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Biomedical subjects

Michael Benninger

Publications and source records attributed to Michael Benninger.

6 recordsLinked to original sources
PubMed2006

Disease severity in acute bacterial rhinosinusitis is greater in patients infected with Streptococcus pneumoniae than in those infected with Haemophilus influenzae.

BACKGROUND: Streptococcus pneumoniae and Haemophilus influenzae are the most common causative pathogens in acute bacterial rhinosinusitis. A post hoc pooled analysis of four multinational Phase III clinical trials was conducted to compare disease severity in acute bacterial rhinosinusitis caused by S. pneumoniae or H. influenzae. METHODS: Patients were evaluated for acute bacterial rhinosinusitis clinician-assessed symptom severity and radiologic findings (total opacity, mucosal thickening, and air-fluid levels on maxillary sinus x-rays). Specimens for bacteriologic identification were collected by maxillary sinus tap, or by selective middle meatal cultures (sinus aspirates or swabs). RESULTS: Compared with patients infected with H. influenzae (n = 106), patients infected with S. pneumoniae (n = 143) showed a statistically significant higher incidence of severe disease (39.2% vs 23.6%, P = 0.0097) and total opacity (46.2% vs 29.2%, P = 0.0085). Mucosal thickening (47.6% vs 56.6%, P = 0.1616) and air-fluid levels (49% vs 56.6%, P = 0.2500) were comparable between the two groups. CONCLUSIONS: In acute bacterial rhinosinusitis, infection with S. pneumoniae is associated with more severe clinical symptoms and radiographic total opacification findings than infection with H. influenzae.

Acute Disease↗
PubMed2005

Development of questionnaires to measure patient preferences for intranasal corticosteroids in patients with allergic rhinitis.

OBJECTIVE: To develop a questionnaire to evaluate preferences for attributes of intranasal corticosteroids (INSs) in clinical trials with allergic rhinitis (AR) patients. STUDY DESIGN AND SETTING: Established questionnaire development practices were used, including performance of a literature review and use of patient and physician focus groups, cognitive debriefing interviews, and pilot testing before validation. RESULTS: Findings from patient and physician focus groups suggest that sensory attributes are relevant to AR patients when choosing INSs. Physician focus groups identified the need for 2 distinct preference instruments, a clinical trial patient preference questionnaire (CTPPQ) and a clinical practice preference questionnaire (CPPPQ). A pilot study suggests that the CTPPQ is capable of discriminating between 2 INSs in the clinical trial setting. CONCLUSIONS: Initial findings suggest that items in the CTPPQ and CPPPQ are easy to understand and relevant to patients. Further validation studies with larger sample sizes are needed to assess the psychometric properties of both questionnaires. EBM RATING: B-20.

Administration, Intranasal↗
PubMed2005

Postoperative tonsillectomy bleed: coblation versus noncoblation.

OBJECTIVE: To examine the incidence of postoperative bleeding after coblation and noncoblation tonsillectomy and to use postoperative bleeding as an outcome measure to determine the presence of a learning curve with this new surgical technique. STUDY DESIGN: A retrospective review of records from January 1999 to April 2003 to determine type of tonsillectomy performed and the presence of postoperative bleeding. A chi-square analysis was used to determine a statistical difference between the postoperative bleed rate of coblation and noncoblation procedures. The examined time period was divided into 3-month intervals, and the coblation postoperative bleeds were tallied for each interval. The Cochraine-Armitage test of linear trend was used to assess change in the postoperative bleeds. RESULTS: One thousand seven hundred sixty-two tonsillectomies were performed. The postoperative bleed rate for noncoblation tonsillectomy was 6.1% (74/1,216). The bleeding rate for coblation tonsillotomy was 5.9% (18/303) and 5.4% (13/239) for coblation tonsillectomy. There was no statistical difference (P = .93) between bleed rates for coblation versus noncoblation techniques. There was no difference in the need for operative intervention to control postoperative bleeding: 16.2% (12/74) for noncoblation technique and 25.85 (8/31) for coblation procedures (P = .25). The postoperative coblation bleed rates for the 3-month periods did not reveal an increasing or decreasing trend in the postoperative bleed rate (P = .49). CONCLUSION: Coblation is a safe procedure for performing tonsil surgery with no significant difference in postoperative bleeding from previous techniques and no increased need for operative intervention to control postoperative bleeding. A learning curve could not be identified when using postoperative bleeding as an outcome measure for coblation tonsillectomy.

Humans↗
PubMed2004

Safety review of benzalkonium chloride used as a preservative in intranasal solutions: an overview of conflicting data and opinions.

BACKGROUND: For most multiuse aqueous nasal, ophthalmic, and otic products, benzalkonium chloride (BKC) is the preservative of choice. The American College of Toxicology has concluded that BKC can be safely used as an antimicrobial agent at concentrations up to 0.1%. BKC has been in clinical use since 1935 and is contained in a wide variety of prescription and over-the-counter products. However, over the past several years there have been conflicting reports of damage to human nasal epithelia and/or exacerbation of rhinitis medicamentosa associated with intranasal products containing BKC. OBJECTIVE: We sought to review the published literature and determine whether there is sufficient, clinically significant data that would confirm that intranasal products containing BKC are likely to damage human nasal epithelia or exacerbate rhinitis medicamentosa. METHODS: A literature search was conducted for in vivo and in vitro studies that evaluated the effects of BKC on human nasal epithelia. RESULTS: A total of 18 studies (14 in vivo, 4 in vitro) were identified that evaluated short- and long-term exposure of concentrations of BKC in concentrations ranging from 0.00045% to 0.1%. Eight studies, including a 6-month and 1-year long-term treatment study, demonstrated no toxic effects associated with BKC, indicating that BKC was neither harmful to nasal tissue nor prone to exacerbate rhinitis medicamentosa. Furthermore, of the 10 studies that concluded that BKC resulted in degenerative changes in human nasal epithelia (eg, ciliary beat frequency, ciliary morphology, mucociliary clearance, epithelial thinning and/or destruction) or that BKC exacerbates rhinitis medicamentosa, only 2 (it was 2 according to the Results section) of these studies were supported by statistically significant differences between BKC and placebo or active control groups were compared. It is important to note that in both of these studies, the protocol incorporated the use or oxymetazoline in some or all of the subjects. Oxymetazoline is associated with rhinitis medicamentosa. CONCLUSION: Intranasal products containing the preservative BKC appear to be safe and well tolerated for both long- and short-term clinical use.

Administration, Intranasal↗
PubMed2002

Applications of muscle electroporation gene therapy.

Muscle is a convenient and accessible site for non-viral gene delivery, which can manufacture gene products and provide a long-duration of gene expression. The level of gene expression after administration of naked DNA plasmid or polymer-formulated DNA plasmid containing a reporter gene to muscle via syringe injection, however, is very low. As a result, no significant therapeutic effect can be detected after saline- or polymer-mediated gene delivery into muscle. In 1998, investigators published a striking new approach--electrotransfection--for intramuscular gene delivery (now commonly referred to as electroporation or electroinjection). Electroporation of a non-viral gene into the muscles of small animals has increased the level of gene expression by as much as two orders of magnitude, which is comparable to levels achieved with adenoviral gene delivery. Three years later, intramuscular electroporation gene delivery technology has blossomed. Treatments for different diseases using this approach in animal models have been reported. In this review, I discuss the applications of intramuscular electroporation gene therapy to treat malignancies, renal disease, and anemia, and to prevent drug toxicity to sensory nerves.

Animals↗