109 results on '"Laulajainen-Hongisto A"'
Search Results
2. The effect of single kinetic oscillation stimulation treatment on nonallergic rhinitis
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Sara Sainio, Karin Blomgren, Anu Laulajainen‐Hongisto, and Marie Lundberg
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kinetic oscillation stimulation ,minimally invasive ,nasal congestion ,nonallergic rhinitis ,patient‐reported outcome measures ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Objective Kinetic oscillation stimulation (KOS) is a new treatment method for nonallergic rhinitis (NAR), usually delivered twice with a 2‐ to 4‐week interval, and thought to stabilize autonomous dysregulation in the nasal mucosa. We aimed to assess the long‐term (1 year) results following one KOS treatment amongst patients with NAR. Methods KOS was administered through a latex balloon placed in the patient's nasal cavity. The balloon is connected to a device that fills the balloon with air pulses, thus vibrating the balloon for 10 min per side. Outcomes were evaluated through patient‐reported outcome measures (Sino‐Nasal Outcome Test 22 [SNOT‐22], Total Nasal Symptom Score [TNSS], Nasal Obstruction Symptom Evaluation [NOSE], and 15D) and measures of patency (rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow [PNIF], and clinical inferior turbinate size). Pre‐treatment actions were repeated at 1, 3, 6, and 12 months. Results In all 49 patients, we found significant improvement in the SNOT‐22, NOSE, and TNSS scores. At 12 months, SNOT‐22 improved from 44 to 34, NOSE from 60 to 45, TNSS from 8 to 7, and PNIF from 80 to 100 L/min (p
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- 2023
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3. Chronic Rhinosinusitis Outcome Registry (CHRINOSOR): Establishment of an International Outcome Registry Driven by mHealth Technology
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Seys, Sven F., Hellings, Peter W., Alobid, Isam, Backer, Vibeke, Bequignon, Emilie, von Buchwald, Christian, Cavaliere, Carlo, Coste, André, Deneyer, Lauren, Diamant, Zuzana, Eckl-Dorna, Julia, Fokkens, Wytske J., Gane, Simon, Gevaert, Philippe, Holbaek-Haase, Christiane, Holzmeister, Clemens, Hopkins, Claire, Hox, Valérie, Huart, Caroline, Jankowski, Roger, Jorissen, Mark, Kjeldsen, Anette, Knipps, Lisa, Lange, Bibi, van der Lans, Rik, Laulajainen-Hongisto, Anu, Larsen, Kenneth, Liu, David T., Lund, Valerie, Mariën, Gert, Masieri, Simonetta, Mortuaire, Geoffrey, Mullol, Joaquim, Reitsma, Sietze, Rombaux, Philippe, Schneider, Sven, Steinsvik, Andreas, Tomazic, Peter-Valentin, Toppila-Salmi, Sanna K., Van Gerven, Laura, Van Zele, Thibaut, Virkkula, Paula, Wagenmann, Martin, and Bachert, Claus
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- 2023
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4. Microbiome of the External Auditory Canal: Changes After Long-Term Hearing Aid Use.
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Sjövall, Atte, Mustanoja, Ella, Lyyski, Annina, Auvinen, Petri, Silvola, Juha, Aarnisalo, Antti, Pätäri-Sampo, Anu, and Laulajainen-Hongisto, Anu
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- 2024
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5. Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus
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Juha T. Laakso, Valtteri Rissanen, Eeva Ruotsalainen, Jarkko Korpi, Anu Laulajainen‐Hongisto, Ville Sivonen, and Saku T. Sinkkonen
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acute mastoiditis ,acute otitis media ,group A beta‐hemolytic streptococcus ,health‐related quality of life ,Streptococcus pyogenes ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Objective To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta‐hemolytic streptococcus (GAS). Study design A retrospective cohort study. Methods The yearly incidence of inpatient care‐needing GAS AOM/AM patients in our hospital catchment area between 2002 and 2018 was investigated. A detailed analysis was performed for cases treated during the last GAS epidemic in 2017‐2018. Anamnesis, signs and symptoms, pure‐tone audiometry results, treatment, complications, and outcome were collected from medical charts. Patients responded to an otology‐specific health‐related quality of life survey (EOS‐16) 1.5 to 3 years after their treatment. Results The number of GAS infections peaks at approximately 7‐year intervals. During 2017 and 2018, altogether 37 patients (29 adults and 8 children) were hospitalized due to GAS AOM/AM. AM was diagnosed in 14 (38%) patients. The disease progression was typically very rapid. At presentation, all patients had severe ear pain, 68% tympanic membrane perforation and discharge, 43% fever, and 43% vertigo. In pure‐tone audiometry, there was usually a marked mixed hearing loss at presentation. There was a significant recovery in both air and bone conduction thresholds; the pure tone average improvement from presentation was 32.3 ± 14.8 dB. Rapid strep tests (RST) proved to be more sensitive than bacterial culture in identifying GAS as a cause of AOM/AM. Conclusion GAS AOM/AM has a rapid onset. Hearing loss usually includes a sensorineural component, which is usually reversible with adequate treatment. RST seems to be useful in detecting GAS from middle ear discharge. Level of Evidence 4.
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- 2021
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6. Detection of Coalescent Acute Mastoiditis on MRI in Comparison with CT
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Saat, R., Kurdo, G., Laulajainen-Hongisto, A., Markkola, A., and Jero, J.
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- 2021
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7. Factors affecting upper airway control of NSAID‐exacerbated respiratory disease: A real‐world study of 167 patients
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Annina Lyly, Anu Laulajainen‐Hongisto, Heikki Turpeinen, Seija I. Vento, Jyri Myller, Jura Numminen, Saara Sillanpää, Johanna Sahlman, Paula Kauppi, and Sanna Toppila‐Salmi
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asthma ,CRS ,disease control ,eosinophilia ,nasal polyps ,N‐ERD ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Background Nonsteroidal anti‐inflammatory drug (NSAID) exacerbated respiratory disease (N‐ERD) is a triad with asthma, chronic rhinosinusitis with nasal polyps, and NSAID intolerance. Uncontrolled N‐ERD forms a major public health problem due to frequent and difficult‐to‐treat exacerbations and/or requiring putatively frequent endoscopic sinus surgeries (ESS). Our aim was to study factors affecting control of N‐ERD. Methods Retrospective patient record data (patient characteristics, prior sinus surgeries, follow‐up data in 2020) from 167 N‐ERD patients undergoing consultation at three tertiary hospitals from 2001 to 2017 was used. Outcome measurements reflecting uncontrolled N‐ERD were revision ESS, corticosteroids/biological therapy, and antibiotic courses during 2016–2020. Associations were analyzed by using nonparametric tests, Cox's proportional hazard, and binary logistic regression models. Results Nasal polyp eosinophilia increased the risk of revision surgery during the follow‐up (adjusted hazard ratio [aHR] 3.21, confidence interval 1.23–8.38). Also baseline oral corticosteroids (OCS; HR, 1.73, 1.04–2.89) and baseline surgery without total ethmoidectomy increased the risk of revision ESS (HR, 2.17, 1.07–4.42) in unadjusted models. In addition, both baseline OCS (adjusted odds ratio [aOR] 2.78, 1.23–6.26) and a history of ≥4 previous ESS (aOR, 2.15, 0.98–4.70) were associated with the use of OCS/biological therapy during the follow‐up, but not with high number of antibiotics. Conclusions Nasal polyp eosinophilia, baseline OCS, and a history of recurrent ESS predict uncontrolled N‐ERD. These factors might be clinically useful in risk‐estimation of uncontrolled disease and for organizing follow‐ups. Prospective cohort studies with larger sample size are needed to further study the factors affecting the upper airway control of N‐ERD.
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- 2021
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8. High Discontinuation Rates of Peroral ASA Treatment for CRSwNP: A Real-World Multicenter Study of 171 N-ERD Patients
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Laulajainen-Hongisto, Anu, Turpeinen, Heikki, Vento, Seija I., Numminen, Jura, Sahlman, Johanna, Kauppi, Paula, Virkkula, Paula, Hytönen, Maija, and Toppila-Salmi, Sanna
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- 2020
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9. Genomics of asthma, allergy and chronic rhinosinusitis: novel concepts and relevance in airway mucosa
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Anu Laulajainen-Hongisto, Annina Lyly, Tanzeela Hanif, Kishor Dhaygude, Matti Kankainen, Risto Renkonen, Kati Donner, Pirkko Mattila, Tuomas Jartti, Jean Bousquet, Paula Kauppi, and Sanna Toppila-Salmi
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Asthma ,Allergic rhinitis ,Airway epithelium ,GWAS ,Gene ontology ,Pathway ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Abstract Genome wide association studies (GWASs) have revealed several airway disease-associated risk loci. Their role in the onset of asthma, allergic rhinitis (AR) or chronic rhinosinusitis (CRS), however, is not yet fully understood. The aim of this review is to evaluate the airway relevance of loci and genes identified in GWAS studies. GWASs were searched from databases, and a list of loci associating significantly (p
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- 2020
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10. Eosinophilia, asthma, NERD and the use of oral corticosteroids predict uncontrolled chronic rhinosinusitis with nasal polyps after surgery.
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Penttilä, Elina, Sillanpää, Saara, Vento, Seija I., Myller, Jyri, Koskinen, Anni, Hammarén-Malmi, Sari, Laulajainen-Hongisto, Anu, Hytönen, Maija, Lyly, Annina, Lilja, Markus, Kauppi, Paula, Numminen, Jura, Rautiainen, Markus, Sahlman, Johanna, Nuutinen, Mikko, Toppila-Salmi, Sanna, and Virkkula, Paula
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- 2024
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11. Microbiome of the Healthy External Auditory Canal
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Sjövall, Atte, Aho, Velma T.E., Hyyrynen, Taneli, Kinnari, Teemu J., Auvinen, Petri, Silvola, Juha, Aarnisalo, Antti, and Laulajainen-Hongisto, Anu
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- 2020
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12. Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps: A Comparison in Patients With or Without NERD
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Markus Jukka Lilja MD, PhD, Anni Koskinen MD, PhD, Paula Virkkula MD, PhD, Seija Inkeri Vento MD, PhD, Jyri Myller MD, PhD, Sari Hammarén-Malmi MD, PhD, Anu Laulajainen-Hongisto MD, PhD, Maija Hytönen MD, PhD, Antti Mäkitie MD, PhD, Jura Numminen MD, PhD, Saara Sillanpää MD, PhD, Hannu Raitiola MD, PhD, Markus Rautiainen MD, PhD, and Sanna Katriina Toppila-Salmi MD, PhD
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Otorhinolaryngology ,RF1-547 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Objectives The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing : A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting Tertiary rhinology centers. Methods Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001–17 were studied. Mean follow-up time was 9.9 years (range 1.1–15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean ± SD of 4.3 ± 2.8 and 3.7 ± 2.6 years, respectively (p = .013, by Logrank test). In Cox´s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.
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- 2021
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13. Lung function and side effects of Aspirin desensitization: a real world study
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Heikki Turpeinen, Anu Laulajainen-Hongisto, Annina Lyly, Jura Numminen, Elina Penttilä, Johanna Sahlman, Sanna Toppila-Salmi, and Paula Kauppi
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asthma ,rhinosinusitis ,acetylsalicylic acid ,aspirin ,desensitization ,aerd ,n-erd ,Diseases of the respiratory system ,RC705-779 - Abstract
Introduction: NSAID-exacerbated respiratory disease (N-ERD) is mainly treated with topical and oral corticosteroids, as well as acetylsalicylic acid (ASA) treatment after desensitization (ATAD). During desensitization and ATAD, it is common to experience an exacerbation of respiratory symptoms and other side effects, which may lead to cessation of treatment. Objectives: The aim of this retrospective follow-up study was to evaluate the effect of ATAD on lung functions and respiratory symptoms, and to clarify the occurrence of adverse events. Methods: We analysed the patient data of 67 patients treated with ASA desensitization between 2006 and 2016 in three hospitals, concerning adverse events, respiratory symptoms, lung function tests, and reasons for discontinuation. Results: 26 patients discontinued AD or ATAD. The most common reasons for discontinuation were lack of response (9%) and side effects (18%). ATAD did not affect lung function values in the follow-up of up to 5 years. Upper respiratory symptoms improved in 31 (52%) and lower respiratory symptoms (LRS) in 7 (10%) cases. Side effects occurred in 42 (63%) cases, the most common being dyspepsia and lower respiratory symptoms. Conclusion: Our study suggests that ATAD has little effect on lower airway functions. Side effects were common, and discontinuation rates high.
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- 2021
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14. Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study
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P. Virkkula MD, PhD, E. Penttilä MD, PhD, S. I. Vento MD, PhD, J. Myller MD, PhD, A. Koskinen MD, PhD, S. Hammarén-Malmi MD, PhD, A. Laulajainen-Hongisto MD, PhD, M. Hytönen MD, PhD, M. Lilja MD, PhD, J. Numminen MD, PhD, S. Sillanpää MD, PhD, J. Sahlman MD, PhD, and S. Toppila-Salmi MD, PhD
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Otorhinolaryngology ,RF1-547 ,Immunologic diseases. Allergy ,RC581-607 - Abstract
Background Developing tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients. Methods Data of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001–19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC). Results ESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60–0.83), p = 0.001, for LM score 0.59 (0.50–0.67), p = 0.054; for NP score 0.56 (0.48–0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46–0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 10 9 /L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8). Conclusions Polyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.
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- 2020
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15. A New Classification System is Helpful in Diagnosing Intracranial Complications of Acute Mastoiditis in CT
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Saat, R., Kurdo, G., Brandstack, N., Laulajainen-Hongisto, A., Jero, J., and Markkola, A.
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- 2018
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16. Genomics of asthma, allergy and chronic rhinosinusitis: novel concepts and relevance in airway mucosa
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Laulajainen-Hongisto, Anu, Lyly, Annina, Hanif, Tanzeela, Dhaygude, Kishor, Kankainen, Matti, Renkonen, Risto, Donner, Kati, Mattila, Pirkko, Jartti, Tuomas, Bousquet, Jean, Kauppi, Paula, and Toppila-Salmi, Sanna
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- 2020
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17. Airway Epithelial Dynamics in Allergy and Related Chronic Inflammatory Airway Diseases
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Anu Laulajainen-Hongisto, Sanna Katriina Toppila-Salmi, Annika Luukkainen, and Robert Kern
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asthma ,chronic rhinosinusitis ,epithelium ,allergic rhinitis (AR) ,inflammation ,Biology (General) ,QH301-705.5 - Abstract
Allergic rhinitis, chronic rhinosinusitis, and asthma are highly prevalent, multifactorial chronic airway diseases. Several environmental and genetic factors affect airway epithelial dynamics leading to activation of inflammatory mechanisms in the airways. This review links environmental factors to host epithelial immunity in airway diseases. Understanding altered homeostasis of the airway epithelium might provide important targets for diagnostics and therapy of chronic airway diseases.
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- 2020
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18. Laser, radiofrequency or tympanostomy knife? : Comparison of surgical methods in tympanostomy treatment of young children and predictive value of tympanometry
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Anu Laulajainen-Hongisto, Juha Silvola, Atte Sjövall, Korva-, nenä- ja kurkkutautien klinikka, Päijät-Häme Welfare Consortium, HUS Head and Neck Center, Faculty Common Matters (Faculty of Medicine), HYKS erva, and Clinicum
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Otorhinolaryngology ,CO2 laser ,Radiofrequency ,Pediatrics, Perinatology and Child Health ,Tympanometry ,Myringosclerosis ,General Medicine ,3125 Otorhinolaryngology, ophthalmology ,Tympanostomy treatment ,Myringotomy - Abstract
Objectives: To investigate tympanostomy tube (TT) treatment in young children, with special interest in bloodless surgical methods (laser and radiofrequency), myringosclerosis formation and tympanometric testing.Methods: This prospective study includes 76 children whose 121 ears with middle ear effusion were treated with tympanostomy tubes. Myringotomy was performed with CO2 laser in 37, radiofrequency in 40 and myringotomy knife in 44 ears. The ears were evaluated with otomicroscopy and tympanometry preoperatively and post-operatively every 3-4 months until spontaneous tube extrusion.Results: All tubes extruded spontaneously (mean 12.8 months, range 3-36 months), with no persistent perfora-tions or cholesteatomas. CO2 laser and radiofrequency inserted tympanostomy tubes extruded faster (mean 11 months) compared to incisional myringotomy (mean 15 months, p = 0.002). Myringosclerosis was noted in 25 (21%) ears after treatment. There was a tendency to less myringosclerosis with bloodless techniques, but the difference was not significant. Flat tympanograms on the day of procedure predicted continuation of ventilation problems also after TT treatment (p = 0.003). Ears with preoperative type B tympanogram had significantly more myringosclerosis 21/75 (28%) compared with type A and C tympanograms 4/41 (10%) (p = 0.032).Conclusions: While all myringotomy methods were effective and safe, the traditional incisional myringotomy with a tympanostomy knife is still a good, feasible and cost-effective myringotomy method. No surgical removal of tympanostomy tubes is needed before 3 years of uncomplicated tympanostomy treatment. Tympanometry turned out to be a useful tool in prediction of post TT treatment ventilation problems of the middle ear.
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- 2023
19. Monoclonal Antibodies and Airway Diseases
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Annina Lyly, Anu Laulajainen-Hongisto, Philippe Gevaert, Paula Kauppi, and Sanna Toppila-Salmi
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airways ,asthma ,chronic rhinosinusitis ,biologicals ,monoclonal antibody ,Biology (General) ,QH301-705.5 ,Chemistry ,QD1-999 - Abstract
Monoclonal antibodies, biologics, are a relatively new treatment option for severe chronic airway diseases, asthma, allergic rhinitis, and chronic rhinosinusitis (CRS). In this review, we focus on the physiological and pathomechanisms of monoclonal antibodies, and we present recent study results regarding their use as a therapeutic option against severe airway diseases. Airway mucosa acts as a relative barrier, modulating antigenic stimulation and responding to environmental pathogen exposure with a specific, self-limited response. In severe asthma and/or CRS, genome–environmental interactions lead to dysbiosis, aggravated inflammation, and disease. In healthy conditions, single or combined type 1, 2, and 3 immunological response pathways are invoked, generating cytokine, chemokine, innate cellular and T helper (Th) responses to eliminate viruses, helminths, and extracellular bacteria/fungi, correspondingly. Although the pathomechanisms are not fully known, the majority of severe airway diseases are related to type 2 high inflammation. Type 2 cytokines interleukins (IL) 4, 5, and 13, are orchestrated by innate lymphoid cell (ILC) and Th subsets leading to eosinophilia, immunoglobulin E (IgE) responses, and permanently impaired airway damage. Monoclonal antibodies can bind or block key parts of these inflammatory pathways, resulting in less inflammation and improved disease control.
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- 2020
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20. Otitis Media-associated Bacterial Meningitis in Children in a Low-income Country
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Lempinen, Laura, Karppinen, Mariia, Pelkonen, Tuula, Laulajainen-Hongisto, Anu, Aarnisalo, Antti A., Sinkkonen, Saku T., Bernardino, Luis, Peltola, Heikki, Pitkäranta, Anne, and Jero, Jussi
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- 2019
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21. Children hospitalized due to acute otitis media: How does this condition differ from acute mastoiditis?
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Laulajainen-Hongisto, Anu, Saat, Riste, Lempinen, Laura, Aarnisalo, Antti A., and Jero, Jussi
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- 2015
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22. Differentiating Acute Otitis Media and Acute Mastoiditis in Hospitalized Children
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Laulajainen-Hongisto, Anu, Aarnisalo, Antti A., and Jero, Jussi
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- 2016
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23. Bacteriology in relation to clinical findings and treatment of acute mastoiditis in children
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Laulajainen-Hongisto, Anu, Saat, Riste, Lempinen, Laura, Markkola, Antti, Aarnisalo, Antti A., and Jero, Jussi
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- 2014
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24. Hearing impairment in Angolan children with acute bacterial meningitis with and without otitis media
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Laura Lempinen, Anu Laulajainen‐Hongisto, Antti A. Aarnisalo, Luis Bernardino, Heikki Peltola, Anne Pitkäranta, Tuula Pelkonen, Jussi Jero, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Faculty Common Matters (Faculty of Medicine), University of Helsinki, HUS Children and Adolescents, Lastentautien yksikkö, Children's Hospital, and Clinicum
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child ,COMPLICATIONS ,Hearing Tests ,otitis media ,General Medicine ,hearing impairment ,Meningitis, Bacterial ,INFECTIONS ,3123 Gynaecology and paediatrics ,Pediatrics, Perinatology and Child Health ,Evoked Potentials, Auditory, Brain Stem ,Humans ,Hearing Loss ,bacterial meningitis ,PREDICTORS ,otorrhoea - Abstract
Aim Bacterial meningitis (BM) is a common cause of hearing loss in childhood. Our aim was to investigate bacterial aetiology, hearing impairment and outcome in childhood BM with vs. without otitis media (OM) in Angola. Methods Hearing was tested by auditory brainstem response in 391 (76%) children with confirmed BM. The bacteria identified from the ear discharge were compared to those from cerebrospinal fluid (CSF). The hearing findings were compared among children with vs. without OM on days 1 and 7 of hospitalization, and at follow-ups of 1, 3 and 6 month(s). Results No correlation was found in bacteriology between the ear discharge and CSF. On day 7 in hospital, hearing impairment (>40 dB) was common, regardless of whether concomitant OM or not (in 27% vs. 30%, respectively). Any hearing deficit on day 7 was associated with a higher risk of complicated or fatal clinical course (OR 2.76, CI95% 1.43-5.29, p = 0.002). Conclusion No significant difference prevailed in hearing thresholds between children with or without OM in hospital on day 7 or at later follow-ups. Any hearing impairment during hospital stay associated with a higher risk for complicated clinical course or death.
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- 2022
25. The effect of single kinetic oscillation stimulation treatment on nonallergic rhinitis.
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Sainio, Sara, Blomgren, Karin, Laulajainen‐Hongisto, Anu, and Lundberg, Marie
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RHINITIS ,NASAL mucosa ,NASAL cavity ,OSCILLATIONS ,DEEP brain stimulation - Abstract
Objective: Kinetic oscillation stimulation (KOS) is a new treatment method for nonallergic rhinitis (NAR), usually delivered twice with a 2‐ to 4‐week interval, and thought to stabilize autonomous dysregulation in the nasal mucosa. We aimed to assess the long‐term (1 year) results following one KOS treatment amongst patients with NAR. Methods: KOS was administered through a latex balloon placed in the patient's nasal cavity. The balloon is connected to a device that fills the balloon with air pulses, thus vibrating the balloon for 10 min per side. Outcomes were evaluated through patient‐reported outcome measures (Sino‐Nasal Outcome Test 22 [SNOT‐22], Total Nasal Symptom Score [TNSS], Nasal Obstruction Symptom Evaluation [NOSE], and 15D) and measures of patency (rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow [PNIF], and clinical inferior turbinate size). Pre‐treatment actions were repeated at 1, 3, 6, and 12 months. Results: In all 49 patients, we found significant improvement in the SNOT‐22, NOSE, and TNSS scores. At 12 months, SNOT‐22 improved from 44 to 34, NOSE from 60 to 45, TNSS from 8 to 7, and PNIF from 80 to 100 L/min (p <.005 for all). We observed no major complications. Conclusion: One KOS treatment appears to provide NAR patients with a subjective symptom improvement for at least 1 year, thus possibly decreasing the need for invasive treatment methods. Level of Evidence: III. [ABSTRACT FROM AUTHOR]
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- 2023
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26. Comparison of MR imaging findings in paediatric and adult patients with acute mastoiditis and incidental intramastoid bright signal on T2-weighted images
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Saat, R., Mahmood, G., Laulajainen-Hongisto, A., Lempinen, L., Aarnisalo, A. A., Jero, J., and Markkola, A.
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- 2016
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27. Detection of Coalescent Acute Mastoiditis on MRI in Comparison with CT
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Anu Laulajainen-Hongisto, Riste Saat, Jussi Jero, G. Kurdo, Antti Markkola, HUS Medical Imaging Center, Department of Diagnostics and Therapeutics, University of Helsinki, Helsinki University Hospital Area, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, and Clinicum
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Mastoiditis ,Temporal bone ,Middle ear ,Computed tomography ,DIAGNOSIS ,Sensitivity and Specificity ,030218 nuclear medicine & medical imaging ,Coalescent theory ,Imaging ,03 medical and health sciences ,0302 clinical medicine ,CONTRAST-ENHANCED FLAIR ,medicine ,Effective diffusion coefficient ,Humans ,Radiology, Nuclear Medicine and imaging ,COMPUTED-TOMOGRAPHY ,Otitis media ,Neuroradiology ,Retrospective Studies ,ACUTE OTITIS-MEDIA ,medicine.diagnostic_test ,business.industry ,Magnetic resonance imaging ,medicine.disease ,3126 Surgery, anesthesiology, intensive care, radiology ,Magnetic Resonance Imaging ,Acute mastoiditis ,Diffusion Magnetic Resonance Imaging ,EMPYEMAS ,Original Article ,Neurology (clinical) ,business ,Nuclear medicine ,Infection ,Tomography, X-Ray Computed ,030217 neurology & neurosurgery - Abstract
Purpose Current imaging standard for acute mastoiditis (AM) is contrast-enhanced computed tomography (CT), revealing inflammation-induced bone destruction, whereas magnetic resonance imaging (MRI) outperforms CT in detecting intracranial infection. Our aim was to compare the diagnostic performance of MRI with CT in detecting coalescent AM and see to which extent MRI alone would suffice to diagnose or rule out this condition. Methods The MR images of 32 patients with AM were retrospectively analyzed. Bone destruction was evaluated from T2 turbo spin echo (TSE) and T1 Gd magnetization-prepared rapid acquisition with gradient echo (MPRAGE) images. Intramastoid enhancement and diffusion restriction were evaluated subjectively and intramastoid apparent diffusion coefficient (ADC) values were measured. The MRI findings were compared with contrast-enhanced CT findings of the same patients within 48 h of the MR scan. Results Depending on the anatomical subsite, MRI detected definite bone defects with a sensitivity of 100% and a specificity of 54–82%. Exception was the inner cortical table where sensitivity was only 14% and specificity was 76%. Sensitivity for general coalescent mastoiditis remained 100% due to multiple coexisting lesions. The absence of intense enhancement and non-restricted diffusion had a high negative predictive value for coalescent mastoiditis: an intramastoid ADC above 1.2 × 10−3 mm2/s excluded coalescent mastoiditis with a negative predictive value of 92%. Conclusion The MRI did not miss coalescent mastoiditis but was inferior to CT in direct estimation of bone defects. When enhancement and diffusion characteristics are also considered, MRI enables dividing patients into low, intermediate and high-risk categories with respect to coalescent mastoiditis, where only the intermediate risk group is likely to benefit from additional CT.
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- 2020
28. Severe acute otitis media and mastoiditis caused by group A beta-hemolytic streptococcus
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Jarkko Korpi, Valtteri Rissanen, Anu Laulajainen-Hongisto, Saku T. Sinkkonen, Ville Sivonen, Juha Laakso, Eeva Ruotsalainen, Korva-, nenä- ja kurkkutautien klinikka, HUS Head and Neck Center, HUS Inflammation Center, Infektiosairauksien yksikkö, and University of Helsinki
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Pediatrics ,medicine.medical_specialty ,Mastoiditis ,Microbiological culture ,RD1-811 ,Hearing loss ,Streptococcus pyogenes ,UNITED-STATES ,CHILDREN ,acute mastoiditis ,DISEASE ,03 medical and health sciences ,0302 clinical medicine ,Vertigo ,medicine ,otorhinolaryngologic diseases ,EPIDEMIOLOGY ,030212 general & internal medicine ,3125 Otorhinolaryngology, ophthalmology ,Original Research ,0303 health sciences ,COMPLICATIONS ,health‐related quality of life ,biology ,medicine.diagnostic_test ,030306 microbiology ,business.industry ,Incidence (epidemiology) ,acute otitis media ,Retrospective cohort study ,General Medicine ,biology.organism_classification ,medicine.disease ,group A beta‐hemolytic streptococcus ,3. Good health ,health-related quality of life ,PYOGENES ,medicine.anatomical_structure ,Otorhinolaryngology ,RF1-547 ,INFECTIONS ,Middle ear ,Surgery ,Otology, Neurotology, and Neuroscience ,medicine.symptom ,Audiometry ,business ,group A beta-hemolytic streptococcus - Abstract
Objective To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta-hemolytic streptococcus (GAS). Study design A retrospective cohort study. Methods The yearly incidence of inpatient care-needing GAS AOM/AM patients in our hospital catchment area between 2002 and 2018 was investigated. A detailed analysis was performed for cases treated during the last GAS epidemic in 2017-2018. Anamnesis, signs and symptoms, pure-tone audiometry results, treatment, complications, and outcome were collected from medical charts. Patients responded to an otology-specific health-related quality of life survey (EOS-16) 1.5 to 3 years after their treatment. Results The number of GAS infections peaks at approximately 7-year intervals. During 2017 and 2018, altogether 37 patients (29 adults and 8 children) were hospitalized due to GAS AOM/AM. AM was diagnosed in 14 (38%) patients. The disease progression was typically very rapid. At presentation, all patients had severe ear pain, 68% tympanic membrane perforation and discharge, 43% fever, and 43% vertigo. In pure-tone audiometry, there was usually a marked mixed hearing loss at presentation. There was a significant recovery in both air and bone conduction thresholds; the pure tone average improvement from presentation was 32.3 +/- 14.8 dB. Rapid strep tests (RST) proved to be more sensitive than bacterial culture in identifying GAS as a cause of AOM/AM. Conclusion GAS AOM/AM has a rapid onset. Hearing loss usually includes a sensorineural component, which is usually reversible with adequate treatment. RST seems to be useful in detecting GAS from middle ear discharge. Level of Evidence 4.
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- 2021
29. The Nose as a Route for Therapy: Part 1. Pharmacotherapy
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Nuray Bayar Muluk, Nikolaos G. Papadopoulos, Anu Laulajainen-Hongisto, Ludger Klimek, Maija Hytönen, Glenis K. Scadding, Dimitrios Mitsias, Cemal Cingi, Sanna Toppila-Salmi, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Clinicum, HUS Inflammation Center, Department of Pathology, Department of Dermatology, Allergology and Venereology, and Medicum
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business.industry ,Mucociliary clearance ,Nasal structure ,Nasal epithelium ,3. Good health ,03 medical and health sciences ,0302 clinical medicine ,medicine.anatomical_structure ,Pharmacotherapy ,030228 respiratory system ,Anesthesia ,medicine ,otorhinolaryngologic diseases ,Nasal administration ,3125 Otorhinolaryngology, ophthalmology ,030223 otorhinolaryngology ,Adverse effect ,business ,Sinus (anatomy) ,Nose - Abstract
This article reviews nasal structure and function in the light of intranasal pharmacotherapy. The nose provides an accessible, fast route for local treatment of nose and sinus diseases, with lower doses than are necessary systemically and few adverse effects. It can also be used for other medications as it has sufficient surface area protected from local damage by mucociliary clearance, absence of digestive enzymes, responsive blood flow, and provides a rapid route to the central nervous system.
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- 2021
30. Lung function and side effects of Aspirin desensitization: a real world study
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Toppila Salmi Sanna, Turpeinen Heikki, Johanna Sahlman, Laulajainen Hongisto Anu, Lyly Annina, Penttilä Elina, Numminen Jura, Kauppi Paula, Tampere University, Department of Otology and Oral Diseases, Clinical Medicine, Department of Dermatology, Allergology and Venereology, Helsinki University Hospital Area, University of Helsinki, Department of Diagnostics and Therapeutics, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Clinicum, and HUS Inflammation Center
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Pulmonary and Respiratory Medicine ,aspirin ,medicine.medical_treatment ,desensitization ,Pharmacology ,3121 Internal medicine ,03 medical and health sciences ,Diseases of the respiratory system ,0302 clinical medicine ,Medicine ,3125 Otorhinolaryngology, ophthalmology ,030223 otorhinolaryngology ,rhinosinusitis ,n-erd ,Lung function ,Desensitization (medicine) ,Asthma ,aerd ,Aspirin ,RC705-779 ,business.industry ,Respiratory disease ,asthma ,acetylsalicylic acid ,medicine.disease ,digestive system diseases ,3. Good health ,stomatognathic diseases ,030228 respiratory system ,3121 General medicine, internal medicine and other clinical medicine ,business ,medicine.drug ,Research Article - Abstract
Introduction: NSAID-exacerbated respiratory disease (N-ERD) is mainly treated with topical and oral corticosteroids, as well as acetylsalicylic acid (ASA) treatment after desensitization (ATAD). During desensitization and ATAD, it is common to experience an exacerbation of respiratory symptoms and other side effects, which may lead to cessation of treatment. Objectives: The aim of this retrospective follow-up study was to evaluate the effect of ATAD on lung functions and respiratory symptoms, and to clarify the occurrence of adverse events. Methods: We analysed the patient data of 67 patients treated with ASA desensitization between 2006 and 2016 in three hospitals, concerning adverse events, respiratory symptoms, lung function tests, and reasons for discontinuation. Results: 26 patients discontinued AD or ATAD. The most common reasons for discontinuation were lack of response (9%) and side effects (18%). ATAD did not affect lung function values in the follow-up of up to 5 years. Upper respiratory symptoms improved in 31 (52%) and lower respiratory symptoms (LRS) in 7 (10%) cases. Side effects occurred in 42 (63%) cases, the most common being dyspepsia and lower respiratory symptoms. Conclusion: Our study suggests that ATAD has little effect on lower airway functions. Side effects were common, and discontinuation rates high. publishedVersion
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- 2021
31. Factors Affecting the Control of Chronic Rhinosinusitis With Nasal Polyps : A Comparison in Patients With or Without NERD
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Lilja, Markus Jukka, Koskinen, Anni, Virkkula, Paula, Vento, Seija Inkeri, Myller, Jyri, Hammaren-Malmi, Sari, Laulajainen-Hongisto, Anu, Hytönen, Maija, Mäkitie, Antti, Numminen, Jura, Sillanpää, Saara, Raitiola, Hannu, Rautiainen, Markus, Toppila-Salmi, Sanna Katriina, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Department of Dermatology, Allergology and Venereology, HUS Inflammation Center, University of Helsinki, HYKS erva, Päijät-Häme Welfare Consortium, Clinicum, Department of Pathology, Medicum, Tampere University, Department of Otology and Oral Diseases, and Clinical Medicine
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RISK ,EOSINOPHIL ,chronic rhinosinusitis ,sinusitis ,computed tomography ,Clinical Trial ,REVISION RATE ,LIFE ,paranasal sinuses ,diagnostics ,RATES ,3125 Otorhinolaryngology, ophthalmology ,RECURRENCE ,ENDOSCOPIC SINUS SURGERY - Abstract
Objectives: The aim was to compare the control of chronic rhinosinusitis with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS), in patients with/without nonsteroidal anti-inflammatory drug exacerbated respiratory disease (NERD). Study Desing: A retrospective hospital-based sample of CRSwNP patients with/without NERD with follow-up. Setting: Tertiary rhinology centers. Methods: Electronic patient record data from 116 CRSwNP patients (46 with NERD and 70 without NERD) undergoing ESS during 2001-17 were studied. Mean follow-up time was 9.9 years (range 1.1-15.3). Endpoints reflecting uncontrolled CRSwNP were revision ESS, and need for rescue/advanced therapy (e.g. antibiotics, oral corticosteroids and/or biological therapy) during follow-up. NERD was variable of interest and gender, age, asthma, allergic rhinitis (AR), smoking, Lund-Mackay (LM) score of sinus computed tomography scans previous ESS and baseline total ethmoidectomy were used as covariates. Results: Twenty-one (49.7%) NERD patients and 18 (25.7%) non-NERD patients underwent revision ESS within a mean +/- SD of 4.3 +/- 2.8 and 3.7 +/- 2.6 years, respectively (p = .013, by Logrank test). In Cox ' s regression models, NERD, female gender, young age, asthma, AR, previous ESS, and lack of total ethmoidectomy were associated with revision-ESS. In adjusted model, only the total ethmoidectomy predicted revision-free survival. In adjusted logistic regression model, there was an insignificant trend that NERD and LM score were associated with the need for rescue/advanced therapy in the follow-up. Conclusions: Patients with NERD had higher risk of uncontrolled CRSwNP than patient group without NERD, as measured by revision ESS and/or need for rescue/advanced therapy in the follow-up. In addition, baseline total ethmoidectomy was associated with revision-free survival.
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- 2021
32. Hearing impairment in Angolan children with acute bacterial meningitis with and without otitis media.
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Lempinen, Laura, Laulajainen‐Hongisto, Anu, Aarnisalo, Antti A., Bernardino, Luis, Peltola, Heikki, Pitkäranta, Anne, Pelkonen, Tuula, and Jero, Jussi
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HEARING impaired children , *BACTERIAL meningitis , *OTITIS media , *HEARING disorders , *CEREBROSPINAL fluid - Abstract
Aim: Bacterial meningitis (BM) is a common cause of hearing loss in childhood. Our aim was to investigate bacterial aetiology, hearing impairment and outcome in childhood BM with vs. without otitis media (OM) in Angola. Methods: Hearing was tested by auditory brainstem response in 391 (76%) children with confirmed BM. The bacteria identified from the ear discharge were compared to those from cerebrospinal fluid (CSF). The hearing findings were compared among children with vs. without OM on days 1 and 7 of hospitalization, and at follow‐ups of 1, 3 and 6 month(s). Results: No correlation was found in bacteriology between the ear discharge and CSF. On day 7 in hospital, hearing impairment (>40 dB) was common, regardless of whether concomitant OM or not (in 27% vs. 30%, respectively). Any hearing deficit on day 7 was associated with a higher risk of complicated or fatal clinical course (OR 2.76, CI95% 1.43–5.29, p = 0.002). Conclusion: No significant difference prevailed in hearing thresholds between children with or without OM in hospital on day 7 or at later follow‐ups. Any hearing impairment during hospital stay associated with a higher risk for complicated clinical course or death. [ABSTRACT FROM AUTHOR]
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- 2022
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33. Monoclonal Antibodies and Airway Diseases
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Lyly, Annina, Laulajainen-Hongisto, Anu, Gevaert, Philippe, Kauppi, Paula, Toppila-Salmi, Sanna, Clinicum, Department of Dermatology, Allergology and Venereology, Helsinki University Hospital Area, HUS Inflammation Center, Korva-, nenä- ja kurkkutautien klinikka, HUS Head and Neck Center, Keuhkosairauksien yksikkö, HUS Heart and Lung Center, Department of Pathology, and Medicum
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ORAL CRTH2 ANTAGONIST ,chronic rhinosinusitis ,ANTI-TNF-ALPHA ,asthma ,CELL-MEDIATED CYTOTOXICITY ,STAPHYLOCOCCUS-AUREUS ENTEROTOXIN ,EOSINOPHILIC INFLAMMATION ,DOUBLE-BLIND ,biologicals ,monoclonal antibody ,3121 General medicine, internal medicine and other clinical medicine ,NASAL POLYPS ,1182 Biochemistry, cell and molecular biology ,EPSILON-RI EXPRESSION ,airways ,SEVERE ASTHMA - Abstract
Monoclonal antibodies, biologics, are a relatively new treatment option for severe chronic airway diseases, asthma, allergic rhinitis, and chronic rhinosinusitis (CRS). In this review, we focus on the physiological and pathomechanisms of monoclonal antibodies, and we present recent study results regarding their use as a therapeutic option against severe airway diseases. Airway mucosa acts as a relative barrier, modulating antigenic stimulation and responding to environmental pathogen exposure with a specific, self-limited response. In severe asthma and/or CRS, genome-environmental interactions lead to dysbiosis, aggravated inflammation, and disease. In healthy conditions, single or combined type 1, 2, and 3 immunological response pathways are invoked, generating cytokine, chemokine, innate cellular and T helper (Th) responses to eliminate viruses, helminths, and extracellular bacteria/fungi, correspondingly. Although the pathomechanisms are not fully known, the majority of severe airway diseases are related to type 2 high inflammation. Type 2 cytokines interleukins (IL) 4, 5, and 13, are orchestrated by innate lymphoid cell (ILC) and Th subsets leading to eosinophilia, immunoglobulin E (IgE) responses, and permanently impaired airway damage. Monoclonal antibodies can bind or block key parts of these inflammatory pathways, resulting in less inflammation and improved disease control.
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- 2020
34. Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study
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Sanna Toppila-Salmi, Elina Penttilä, Jyri Myller, Anni Koskinen, Maija Hytönen, Saara Sillanpää, Seija Vento, Sari Hammarén-Malmi, Anu Laulajainen-Hongisto, Johanna Sahlman, Markus Lilja, Jura Numminen, Paula Virkkula, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, University of Helsinki, Helsinki University Hospital Area, Clinicum, HYKS erva, Päijät-Häme Welfare Consortium, HUS Inflammation Center, Department of Pathology, Department of Dermatology, Allergology and Venereology, Medicum, Tampere University, Department of Otology and Oral Diseases, and Clinical Medicine
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lcsh:Immunologic diseases. Allergy ,medicine.medical_specialty ,Allergy ,Chronic rhinosinusitis ,sinusitis ,3121 Internal medicine ,03 medical and health sciences ,0302 clinical medicine ,LONG-TERM OUTCOMES ,medicine ,Immunology and Allergy ,Nasal polyps ,3125 Otorhinolaryngology, ophthalmology ,030223 otorhinolaryngology ,Sinusitis ,Surgical treatment ,RECURRENCE ,HYPERSENSITIVITY ,Asthma ,Original Research ,nasal polyp ,Aspirin ,business.industry ,chronic rhinosinusitis ,computed tomography ,medicine.disease ,lcsh:Otorhinolaryngology ,lcsh:RF1-547 ,Surgery ,PREVALENCE ,ASPIRIN ,ALLERGY ,Endoscopic sinus surgery ,REVISION RATES ,030228 respiratory system ,Otorhinolaryngology ,ASTHMA ,business ,lcsh:RC581-607 ,ENDOSCOPIC SINUS SURGERY ,medicine.drug - Abstract
BackgroundDeveloping tools to identify chronic rhinosinusitis with nasal polyps (CRSwNP) patients requiring surgical treatment would help clinicians treat patients more effectively. The aim of this retrospective cross-sectional study was to identify cut-off values for eosinophil percentage, nasal polyps (NP), and Lund-Mackay (LM) scores that may predict the need for surgical treatment in Finnish CRSwNP patients.MethodsData of CRSwNP patients (N = 378) undergoing consultation for ESS in 2001–19 were used. Data was collected from patient records and Lund-Mackay scores were determined from sinus computed tomography scans. The percentage of eosinophils was microscopically evaluated from the polyp samples available (n = 81). Associations were analyzed by Mann Whitney U test, and cut-off values by the area under the receiver operating characteristic curve (AUROC).ResultsESS was performed to 293 (77.5%) of patients. Polyp eosinophilia was associated significantly with ESS (p = 0.001), whereas peripheral blood eosinophil count, LM- score and endoscopic NP- score were not (p > 0.05). AUROC values (95% CI) for detecting those needing ESS were for polyp eosinophilia 0.71 (0.60–0.83), p = 0.001, for LM score 0.59 (0.50–0.67), p = 0.054; for NP score 0.56 (0.48–0.64), p = 0.17, and for blood eosinophil count 0.68 (0.46–0.90), p = 0.08. With the threshold value of polyp eosinophilia (>25%), the sensitivity and specificity were optimal for detecting the group needing ESS from the group not undergoing ESS. The cut-off value of blood eosinophil count (>0.26 × 109/L) had relatively good, yet statistically insignificant (underpowered), predictive potential. Moderate cut-off values were found for endoscopic LM score (≥14/24) and NP score (≥4/8).ConclusionsPolyp eosinophilia (>25%) predicted ESS among Finnish hospital-level CRSwNP patients. A future challenge would be to find less invasive and cost-effective clinical factors predicting uncontrolled CRSwNP.
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- 2020
35. Airway Epithelial Dynamics in Allergy and Related Chronic Inflammatory Airway Diseases
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Laulajainen-Hongisto, Anu, Toppila-Salmi, Sanna Katriina, Luukkainen, Annika, Kern, Robert, HUS Head and Neck Center, Korva-, nenä- ja kurkkutautien klinikka, Clinicum, Helsinki University Hospital Area, University of Helsinki, HUS Inflammation Center, Department of Pathology, Department of Dermatology, Allergology and Venereology, and Medicum
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MUCOUS CELL METAPLASIA ,chronic rhinosinusitis ,allergic rhinitis (AR) ,RHINOVIRUS INFECTION ,BARRIER DYSFUNCTION ,respiratory system ,asthma ,respiratory tract diseases ,DIFFERENTIAL EXPRESSION ,inflammation ,CIGARETTE-SMOKE ,PERIOSTIN EXPRESSION ,NASAL POLYPS ,1182 Biochemistry, cell and molecular biology ,PRIMARY CILIARY DYSKINESIA ,epithelium ,GENE-EXPRESSION - Abstract
Allergic rhinitis, chronic rhinosinusitis, and asthma are highly prevalent, multifactorial chronic airway diseases. Several environmental and genetic factors affect airway epithelial dynamics leading to activation of inflammatory mechanisms in the airways. This review links environmental factors to host epithelial immunity in airway diseases. Understanding altered homeostasis of the airway epithelium might provide important targets for diagnostics and therapy of chronic airway diseases.
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- 2020
36. Lung function and side effects of Aspirin desensitization: a real world study.
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Turpeinen, Heikki, Laulajainen-Hongisto, Anu, Lyly, Annina, Numminen, Jura, Penttilä, Elina, Sahlman, Johanna, Toppila-Salmi, Sanna, and Kauppi, Paula
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- 2021
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37. Severe acute otitis media and mastoiditis caused by group A beta‐hemolytic streptococcus.
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Laakso, Juha T., Rissanen, Valtteri, Ruotsalainen, Eeva, Korpi, Jarkko, Laulajainen‐Hongisto, Anu, Sivonen, Ville, and Sinkkonen, Saku T.
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ACUTE otitis media ,BONE conduction ,MASTOIDITIS ,TYMPANIC membrane perforation ,STREPTOCOCCUS ,EAR ,MIDDLE ear - Abstract
Objective: To describe the characteristics, diagnostics, treatment, and outcome of severe acute otitis media (AOM) and acute mastoiditis (AM) caused by group A beta‐hemolytic streptococcus (GAS). Study design: A retrospective cohort study. Methods: The yearly incidence of inpatient care‐needing GAS AOM/AM patients in our hospital catchment area between 2002 and 2018 was investigated. A detailed analysis was performed for cases treated during the last GAS epidemic in 2017‐2018. Anamnesis, signs and symptoms, pure‐tone audiometry results, treatment, complications, and outcome were collected from medical charts. Patients responded to an otology‐specific health‐related quality of life survey (EOS‐16) 1.5 to 3 years after their treatment. Results: The number of GAS infections peaks at approximately 7‐year intervals. During 2017 and 2018, altogether 37 patients (29 adults and 8 children) were hospitalized due to GAS AOM/AM. AM was diagnosed in 14 (38%) patients. The disease progression was typically very rapid. At presentation, all patients had severe ear pain, 68% tympanic membrane perforation and discharge, 43% fever, and 43% vertigo. In pure‐tone audiometry, there was usually a marked mixed hearing loss at presentation. There was a significant recovery in both air and bone conduction thresholds; the pure tone average improvement from presentation was 32.3 ± 14.8 dB. Rapid strep tests (RST) proved to be more sensitive than bacterial culture in identifying GAS as a cause of AOM/AM. Conclusion: GAS AOM/AM has a rapid onset. Hearing loss usually includes a sensorineural component, which is usually reversible with adequate treatment. RST seems to be useful in detecting GAS from middle ear discharge. Level of Evidence: 4. [ABSTRACT FROM AUTHOR]
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- 2021
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38. Microbiome of the Healthy External Auditory Canal.
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Sjövall, Atte, Aho, Velma T. E., Hyyrynen, Taneli, Kinnari, Teemu J., Auvinen, Petri, Silvola, Juha, Aarnisalo, Antti, and Laulajainen-Hongisto, Anu
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- 2021
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39. Factors affecting upper airway control of NSAID‐exacerbated respiratory disease: A real‐world study of 167 patients.
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Lyly, Annina, Laulajainen‐Hongisto, Anu, Turpeinen, Heikki, Vento, Seija I., Myller, Jyri, Numminen, Jura, Sillanpää, Saara, Sahlman, Johanna, Kauppi, Paula, and Toppila‐Salmi, Sanna
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RESPIRATORY diseases , *NASAL polyps , *REOPERATION , *AIRWAY (Anatomy) , *LOGISTIC regression analysis , *BIOTHERAPY - Abstract
Background: Nonsteroidal anti‐inflammatory drug (NSAID) exacerbated respiratory disease (N‐ERD) is a triad with asthma, chronic rhinosinusitis with nasal polyps, and NSAID intolerance. Uncontrolled N‐ERD forms a major public health problem due to frequent and difficult‐to‐treat exacerbations and/or requiring putatively frequent endoscopic sinus surgeries (ESS). Our aim was to study factors affecting control of N‐ERD. Methods: Retrospective patient record data (patient characteristics, prior sinus surgeries, follow‐up data in 2020) from 167 N‐ERD patients undergoing consultation at three tertiary hospitals from 2001 to 2017 was used. Outcome measurements reflecting uncontrolled N‐ERD were revision ESS, corticosteroids/biological therapy, and antibiotic courses during 2016–2020. Associations were analyzed by using nonparametric tests, Cox's proportional hazard, and binary logistic regression models. Results: Nasal polyp eosinophilia increased the risk of revision surgery during the follow‐up (adjusted hazard ratio [aHR] 3.21, confidence interval 1.23–8.38). Also baseline oral corticosteroids (OCS; HR, 1.73, 1.04–2.89) and baseline surgery without total ethmoidectomy increased the risk of revision ESS (HR, 2.17, 1.07–4.42) in unadjusted models. In addition, both baseline OCS (adjusted odds ratio [aOR] 2.78, 1.23–6.26) and a history of ≥4 previous ESS (aOR, 2.15, 0.98–4.70) were associated with the use of OCS/biological therapy during the follow‐up, but not with high number of antibiotics. Conclusions: Nasal polyp eosinophilia, baseline OCS, and a history of recurrent ESS predict uncontrolled N‐ERD. These factors might be clinically useful in risk‐estimation of uncontrolled disease and for organizing follow‐ups. Prospective cohort studies with larger sample size are needed to further study the factors affecting the upper airway control of N‐ERD. [ABSTRACT FROM AUTHOR]
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- 2021
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40. Hierarchical clustering in evaluating inflammatory upper airway phenotypes; increased symptoms in adults with allergic multimorbidity.
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Hanif, Tanzeela, Laulajainen-Hongisto, Anu, Luukkainen, Annika, Numminen, Jura, Kääriäinen, Janne, Myller, Jyri, Kalogjera, Livije, Huhtala, Heini, Kankainen, Matti, Renkonen, Risto, and Toppila-Salmi, Sanna
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- 2020
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41. Assessing Cut-off Points of Eosinophils, Nasal Polyp, and Lund-Mackay Scores to Predict Surgery in Nasal Polyposis: A Real-World Study.
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Virkkula, P., Penttilä, E., Vento, S. I., Myller, J., Koskinen, A., Hammarén-Malmi, S., Laulajainen-Hongisto, A., Hytönen, M., Lilja, M., Numminen, J., Sillanpää, S., Sahlman, J., and Toppila-Salmi, S.
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- 2020
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42. Complications of COVID-19 Nasopharyngeal Swab Test.
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Koskinen, Anni, Tolvi, Morag, Jauhiainen, Maria, Kekäläinen, Eliisa, Laulajainen-Hongisto, Anu, and Lamminmäki, Satu
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- 2021
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43. Acute severe complications of otitis media in children and adults
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Laulajainen-Hongisto, Anu, University of Helsinki, Faculty of Medicine, Institute of Clinical Medicine, Department of Otorhinolaryngology - Head and Neck Surgery, Helsingin yliopisto, lääketieteellinen tiedekunta, kliininen laitos, Helsingfors universitet, medicinska fakulteten, institutionen för klinisk medicin, Alho, Olli-Pekka, Jero, Jussi, and Aarnisalo, Antti
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lääketiede - Abstract
Acute otitis media (AOM) is an infection that is particularly common in children. The bacterial etiology of AOM, in both children and adults, affects its clinical picture. While in some cases the infection can simply be carefully monitored without treatment, antimicrobials are often prescribed. Caution is required, however, when prescribing antimicrobials as their excessive use has led to antimicrobial resistance; this resistance has been seen among some of the causative pathogens for these infections. Before the development of antimicrobial treatment, complications due to middle ear infections were common, potentially causing severe symptoms or even death. Some middle ear infections spread into surrounding structures, leading to intratemporal or extratemporal (extracranial or intracranial) complications. This thesis focuses on complicated otitis media and the causative factors of its complications. In the first two studies, we evaluated the medical records of all (n=100) children (0-16 years old) hospitalized at the Department of Otorhinolaryngology in the Helsinki University Hospital from 2003 to 2012 for acute mastoiditis (AM) or AOM, as well as the infection s bacteriology in relation to the patient s clinical findings and treatment. Using this information, we analyzed the differences in the etiologies and clinical pictures of those children hospitalized due to AOM compared to AM. In our third study, we examined the medical records of all (n=166) patients hospitalized at our institution from 1970 to 2012 due to intracranial abscesses (IA), including those of otogenic background (oIA). In the fourth study, we evaluated the bacteriology in relation to the patients clinical findings and treatment in all (n=160) adult patients treated at our institution from 2003 to 2012 for AOM or acute mastoid infection. In adults, acute mastoid infection was subclassified into AM, latent mastoiditis (LM), and AM following chronic middle ear infection (AMc). The clinical picture of AM in children differed according to the causative pathogen. Streptococcus pneumoniae (Pnc), especially its resistant strains, caused severe symptoms and often led to mastoidectomies. Pseudomonas aeruginosa (Ps) typically affected older children with prior tympanostomy tubes and generally caused milder symptoms. Furthermore, the bacteriological etiology of hospitalized AOM and AM patients was different compared to outpatient AOM. Two of the typical AOM pathogens, Haemophilus influenzae (Hi) and Moraxella catarrhalis (Mc), were uncommon among the hospitalized patients. Pnc, especially its resistant strains, was less common in children hospitalized for AOM compared to AM, and less common in adults than children. Streptococcus pyogenes (StrA) and Ps were both linked to otorrhea and were found only in older children. Over our 42 year study period, oIAs became less common and typically developed following chronic middle ear infections, often in connection with cholesteatoma. In adults, the bacteriological etiology and clinical picture of AMc differed from AOM as well as the other acute mastoid infection types (AM, LM). AOM and AM led to less surgical procedures than the more prolonged forms of acute mastoid infection (LM, AMc). In children, the hospitalized cases of AOM and AM differed from outpatient AOM. In adults, severe AOM, AM, and LM seem to compose a continuum that may lead to chronic otitis media and its acute complications, including oIAs. Otogenic IAs are quite rare, however, and became less common over our study period. Äkillinen välikorvatulehdus on yksi lasten tavallisimmista taudeista; aikuisilla se on lapsia harvinaisempi. Vaikka pelkkä seuranta voi riittää äkillisen välikorvatulehduksen hoidoksi, usein hoitona käytetään antibioottia. Välikorvatulehdus voi levitä välikorvaa ympäröiviin rakenteisiin aiheuttaen vakaviakin komplikaatioita (esim. kartiolisäketulehdus, aivopaise). Ennen antibioottien kehittämistä välikorvatulehduksen komplikaatioita esiintyi nykyistä enemmän. Turhaa antibioottien käyttöä on vältettävä, mutta komplisoitunutta tautia sairastavat potilaat on tunnistettava varhain ja hoidettava tehokkaasti. Tässä tutkimuksessa selvitettiin komplisoituneen välikorvatulehduksen taustatekijöitä. Äkillisen kartiolisäketulehduksen tai välikorvatulehduksen vuoksi HUS:n Korvaklinikalle sairaalahoitoon vuosina 2003 2012 joutuneiden potilaiden (100 lasta, 160 aikuista) sairauskertomustiedot käytiin läpi. Bakteereiden suhdetta taudinkuvaan ja hoitoon arvioitiin, ja potilasryhmien tietoja vertailtiin keskenään. Kaikkien aivopaiseen vuoksi sairaalahoitoon HUS:n Neurokirurgian klinikalle vuosina 1970 2012 joutuneiden potilaiden (166) sairauskertomustiedot käytiin läpi. Aineistoon sisältyivät myös korvaperäiset aivopaiseet. Streptococcus pneumoniae on tavallinen välikorvatulehduksen taudinaiheuttaja, myös tässä tutkimuksessa. Erityisesti kartiolisäketulehdusta sairastavilla lapsipotilailla esiintyi muita lapsia ja aikuisia enemmän tavallisille korvatulehduksen hoidossa käytettäville antibiooteille vastustuskykyisiä Streptococcus pneumoniae -kantoja. Nämä johtivat muita taudinaiheuttajia useammin kartiolisäkkeen puhdistusleikkauksiin. Kaksi tavallisimmista äkillisen välikorvatulehduksen taudinaiheuttajista, Haemophilus influenzae ja Moraxella catarrhalis, olivat sen sijaan harvinaisia komplisoitunutta välikorvatulehdusta sairastavilla potilailla. Aikuisilla pitkäkestoisten välikorvatulehdusten äkillisiin komplikaatioihin liittyi enemmän leikkaushoidon tarvetta kuin äkillisten välikorvatulehdusten komplikaatioihin. Korvaperäiset aivopaiseet harvinaistuivat ajan kuluessa, ja ne liittyivät yleensä pitkäkestoiseen välikorvatulehdukseen ja helmiäiskasvamaan. Avohoidossa hoidettava välikorvatulehdus eroaa sairaalahoitoon johtaneesta välikorvatulehduksesta ja kartiolisäketulehduksesta. Välikorvatulehduksen komplikaatiot voivat johtaa pitkäkestoiseen välikorvatulehdukseen ja sen akuutteihin komplikaatioihin, myös aivopaiseisiin. Korvaperäiset aivopaiseet olivat tutkimusaineistossa kuitenkin harvinaisia, ja niiden määrä vähentyi tutkimusjakson kuluessa.
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- 2016
44. Otogenic Intracranial Abscesses, Our Experience Over the Last Four Decades.
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Laulajainen-Hongisto, Anu, Aarnisalo, Antti A., Lempinen, Laura, Saat, Riste, Markkola, Antti, Leskinen, Kimmo, Blomstedt, Göran, and Jero, Jussi
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BRAIN abscess , *OTITIS treatment , *EAR infections , *NEUROSURGERY , *BACTEROIDES , *THERAPEUTICS - Abstract
OBJECTIVE: To evaluate the predisposing factors for otogenic intracranial abscesses, assess their changes over time, and analyze how they differ from those due to other causes. MATERIALS and METHODS: The medical records of all patients treated for otogenic intracranial abscesses, between 1970 and 2012 at a tertiary referral center, were retrospectively analyzed. The analysis included patient demographics, clinical characteristics, causative pathogens, treatments, outcomes, and comparisons of otogenic and non-otogenic intracranial abscesses. RESULTS: Of all intracranial abscesses, 11% (n=18) were otogenic. In the 1970s, otogenic infections were a common predisposing factor for intracranial abscess; but within our study period, the incidence of otogenic intracranial abscesses decreased. Most (94%) otogenic cases were due to chronic suppurative otitis media and 78% were associated with cholesteatoma. Most patients (94%) had ear symptoms. The most common presenting symptoms were discharge from the infected ear (50%), headache (39%), neurological symptoms (28%), and fever (17%). The most common pathogens belonged to Streptococcus spp. (33%), Gram-negative enteric bacteria (22%), and Bacteroides spp. (11%). Neurosurgery was performed on all patients, 69% of which were prior to a later ear surgery. Surgery of the affected ear was performed on 14 patients (78%). A favorable recovery was typical (78%); however, one patient died. CONCLUSION: Otogenic intracranial abscesses were most commonly due to a chronic ear infection with cholesteatoma. Ear symptoms and Gram-negative enteric bacteria were more common among patients with otogenic than non-otogenic intracranial abscesses. [ABSTRACT FROM AUTHOR]
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- 2017
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45. Laser, radiofrequency or tympanostomy knife? Comparison of surgical methods in tympanostomy treatment of young children and predictive value of tympanometry.
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Sjövall, Atte, Laulajainen-Hongisto, Anu, and Silvola, Juha
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MIDDLE ear ventilation , *IMPEDANCE audiometry , *RADIO frequency , *OTITIS media with effusion , *MYRINGOTOMY , *LASERS - Abstract
To investigate tympanostomy tube (TT) treatment in young children, with special interest in bloodless surgical methods (laser and radiofrequency), myringosclerosis formation and tympanometric testing. This prospective study includes 76 children whose 121 ears with middle ear effusion were treated with tympanostomy tubes. Myringotomy was performed with CO 2 laser in 37, radiofrequency in 40 and myringotomy knife in 44 ears. The ears were evaluated with otomicroscopy and tympanometry preoperatively and postoperatively every 3–4 months until spontaneous tube extrusion. All tubes extruded spontaneously (mean 12.8 months, range 3–36 months), with no persistent perforations or cholesteatomas. CO 2 laser and radiofrequency inserted tympanostomy tubes extruded faster (mean 11 months) compared to incisional myringotomy (mean 15 months, p = 0.002). Myringosclerosis was noted in 25 (21%) ears after treatment. There was a tendency to less myringosclerosis with bloodless techniques, but the difference was not significant. Flat tympanograms on the day of procedure predicted continuation of ventilation problems also after TT treatment (p = 0.003). Ears with preoperative type B tympanogram had significantly more myringosclerosis 21/75 (28%) compared with type A and C tympanograms 4/41 (10%) (p = 0.032). While all myringotomy methods were effective and safe, the traditional incisional myringotomy with a tympanostomy knife is still a good, feasible and cost-effective myringotomy method. No surgical removal of tympanostomy tubes is needed before 3 years of uncomplicated tympanostomy treatment. Tympanometry turned out to be a useful tool in prediction of post TT treatment ventilation problems of the middle ear. [ABSTRACT FROM AUTHOR]
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- 2023
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46. Severe Acute Otitis Media and Acute Mastoiditis in Adults.
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Laulajainen-Hongisto, Anu, Jero, Jussi, Markkola, Antti, Saat, Riste, and Aarnisalo, Antti A.
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ACUTE otitis media , *MASTOIDITIS , *HEALTH of adults , *MASTOIDECTOMY , *MEDICAL records , *THERAPEUTICS - Abstract
OBJECTIVE: To evaluate and compare clinical and microbiological findings in adults hospitalized for acute otitis media (AOM) or mastoid infections (acute or latent). MATERIALS and METHODS: We retrospectively reviewed the medical records of all adults (≥17 years old) hospitalized (between 2003 and 2012) at a tertiary referral center for acute mastoid infections or AOM not responding to outpatient medical treatment. RESULTS: Of the 160 patients in the study sample, 19% had an infection caused by S. pyogenes, 14% by S. pneumoniae, and 11% by P. aeruginosa. AOM was the most common infection (38%), whereas 33% had acute mastoiditis (AM), 18% had latent mastoiditis (LM), and 13% AM of a chronically infected ear (AMc). In contrast to the other infections, P. aeruginosa (30%) and S. aureus (25%) were most common in AMc. Otorrhea (83%), tympanic membrane perforation (57%), and hearing problems (83%) were common in S. pyogenes infections. Patients with S. pneumoniae had longer lengths of hospitalization than those with other bacterial infections (7 vs. 4 days). Otorrhea (94%) and retroauricular symptoms were more common in P. aeruginosa infections. Hearing symptoms were common (67%) but fever (32%) and retroauricular symptoms were uncommon in AOM. Fever (44%) and mastoid tenderness (65%) were common in AM. Patients with LM underwent the most mastoidectomies (54%). Prior medical conditions, retroauricular symptoms, otorrhea (90%), and post-infection problems were common in AMc. CONCLUSION: The bacteriological etiology of hospitalized AOM more closely resembled those of LM and AM than that of AMc. Adults hospitalized for AOM or AM required fewer mastoidectomies than those hospitalized for LM or AMc. [ABSTRACT FROM AUTHOR]
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- 2016
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47. Intracranial abscesses over the last four decades; changes in aetiology, diagnostics, treatment and outcome.
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Laulajainen-Hongisto, Anu, Lempinen, Laura, Färkkilä, Esa, Saat, Riste, Markkola, Antti, Leskinen, Kimmo, Blomstedt, Göran, Aarnisalo, Antti A., and Jero, Jussi
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ABSCESSES , *CHI-squared test , *FISHER exact test , *INFECTION , *EVALUATION of medical care , *OTITIS media , *VANCOMYCIN resistance , *TREATMENT effectiveness , *MEDICAL records , *RETROSPECTIVE studies , *DATA analysis software , *DESCRIPTIVE statistics , *MANN Whitney U Test - Abstract
Background The development of modern medicine has resulted in changes in the predisposing conditions, clinical picture, treatment and results of treatment of intracranial abscesses. This study sought to evaluate these changes in a hospital district. Methods A retrospective analysis of the clinical data of all patients treated due to intracranial abscesses at a tertiary referral centre, between 1970–2012. Results The total number of intracranial abscesses was 166. The incidence of intracranial abscesses was 0.33/100 000/year (2000–2012). The most common predisposing conditions were infection of the ear-, nose- and throat region (22%), odontogenic infection (15%) and cardiac anomaly (13%). Lately (2000–2012), infections of the ear-, nose- and throat region (15%) and cardiac anomalies (5%) have become less common, whereas odontogenic infections (32%) have become more common. The most common pathogens belong to Streptococcus spp (42%), Fusobacteriae (14%), Actinomycetales (8%) and Staphylococcus spp (8%). Most patients (66%) experienced a favourable recovery; the proportion of patients with favourable outcome enabling return to prior occupation rose over time, from 12% in 1970–1989 to 24% in 1990–2012. Conclusions The predisposing conditions for intracranial abscesses have changed markedly within the study period. Odontogenic infections have become a common predisposing condition, whereas infections of the ear-, nose- and throat region and cardiac malformations are nowadays less common as predisposing conditions compared to at the beginning of the study period. The proportion of patients with favourable outcome enabling return to prior occupation seems to have increased with time. [ABSTRACT FROM AUTHOR]
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- 2016
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48. CHronic RhINOSinusitis Outcome Registry (CHRINOSOR): development of an international outcome registry driven by mHealth technology.
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Seys, Sven F., Hellings, Peter W., Alobid, Isam, Arndal, Elisabeth, Bachmann, Gregor, Backer, Vibeke, Bast, Florian, Bernal-Sprekelsen, Manuel, Cardell, Lars Olaf, Cavaliere, Carlo, Deneyer, Lauren, Fokkens, Wytske J., Gane, Simon, Gevaert, Philippe, Holzmeister, Clemens, Hopkins, Claire, Hox, Valérie, Hrubos, Harald, Jorissen, Mark, and Laulajainen-Hongisto, Anu
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- 2021
49. Asthma is Underdiagnosed and Often Uncontrolled in Preoperative Patients With Chronic Rhinosinusitis With Nasal Polyps.
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Genberg, Emma, Kauppi, Paula, Sahlman, Johanna, Laulajainen‐Hongisto, Anu, Lilja, Markus, Hammarén‐Malmi, Sari, Hafrén, Lena, Mäkitie, Antti, Vento, Seija, Toppila‐Salmi, Sanna, and Virkkula, Paula
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NASAL polyps , *ENDOSCOPIC surgery , *ASTHMA , *SINUSITIS , *FORCED expiratory volume - Abstract
A study published in Clinical & Experimental Allergy reveals that asthma is often overlooked and poorly managed in preoperative patients with chronic rhinosinusitis with nasal polyps (CRSwNP). The study, conducted at a tertiary center, aimed to determine the prevalence of asthma and assess its control in this group. The findings indicate a high prevalence of asthma in these patients, with approximately half potentially having undiagnosed or uncontrolled asthma prior to undergoing endoscopic sinus surgery. The study also identifies factors associated with asthma in this population. However, the document acknowledges the study's limitations, such as its small sample size, and suggests the need for further research to validate the results. [Extracted from the article]
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- 2024
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50. IDENTIFYING PATIENTS AT RISK FOR UNCONTROLLED CHRONIC RHINOSINUSITIS WITH NASAL POLYPS: DEVELOPMENT OF A MULTIVARIABLE MODEL.
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Vento, Seija, Virkkula, Paula, Koskinen, Anni, Hammarén-Malmi, Sari, Laulajainen-Hongisto, Anu, Hytönen, Maija, Kauppi, Paula, Numminen, Jura, Rautiainen, Markus, Sillanpää, Saara, Fokkens, Wytske, Reitsma, Sietze, Lilja, Markus, and Toppila-salmi, Sanna
- Published
- 2018
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