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

Redox-dependent regulation of the Na+-K+ pump: new twists to an old target for treatment of heart failure

By the time it was appreciated that the positive inotropic effect of cardiac glycosides is due to inhibition of the membrane Na-K pump, glycosides had been used for treatment of heart failure on an empiric basis for ~200years. The subsequent documentation of their lack of clinical efficacy and possible harmful effect largely coincided with the discovery that a raised Na concentration in cardiac myocytes plays an important role in the electromechanical phenotype of heart failure syndromes. Consistent with this, efficacious pharmacological treatments for heart failure have been found to stimulate the Na-K pump, effectively the only export route for intracellular Na in the heart failure. A paradigm has emerged that implicates pump inhibition in the raised Na levels in heart failure. It invokes protein kinase-dependent activation of nicotinamide adenine dinucleotide phosphate oxidase (NADPH oxidase) and glutathionylation, a reversible oxidative modification, of the Na-K pump molecular complex that inhibits its activity. Since treatments of proven efficacy reverse the oxidative Na-K pump inhibition, the pump retains its status as a key pharmacological target in heart failure. Its role as a target is well integrated with the paradigms of neurohormonal abnormalities, raised myocardial oxidative stress and energy deficiency implicated in the pathophysiology of the failing heart. We propose that targeting oxidative inhibition of the pump is useful for the exploration of future treatment strategies. This article is part of a Special Issue entitled "NaRegulation in Cardiac Myocytes"

A STOCHASTIC MODEL FOR SPECIATION BY MATING PREFERENCES

International audienceMechanisms leading to speciation are a major focus in evolutionary biology. In this paper, we present and study a stochastic model of population where individuals, with type a or A, are equivalent from ecological, demographical and spatial points of view, and differ only by their mating preference: two individuals with the same genotype have a higher probability to mate and produce a viable offspring. The population is subdivided in several patches and individuals may migrate between them. We show that mating preferences by themselves, even if they are very small, are enough to entail reproductive isolation between patches, and we provide the time needed for this isolation to occur as a function of the carrying capacity. Our results rely on a fine study of the stochastic process and of its deterministic limit in large population, which is given by a system of coupled nonlinear differential equations. Besides, we propose several generalisations of our model, and prove that our findings are robust for those generalisations