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

International Bordetella pertussis assay standardization and harmonization meeting report. Centers for Disease Control and Prevention, Atlanta, Georgia, United States, 19-20 July 2007.

An international meeting on Bordetella pertussis assay standardization and harmonization was held at the Centers for Disease Control and Prevention (CDC), Atlanta, GA, 19-20 July 2007. The goal of the meeting was to harmonize the immunoassays used for pertussis diagnostics and vaccine evaluation, as agreed upon by academic and government researchers, regulatory authorities, vaccine manufacturers, and the World Health Organization (WHO). The primary objectives were (1) to provide epidemiologic, laboratory, and statistical background for support of global harmonization; (2) to overview the current status of global epidemiology, pathogenesis and immunology of pertussis; (3) to develop a consensus opinion on existing gaps in understanding standardization of pertussis assays used for serodiagnosis and vaccine evaluation; and (4) to search for a multicenter process for addressing these priority gaps. Presentations and discussions by content experts addressed these objectives. A prioritized list of action items to improve standardization and harmonization of pertussis assays was identified during a group discussion at the end of the meeting. The major items included: (1) to identify a group that will organize, prepare, maintain, and distribute proficiency panels and key reagents such as reference and control sera; (2) to encourage the development and identification of one or more reference laboratories that can serve as an anchor and resource for other laboratories; (3) to define a performance-based assay method that can serve as a reference point for evaluating laboratory differences; (4) to develop guidance on quality of other reagents, e.g., pertussis toxin and other antigens, and methods to demonstrate their suitability; (5) to establish an international working group to harmonize the criteria to evaluate the results obtained on reference and proficiency panel sera; (6) to create an inventory to determine the amount of appropriate and well-characterized sera that are available globally to be used as bridging reagents for vaccine licensure; and (7) to seek specific guidance from regulatory authorities regarding the expectations and requirements for the licensure of new multicomponent pertussis vaccines

Coxins interfalangeanos sobre paquidermodactilia Interphalangeal pads on pachydermodactyly

Coxins interfalangeanos são nodulações ceratósicas, de limites precisos, com aproximadamente um centímetro de diâmetro, geralmente sobre as articulações interfalangenas das mãos. A paquidermodactilia é uma tumefação uniforme da pele que ocorre nas falanges proximais das mãos. É relatado o caso de um jovem com associação de paquidermodactilia e coxins interfalangeanos, fato não encontrado na literatura médica. Embora haja descrição que considera serem essas manifestações diversas da mesma doença, acredita-se que sejam entidades distintas. O ato compulsivo de atritar a pele parece ser o denominador comum mais aceito para justificar as duas doenças. Os autores postulam que o coxim interfalangeano seria uma resposta epidérmica, enquanto a paquidermodactilia, uma resposta dérmica a um mesmo fator traumático sobre a pele. O paciente foi tratado com infiltração intralesional de triancinolona, com melhora clínica expressiva das duas manifestações.<br>Knuckle pads are keratotic nodulations within precise limits and approximately one centimeter in diameter, usually on the interphalangeal joints of the hands. Pachydermodactyly is a uniform swelling of the skin occurring in the proximal phalanges of the hands. A case involving a young man suffering from several knuckle pad lesions concomitant with pachydermodactyly was studied. This association has not been previously described in the literature. Although it has been reported that both conditions are different manifestations of the same disease, they are believed to be distinct disorders. The compulsive act of rubbing the skin seems to be a common denominator mostly accepted as the cause of both diseases. The authors affirm that knuckle pads may be acquired as an epidermal response, while pachydermodactyly, is a dermal response to the same traumatic factor to the skin. The patient was treated with intralesional infiltration of triamcinolone resulting in a remarkable clinical improvement in both manifestations

Dupuytren’s disease

Dupuytren’s Disease is a chronic proliferative fibromatosis of the palmar fascias that affects predominantly males of over 50. First signs are nodules and skin pits in the palm of hand. These may progress into cords that ultimately may contract and obstruct extension of the fingers. There is a wide range of treatments available now, some more invasive and surgical, such as (dermo-) fasciectomy, and some less invasive such as needle fasciotomy and collagenase treatment. This chapter summarized the various aspects of the disease, as well as the short and long term effects of the various treatments, their advantages and disadvantages