problems, systemic diseases or secondary to environmental factors. The vast majority of them are linked to alterations on the pigment melanin, induced by different mechanisms. This review will focus on the major acquired hyperpigmentations associated with increased melanin, reviewing their mechanisms of action and possible preventive measures. Particularly prominent aspects of diagnosis and therapy will be emphasized, with focus on melasma, post-inflammatory hyperpigmentation, periorbital pigmentation, dermatosis papulosa nigra, phytophotodermatoses, flagellate dermatosis, erythema dyschromicum perstans, cervical poikiloderma (Poikiloderma of Civatte), acanthosis nigricans, cutaneous amyloidosis and reticulated confluent dermatiti