Biomedical subjects

Neil Bhattacharyya

Publications and source records attributed to Neil Bhattacharyya.

60 records · Page 4Linked to original sources

PubMedDate not supplied

Outcomes research in otology.

Among the otolaryngologic subspecialties, otology has historically been at the forefront of outcomes research in our specialty. Many traditional outcomes reporting tools have been consistently employed in the study of otologic disease and treatment outcomes including standardized reporting schemes for Meniere's disease and facial nerve dysfunction. However, recent interest has surfaced in disease-specific quality-of-life outcomes measures for many otologic diseases such as sensorineural hearing loss, conductive hearing loss and suppurative otitis media. Several reliable and validated outcomes tools are available for the assessment of the impact on quality of life and treatment outcomes for common otologic afflictions that carry with them significant quality-of-life burdens. Furthermore, similar outcomes tools have been developed that allow a scientific appraisal of disease status and quality of life for dizziness and tinnitus, which have been traditionally difficult to quantify. Increasing familiarity with these outcomes tools will allow investigators to accurately assess and compare treatments for these otologic diseases and justify treatment initiatives in the future.

Hearing Aids↗

PubMedDate not supplied

Factors predicting survival for cancer of the ethmoid sinus.

OBJECTIVE: The aim of this study was to determine survival and prognostic factors for ethmoid sinus cancer. METHODS: From the Surveillance, Epidemiology, and End Results database for the time period 1988-1998, all cases of ethmoid sinus malignancy were extracted. Demographic, staging, treatment, and survival data were computed. Survival analysis was conducted with the Kaplan-Meier method. Clinical factors influencing survival were determined with the Cox proportional hazards model. RESULTS: After excluding patients with metastatic disease on presentation (8.9%) and patients with missing data for T stage, a total of 180 cases were identified. Average age was 60.2 years. Squamous cell carcinoma was the most common tumor (27.8%), followed by adenocarcinoma (12.8%). Overall mean survival was 57 months (median, 38 months) with a 5-year survival of 40.3%. The percentage of patients presenting with T4 lesions was 45.6%, which had a notably lower mean survival of 38 months (median, 18 months). Only 2.3% of patients had positive nodal disease. Increasing age, T stage, and absence of radiation therapy predicted poorer survival in the multivariate model Adenocarcinoma, adenoid cystic carcinoma, esthesioneuroblastoma, and melanoma showed more favorable survival than other tumor types. CONCLUSIONS: T stage and tumor histology are the most important prognostic factors in ethmoid sinus carcinoma. Survival for T4 lesions is markedly worse than survivalfor T1-T3 lesions. Radiation therapy offers a survival benefit in ethmoid sinus malignancy.

Adenocarcinoma↗

PubMedDate not supplied

Bacterial colonization of nasal steroid inhalers in chronic rhinosinusitis.

BACKGROUND: The aim of this study was to determine if nasal steroid inhalers harbor bacteria. METHODS: Nasal steroid inhalers were randomly selected from an adult patient population with chronic rhinosinusitis. Swab cultures of the tip of the nasal inhaler were obtained and submitted for microbiological analysis. Contemporaneous control cultures were obtained from freshly opened nasal steroid inhalers. Comparisons were conducted between bacterial recovery rates and types of organisms recovered from the patient and control groups. RESULTS: Among 31 nasal inhalers in use, 14 inhalers (45%) were found to harbor bacteria. The most common organisms were coagulase negative Staphylococci (11 inhalers) followed by oral flora (2 inhalers) and bacillus species (1 inhaler). None of the 10 control cultures were found to harbor bacteria. Nasal steroid inhalers in use were more likely to have bacterial colonization than new inhalers (p = 0.008, chi-square). CONCLUSIONS: Nasal steroid inhalers may harbor pathogenic bacteria. Therefore, they may serve as a vehicle for subsequent reinfection.

Adult↗

PubMedDate not supplied

The economic burden and symptom manifestations of chronic rhinosinusitis.

BACKGROUND: The aim of this study was to delineate patient symptoms and economic burdens of chronic rhinosinusitis (CRS). METHODS: Adult patients with CRS were assessed prospectively with a survey instrument. Symptom scores for major and minor symptoms of CRS, medication use, physician visits for CRS, and work days missed were determined. Cost analyses were conducted. RESULTS: Three hundred twenty-two patients were studied prospectively (mean age, 42.3 years). Nasal obstruction and facial congestion were the most common and severe major symptoms, and headache and fatigue were the most common and severe minor symptoms. Patients received an average of 2.7 antibiotic courses and used nasal steroids and prescription antihistamines 18.3 and 16.3 weeks, respectively, in a 12-month period. Mean medical resource costs were 921 dollars per patient-year. CRS caused an average of 4.8 days of missed work per 12-month period. The overall yearly economic cost of CRS was 1539 dollars per patient. CONCLUSION: Nasal and facial symptoms prevail over systemic and oropharyngeal symptoms in CRS. Significant medical resource expenditures and global economic costs accompany CRS.

Adolescent↗

PubMedDate not supplied

A comparison of symptom scores and radiographic staging systems in chronic rhinosinusitis.

BACKGROUND: The aim of this study was to determine if one of the popular computed tomography (CT) scan staging systems exhibits better correlation with sinonasal symptom severity in chronic rhinosinusitis (CRS). METHODS: Adult patients meeting diagnostic criteria for CRS were prospectively studied with the Rhinosinusitis Symptom Inventory and their paranasal sinus CT scan was staged according to the Kennedy, Harvard, and Lund staging systems. From the Rhinosinusitis Symptom Inventory, Likert symptom severity scores were obtained and the nasal, facial, oropharyngeal, systemic, and total symptom scores were computed. Correlation analysis was conducted between symptom scores and CT scan stage for each of the three staging systems. RESULTS: Two hundred patients met inclusion criteria (mean age, 41.1 years; 42% men). The mean Lund score for the entire cohort was 10.0 (SD, 5.3). The Kennedy stage distributions were 40, 42, 84, and 34 patients for stages 1-4, respectively. The Harvard stage distributions were 17, 53, 85, and 45 patients for stages 1-4, respectively. All three staging systems exhibited statistically significant Pearson correlation (all p < 0.001) for the nasal symptom domain (nasal obstruction, rhinorrhea, and hyposmia), although the magnitude of the correlation coefficient generally was small (range of Pearson's r, 0.242-0.345). The Kennedy and Harvard systems exhibited significant but negative correlation with the oropharyngeal symptom domain. All three staging systems failed to significantly correlate CT stage with facial symptoms, systemic symptoms, and total symptom scores. CONCLUSION: The Lund staging system exhibited the best correlation between nasal symptom scores and CT stage in CRS, but the degree of correlation remained small. All three systems were lacking in staging value for nonnasal sinonasal symptoms.

Adult↗

PubMedDate not supplied

Bacterial infection in chronic rhinosinusitis: a controlled paired analysis.

BACKGROUND: The aim of this study was to determine if pathogenic bacteria are involved in the pathogenesis of chronic rhinosinusitis (CRS). METHODS: A consecutive series of adult patients with unilateral sinus disease determined by unilateral radiographic involvement or unilateral purulent secretions was microbiologically studied. Aerobic and anaerobic bacterial and fungal cultures were obtained during endoscopic sinus surgery from purulent secretions or tissue culture. Positive culture rates were compared between the diseased sinus and the contralateral nondiseased (control) sinus to determine if pathogenic bacteria were more commonly recovered from the diseased sinuses. RESULTS: Forty-nine adult patients completed the study with appropriate microbiological data. Coagulase-negative staphylococci were the most commonly recovered bacteria followed by Staphylococcus aureus from the diseased side of the sinuses with similar findings for the control sinus. Bacterial species were recovered from 87.8% of the diseased side of the sinuses versus 85.7% from the control sinuses (p = 0.50). Reanalysis with coagulase-negative staphylococci considered as nonpathogen showed a 46.9 and 49.0% positive bacterial culture rate in diseased and control groups, respectively (p = 0.50). No significant difference in positive anaerobic culture rates were identified between groups (59.1% diseased versus 55.1% control, respectively, p = 0.61). Antibiotic resistance rates were no different between bacteria cultured from diseased sinuses versus control (p = 0.115). CONCLUSION: Both aerobic and anaerobic bacterial species may be recovered from both diseased and nondiseased sinuses in patients with CRS. These findings cast some doubt on the exact etiologic role of bacteria in CRS, suggesting other factors or other agents also may be responsible in CRS pathogenesis.

Adult↗