EUFOREA Rhinology Research Forum 2016: report of the brainstorming sessions on needs and priorities in rhinitis and rhinosinusitis

The first European Rhinology Research Forum organized by the European Forum for Research and Education in Allergy and Airway Diseases (EUFOREA) was held in the Royal Academy of Medicine in Brussels on 17th and 18th November 2016, in collaboration with the European Rhinologic Society (ERS) and the Global Allergy and Asthma European Network (GA2LEN). One hundred and thirty participants (medical doctors from different specialties, researchers, as well as patients and industry representatives) from 27 countries took part in the multiple perspective discussions including brainstorming sessions on care pathways and research needs in rhinitis and rhinosinusitis. The debates started with an overview of the current state of the art, including weaknesses and strengths of the current practices, followed by the identification of essential research needs, thoroughly integrated in the context of Precision Medicine (PM), with personalized care, prediction of success of treatment, participation of the patient and prevention of disease as key principles for improving current clinical practices. This report provides a concise summary of the outcomes of the brainstorming sessions of the European Rhinology Research Forum 2016

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

Nasal hyperreactivity in rhinitis: A diagnostic and therapeutic challenge

Although nasal hyperreactivity (NHR) is a common feature in patients suffering from allergic and nonallergic rhinitis, it is widely neglected during history taking, underdiagnosed in the majority of patients with rhinitis and rhinosinusitis, not considered as an outcome parameter in clinical trials on novel treatments for rhinitis and rhinosinusitis, and no target for routine treatment. In contrast to the simple nature of diagnosing NHR by a history of nasal symptoms induced by nonspecific exogenous and/or endogenous triggers, quantification is hardly performed in routine clinic given the lack of a simple tool for its diagnosis. So far, limited efforts have been invested into gaining better insight in the underlying pathophysiology of NHR, helping us to explain why some patients with inflammation develop NHR and others not. Of note, environmental and microbial factors have been reported to influence NHR, contributing to the complex nature of understanding the development of NHR. As a consequence of the neglect of NHR as a key clinical feature of rhinitis and chronic rhinosinusitis (CRS), patients with NHR might be suboptimally controlled and/or dissatisfied with current treatment. We here aim to provide a comprehensive overview of current knowledge on the pathophysiology, and the available tools to diagnose and treat NHR

Parametric Study on Solid Rocket Motor Ignition Transient and Pressure Oscillations Onset

Copyright © 2015 by M. Di Giacinto, E. Cavallini, B. Favini, and J. Steelant. The startup represents a very critical phase during the whole operational life of solid rocket motors. This paper provides a detailed study of the effects on the ignition transient of the main design parameters of solid-propellant motors. The analysisismade with the useofaquasi-one-dimensional unsteady model of solid rocket ignition transient, extensively validated, and used in the frame of the Vega program, for ignition transient predictions, reconstructions, and analyses. Two baseline solid rocket motor configurations are selected for the parametric analysis: a big booster with a three-segment propellant grain shape, similar to Ariane 5, and a small booster/solid stage with an aft-finocyl grain shape, similar to Vega solid rocket motors. The discussion of the results is particularly addressedonthe possible onset of the pressure oscillations during the startup of the two solid rocket motor configurations, pointing out the design parameters that affect them in terms of occurrence and amplitude.status: publishe

Managing nasal valve compromise patients with nasal dilators: objective vs. subjective parameters

Patients suffering from nasal obstruction due to nasal valve compromise may benefit from a nasal dilator. Several devices for widening of the external/internal nasal valve region can be applied endonasally (Airmax, Nasanita, Nozovent) or externally (Breathe Right). 100 patients suffering from nasal obstruction due to external or internal nasal valve compromise were involved in this study. All patients were evaluated for nasal obstruction with visual analogue scores (VAS) and peak nasal inspiratory flow (PNIF) measurements before and after the application of 4 nasal dilators. They were offered to choose 2 out of 4 for a trial period of 1 month. Subsequently, patients were reassessed and asked about their willingness to continue using the dilators, as well as the reasons for discontinuation. There was a significant decrease of VAS scores and improvement in PNIF with the dilators in situ compared to baseline. After 4 weeks, 67% of patients were willing to continue using at least one of the chosen dilators. The reasons for discontinuation were local irritation, inappropriate fit, preference for a permanent solution like surgery, and no relief of symptoms. Nasal dilators represent a valuable option in the therapeutic approach of nasal valve compromise, with endonasal dilators achieving higher increase in PNIF in comparison with external nasal dilator

Parametric study of SRMs design options affecting motor start-up and onset of pressure oscillations

The Ignition Transient (IT) of Solid Rocket Motors (SRMs) is characterized by strong unsteady phenomena occurring in a very short period of time. It starts at the first electric signal given to the igniter charge and ends just after the ignition of the entire grain surface, when the quasi steady state conditions in the bore are reached (usually after 0.2 to 1 seconds). In spite of the short period of time taken by this operative phase, its impact on the launch system design and operation can be relevant. In fact, the IT has significant implications not only from the point of view of the SRM start-up and performances, but also for the launch vehicle operational requirements and structural verifications. Therefore, the development of new SRMs requires to improve the understanding of the IT physical mechanisms and to clarify their origins and dependencies. Moreover, the availability of reliable and ecient IT simulation models to properly predict and analyze the SRM behavior will allow to lead the SRM design towards the accomplishment of system requirements already at the preliminary design phase. Many times unacceptable IT behaviors were detected at an advanced development stage (i.e. at the firsts Static Firing Tests), when remedies and/or design modifications could be very expensive and with a big impact on the project time schedule. Aim of the present study is to present a wide parametric analysis of the eects of the main SRM design options on the SRM start-up phase, with a particular attention on the onset of pressure oscillations during the ignition transient

Occupational upper airway disease: how work affects the nose

Chronic inflammation of the upper airways is common and can arbitrarily be divided into rhinitis and rhinosinusitis. Infection and allergy represent two well-characterized and most frequently diagnosed etiologies of upper airway inflammation. Persistent upper airway inflammation caused by agents inhaled in the work environment represents a diagnostic challenge in clinical practice, and its pathophysiology has been little studied. Occupational rhinitis is a recognized medical condition with diagnostic and therapeutic guidelines. In contrast, only limited evidence is available about the relationship between work exposures and rhinosinusitis. This review aims at providing a comprehensive overview of the available literature on occupational upper airway disease with a focus on pathophysiological mechanisms and with an emphasis on the current unmet needs in work-related upper airway diseas