23 results on '"Cecelia Damask"'
Search Results
2. AERD: Current Roles for Aspirin Desensitization, Surgery, and Biologic Therapies
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Cecelia Damask
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Otorhinolaryngology ,Immunology and Allergy ,Surgery ,Neurology (clinical) - Published
- 2022
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Catalog
3. International consensus statement on allergy and rhinology:Allergic rhinitis - 2023
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Sarah K. Wise, Cecelia Damask, Lauren T. Roland, Charles Ebert, Joshua M. Levy, Sandra Lin, Amber Luong, Kenneth Rodriguez, Ahmad R. Sedaghat, Elina Toskala, Jennifer Villwock, Baharudin Abdullah, Cezmi Akdis, Jeremiah A. Alt, Ignacio J. Ansotegui, Antoine Azar, Fuad Baroody, Michael S. Benninger, Jonathan Bernstein, Christopher Brook, Raewyn Campbell, Thomas Casale, Mohamad Chaaban, Fook Tim Chew, Jeffrey Chambliss, Antonella Cianferoni, Adnan Custovic, Elizabeth Mahoney Davis, John M. DelGaudio, Anne K. Ellis, Carrie Flanagan, Wytske J. Fokkens, Christine Franzese, Matthew Greenhawt, Amarbir Gill, Ashleigh Halderman, Jens M. Hohlfeld, Cristoforo Incorvaia, Stephanie A. Joe, Shyam Joshi, Merin Elizabeth Kuruvilla, Jean Kim, Adam M. Klein, Helene J. Krouse, Edward C. Kuan, David Lang, Desiree Larenas‐Linnemann, Adrienne M. Laury, Matt Lechner, Stella E. Lee, Victoria S. Lee, Patricia Loftus, Sonya Marcus, Haidy Marzouk, Jose Mattos, Edward McCoul, Erik Melen, James W. Mims, Joaquim Mullol, Jayakar V. Nayak, John Oppenheimer, Richard R. Orlandi, Katie Phillips, Michael Platt, Murugappan Ramanathan, Mallory Raymond, Chae‐Seo Rhee, Sietze Reitsma, Matthew Ryan, Joaquin Sastre, Rodney J. Schlosser, Theodore A. Schuman, Marcus S. Shaker, Aziz Sheikh, Kristine A. Smith, Michael B. Soyka, Masayoshi Takashima, Monica Tang, Pongsakorn Tantilipikorn, Malcolm B. Taw, Jody Tversky, Matthew A. Tyler, Maria C. Veling, Dana Wallace, De Yun Wang, Andrew White, Luo Zhang, Omar G. Ahmed, Khashayar Arianpour, Emily Barrow, Carlo Cavaliere, Juan Carlos Ceballos Cantu, Mark B. Chaskes, Andy Jian Kai Chua, Srihari Daggumati, Luke Daines, Paul Daraei, Thomas Edwards, Deanna Gigliotti, Mitchell Gore, Khodayar Goshtasbi, Doo Hee Han, Lubnaa Hossenbaccus, Megan Jolicoeur, Dichapong Kanjanawasee, Suat Kilic, Sophia Linton, David Liu, Christoper Low, Chengetai Mahomva, Jordan A. Malenke, Amar Miglani, Peter Nagy, Jin‐A Park, Marianella Paz‐Lansberg, Paul Pfeffer, Marisa Ryan, Anirudh Saraswathula, Cameron Sheehan, Nadja Struss, Kevin Tie, Sina Torabi, Esmond F. Tsai, Nathalia Velasquez, Jackson Vuncannon, Duncan Watley, and Xinni Xu more...
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microbiome ,IgE ,allergen extract ,allergen immunotherapy ,allergic rhinitis ,allergy ,antihistamine ,asthma ,atopic dermatitis ,avoidance ,biologic ,cockroach ,conjunctivitis ,consensus ,corticosteroid ,cough ,cromolyn ,decongestant ,environment ,eosinophilic esophagitis ,epicutaneous ,epidemiology ,evidence-based medicine ,food allergy ,house dust mite ,immunoglobulin E ,immunotherapy ,inhalant allergy ,leukotriene ,occupational rhinitis ,omalizumab ,pediatric ,perennial ,pet dander ,pollen ,probiotic ,rhinitis ,rhinosinusitis ,saline ,seasonal ,sensitization ,sinusitis ,socioeconomic ,specific IgE ,subcutaneous immunotherapy ,sublingual immunotherapy ,systematic review ,total IgE ,transcutaneous immunotherapy ,validated survey ,Immunology and Allergy ,Otorhinolaryngology - Abstract
BACKGROUND: In the 5 years that have passed since the publication of the 2018 International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis (ICAR-Allergic Rhinitis 2018), the literature has expanded substantially. The ICAR-Allergic Rhinitis 2023 update presents 144 individual topics on allergic rhinitis (AR), expanded by over 40 topics from the 2018 document. Originally presented topics from 2018 have also been reviewed and updated. The executive summary highlights key evidence-based findings and recommendation from the full document.METHODS: ICAR-Allergic Rhinitis 2023 employed established evidence-based review with recommendation (EBRR) methodology to individually evaluate each topic. Stepwise iterative peer review and consensus was performed for each topic. The final document was then collated and includes the results of this work.RESULTS: ICAR-Allergic Rhinitis 2023 includes 10 major content areas and 144 individual topics related to AR. For a substantial proportion of topics included, an aggregate grade of evidence is presented, which is determined by collating the levels of evidence for each available study identified in the literature. For topics in which a diagnostic or therapeutic intervention is considered, a recommendation summary is presented, which considers the aggregate grade of evidence, benefit, harm, and cost.CONCLUSION: The ICAR-Allergic Rhinitis 2023 update provides a comprehensive evaluation of AR and the currently available evidence. It is this evidence that contributes to our current knowledge base and recommendations for patient evaluation and treatment. more...
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- 2023
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4. Mepolizumab for chronic rhinosinusitis with nasal polyps (SYNAPSE): a randomised, double-blind, placebo-controlled, phase 3 trial
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Joseph K Han, Claus Bachert, Wytske Fokkens, Martin Desrosiers, Martin Wagenmann, Stella E Lee, Steven G Smith, Neil Martin, Bhabita Mayer, Steven W Yancey, Ana R Sousa, Robert Chan, Claire Hopkins, Cecilia Ahlström Emanuelsson, Ledit Ardusso, Michael Armstrong, Philip Bardin, Sara Barnes, Miguel Bergna, Christian Betz, Achim Beule, James Blotter, Valeriu Bronescu, Matthew Brown, Sean Carrie, Adam Chaker, Hyung-Ju Cho, Marie-Noëlle Corriveau, Timothy Courville, Mandy Cuevas, Cecelia Damask, Adam DeConde, Jaime Del Carpio, María De Salvo, Hun-Jong Dhong, Stephen Durham, Anton Edin, Dale Ehmer Jr, Pedro Elías, Adil Fatakia, Christine Franzese, Simon Gane, Gabriel García, Andrew Gillman, Moritz Groeger, Richard Harvey, Johan Hellgren, Thomas Higgins, Jonathan Hobson, Mattias Jangard, Arif Janjua, Naveed Kara, Sergey Karpischenko, Edward Kerwin, Fatimat Khanova, Shaun Kilty, Chang-Hoon Kim, Seontae Kim, Ludger Klimek, Craig LaForce, Samuel Leong, Bradley Marple, Anders Mårtensson, Jorge Maspero, Neil Massey, Jonathan Matz, Chad McDuffie, Corina Mella, Steven Miller, Ekaterina Mirzabekyan, Jonathan Moss, Nayla Mumneh, Robert Nathan, Adriana Neagos, Heidi Olze, Andrey Ovchinnikov, Randall Ow, Dmitriy Polyakov, Doinel Radeanu, Chae-Seo Rhee, Ramón Rojas, Jeffrey Rosenbloom, Sergei Ryazantsev, Chady Sader, Pablo Saez Scherbovsky, Guy Scadding, Rodney Schlosser, Heena Shah-Patel, Ronald Shealy, Ayesha Siddiqi, Stacey Silvers, Narinder Singh, Doron Sommer, Weily Soong, Leigh Sowerby, Peter Spafford, Catalin Stefan, Richard Sterling, Valeriy Svistushkin, Neetu Talreja, Galina Tarasova, Martha Tarpay, Alberto Tolcachier, Karin Toll Toll, Carolina van Schaik, Luke Webb, H James Wedner, Luis Wehbe, Soo Whan Kim, Barbara Wollenberg, Simon Wright, Vladimir Yakusevich, Anahí Yañez, Yury Yarin, David Yen, Hyo Yeol Kim, Ear, Nose and Throat, and AII - Inflammatory diseases more...
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Adult ,Pulmonary and Respiratory Medicine ,Nasal cavity ,medicine.medical_specialty ,Adolescent ,Visual analogue scale ,Population ,Mometasone furoate ,Antibodies, Monoclonal, Humanized ,Placebo ,03 medical and health sciences ,Nasal Polyps ,0302 clinical medicine ,Double-Blind Method ,Internal medicine ,otorhinolaryngologic diseases ,medicine ,Humans ,Nasal polyps ,030212 general & internal medicine ,education ,education.field_of_study ,business.industry ,medicine.disease ,Treatment Outcome ,medicine.anatomical_structure ,030228 respiratory system ,Synapses ,Nasal administration ,business ,Mepolizumab ,medicine.drug - Abstract
Background: Chronic rhinosinusitis with nasal polyps affects approximately 2–4% of the general population, and long-term use of systemic corticosteroids is associated with adverse effects. The aim of this study was to assess the efficacy and safety of mepolizumab in adults with recurrent, refractory severe bilateral chronic rhinosinusitis with nasal polyps. Methods: SYNAPSE was a randomised, double-blind, placebo-controlled, parallel-group, phase 3 trial done at 93 centres, mainly hospitals, in 11 countries. Eligible patients were aged 18 years or older with recurrent, refractory, severe, bilateral nasal polyp symptoms (nasal obstruction symptom visual analogue scale [VAS] score of >5), were eligible for repeat nasal surgery (overall symptoms VAS score >7 and endoscopic nasal polyps score of ≥5, with a minimum score of 2 in each nasal cavity) despite standard of care treatment, and had to have at least one nasal surgery in the past 10 years. Patients were randomly assigned (1:1), using permuted block design, to receive either 100 mg mepolizumab subcutaneously or placebo once every 4 weeks, in addition to standard of care (mometasone furoate intranasal spray for at least 8 weeks before screening and during the study, saline nasal irrigations, systemic corticosteroids or antibiotics, or both), as required, for 52 weeks. Site staff, the central study team, and patients were masked to study treatment and absolute blood eosinophil counts. The coprimary endpoints were change from baseline in total endoscopic nasal polyp score at week 52 and in mean nasal obstruction VAS score during weeks 49–52, assessed in the intention-to-treat population (ITT). This study is registered with ClinicalTrials.gov, NCT03085797. Findings: From May 25, 2017, to Dec 12, 2018, 854 patients were screened for eligibility. 414 patients were randomly assigned with 407 included in the ITT population; 206 received mepolizumab and 201 received placebo. Total endoscopic nasal polyp score significantly improved at week 52 from baseline with mepolizumab versus placebo (adjusted difference in medians −0·73, 95% CI −1·11 to −0·34; p more...
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- 2021
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5. Defining the Efficacy of Omalizumab in Nasal Polyposis: A POLYP 1 and POLYP 2 Subgroup Analysis
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Cecelia Damask, Bongin Yoo, L. Millette, Meng Chen, Cecile T.J. Holweg, and Christine B. Franzese
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medicine.medical_specialty ,Subgroup analysis ,Omalizumab ,Disease ,Immunoglobulin E ,Gastroenterology ,Nasal Polyps ,Internal medicine ,medicine ,Immunology and Allergy ,Humans ,Nasal polyps ,Sinusitis ,Asthma ,Patient factors ,Rhinitis ,biology ,business.industry ,General Medicine ,Eosinophil ,medicine.disease ,medicine.anatomical_structure ,Otorhinolaryngology ,Chronic Disease ,biology.protein ,Quality of Life ,business ,medicine.drug - Abstract
Background Chronic rhinosinusitis with nasal polyps (CRSwNP) is a heterogeneous disease with variable underlying pathophysiologies. Numerous patient factors have been linked to differences in disease severity, control, and response to treatment, including asthma status, aspirin sensitivity, previous sinonasal surgery, and blood eosinophil levels. Objective The present study examines the efficacy of the anti-immunoglobulin E therapy, omalizumab, versus placebo in patients with CRSwNP from the replicate POLYP 1 (NCT03280550) and POLYP 2 (NCT03280537) trials, grouped by inherent patient characteristics to determine the response to therapy. Methods Patients in prespecified subgroups from POLYP 1 and POLYP 2 (studies pooled for analysis) were examined. Subgroups included blood eosinophil count at baseline (>300 or ≤300 cells/μL), previous sinonasal surgery (yes or no), asthma status (yes or no), and aspirin sensitivity status (yes or no). Subgroups were examined for subgroup-specific adjusted mean difference (95% confidence interval [CI]) (omalizumab–placebo) in change from baseline at week 24 in Nasal Congestion Score (NCS), Nasal Polyp Score (NPS), Sino-Nasal Outcome Test-22 (SNOT-22), Total Nasal Symptom Score (TNSS), and University of Pennsylvania Smell Identification Test (UPSIT). Results Adjusted mean difference (95% CI) (omalizumab–placebo) in NCS, NPS, SNOT-22, TNSS, and UPSIT change from baseline at week 24 consistently favored omalizumab treatment over placebo in patients with blood eosinophil count >300 and ≤300 cells/μL, with or without previous sinonasal surgery, asthma, and aspirin sensitivity. Conclusion Together, these data suggest broad efficacy of omalizumab across clinical and patient-reported outcomes in patients with CRSwNP, independent of the underlying patient factors examined, including those with high eosinophil levels and those who have undergone previous surgery, which are associated with high recurrence. Clinical Trial Registration ClinicalTrials.gov identifiers: POLYP 1: ClinicalTrials.gov identifier NCT03280550 ( https://clinicaltrials.gov/ct2/show/NCT03280550 ); POLYP 2: ClinicalTrials.gov identifier NCT03280537 ( https://clinicaltrials.gov/ct2/show/NCT03280537 ). more...
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- 2021
6. Mechanisms and Practical Use of Biologic Therapies for Allergy and Asthma Indications
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Cecelia Damask and Christine B. Franzese
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Allergy ,medicine.drug_class ,business.industry ,Biologic therapies ,Antibodies, Monoclonal ,General Medicine ,medicine.disease ,Bioinformatics ,Monoclonal antibody ,Rhinitis, Allergic ,Asthma ,Proinflammatory cytokine ,Biological Therapy ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,Underlying disease ,Novel agents ,030220 oncology & carcinogenesis ,medicine ,Humans ,030223 otorhinolaryngology ,business ,Anti il 13 - Abstract
This article presents a concise overview of the important aspects of the immunologic mechanisms targeted by T-helper 2-directed monoclonal antibodies, as well as their practical applications in the treatment of allergic disorders (specifically allergic rhinitis) and asthma. Several of these novel agents treat multiple diseases, so understanding their targets and the underlying disease process can aid patient selection. In addition, the particular targets of the therapeutics seem to be shifting to include not only agents that intervene against inflammatory cytokines or their receptors but also specific molecular epitopes and cellular surface proteins. more...
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- 2021
7. Targeted Molecular Therapies in Allergy and Rhinology
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Cecelia Damask, Sandra Y. Lin, Peter A. Lio, Christine B. Franzese, Andrew A. White, Joshua M. Levy, Thomas B. Casale, Matthew W. Ryan, Michael P. Platt, Anju T. Peters, Mario Castro, and Stella E. Lee more...
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Allergy ,Omalizumab ,Immunoglobulin E ,Dermatitis, Atopic ,03 medical and health sciences ,Nasal Polyps ,0302 clinical medicine ,Eosinophilia ,Humans ,Medicine ,Molecular Targeted Therapy ,030212 general & internal medicine ,Sinusitis ,Rhinitis ,biology ,business.industry ,Decision Trees ,Granulomatosis with Polyangiitis ,Antibodies, Monoclonal ,Atopic dermatitis ,Eosinophil ,medicine.disease ,Dupilumab ,Asthma ,medicine.anatomical_structure ,030228 respiratory system ,Otorhinolaryngology ,Immunology ,biology.protein ,Surgery ,business ,Granulomatosis with polyangiitis ,Mepolizumab ,medicine.drug - Abstract
Biologic agents, monoclonal antibodies that target highly-specific molecular pathways of inflammation, are becoming integrated into care pathways for multiple disorders that are relevant in otolaryngology and allergy. These conditions share common inflammatory mechanisms of so-called Type 2 inflammation with dysregulation of immunoglobulin E production and eosinophil and mast cell degranulation leading to tissue damage. Biologic agents are now available for the treatment of chronic rhinosinusitis with nasal polyps (CRSwNP), asthma, eosinophilic granulomatosis with polyangiitis (EGPA), atopic dermatitis (AD), and chronic spontaneous urticaria (CSU). This paper summarizes the diagnosis and management of these conditions and critically reviews the clinical trial data that has led to regulatory approval of biologic agents for these conditions. more...
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- 2020
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8. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update) Executive Summary
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Rita R. Patel, Peak Woo, Daniel R. Ouellette, Libby J. Smith, German P Digoy, Charles Charlie W Reavis, Helene J. Krouse, Scott McCoy, Seth R. Schwartz, Cecelia Damask, David O. Francis, Marshall E. Smith, Robert J. Stachler, Lorraine C. Nnacheta, and Steven W Strode more...
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medicine.medical_specialty ,education.field_of_study ,medicine.diagnostic_test ,Laryngology ,business.industry ,Voice therapy ,Laryngoscopy ,Population ,Guideline ,Laryngitis ,medicine.disease ,Spasmodic dysphonia ,03 medical and health sciences ,0302 clinical medicine ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,otorhinolaryngologic diseases ,Medicine ,Surgery ,Voice change ,medicine.symptom ,030223 otorhinolaryngology ,business ,Intensive care medicine ,education - Abstract
Objective This guideline provides evidence-based recommendations on treating patients presenting with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include but are not limited to recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids in patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Differences from Prior Guideline (1) Incorporating new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia. more...
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- 2018
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9. International Consensus Statement on Allergy and Rhinology: Allergic Rhinitis
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Linda Cox, Antoine Azar, G. Walter Canonica, Sandra Y. Lin, Wytske Fokkens, Peter S. Creticos, Rodney J. Schlosser, James W. Mims, Fuad M. Baroody, Adrienne M. Laury, Deborah Jarvis, Luke Rudmik, Adam S. DeConde, Charles S. Ebert, Cecelia Damask, Gianna Moscato, Timothy L. Smith, Maritta Kilpeläinen, Cristoforo Incorvaia, Russell A Settipane, Hemant Sharma, Ayesha N. Khalid, Thomas Chacko, Steven M. Houser, William R. Reisacher, Maria C Veling, Carrie E. Flanagan, Ashleigh A. Halderman, Erik Melén, Jan Gosepath, Jeremiah A. Alt, Amber U Luong, Peter H. Hwang, Matthew W. Ryan, Hans Jürgen Hoffman, Cemal Cingi, Helene J. Krouse, Carmen Rondon, Harold S. Nelson, Giorgio Ciprandi, Bradley F. Marple, Christine B. Franzese, Adnan Custovic, Sarah K. Wise, K. Christopher McMains, Mark A. Zacharek, Désirée Larenas-Linnemann, Oliver Pfaar, Jean Anderson Eloy, Joshua M. Levy, Elina Toskala, Pongsakorn Tantilipikorn, Monica O. Patadia, Jacquelynne P. Corey, Jens M. Hohlfeld, Aziz Sheikh, Joaquim Mullol, Cezmi A. Akdis, Claus Bachert, Jody R. Tversky, De Yun Wang, John M. DelGaudio, Richard R. Orlandi, Magnus Wickman, Joaquín Sastre, Edward D. McCoul, Michael P. Platt, Robert G. Hamilton, Marit Westman, Stella E. Lee, Todd T. Kingdom, and Ruby Pawankar more...
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Rhinology ,Medical education ,medicine.medical_specialty ,Modalities ,business.industry ,MEDLINE ,Evidence-based medicine ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,030228 respiratory system ,Otorhinolaryngology ,Multidisciplinary approach ,medicine ,Immunology and Allergy ,030223 otorhinolaryngology ,business ,Strengths and weaknesses ,Disease burden - Abstract
BACKGROUND: Critical examination of the quality and validity of available allergic rhinitis (AR) literature is necessary to improve understanding and to appropriately translate this knowledge to clinical care of the AR patient. To evaluate the existing AR literature, international multidisciplinary experts with an interest in AR have produced the International Consensus statement on Allergy and Rhinology: Allergic Rhinitis (ICAR:AR). METHODS: Using previously described methodology, specific topics were developed relating to AR. Each topic was assigned a literature review, evidence-based review (EBR), or evidence-based review with recommendations (EBRR) format as dictated by available evidence and purpose within the ICAR:AR document. Following iterative reviews of each topic, the ICAR:AR document was synthesized and reviewed by all authors for consensus. RESULTS: The ICAR:AR document addresses over 100 individual topics related to AR, including diagnosis, pathophysiology, epidemiology, disease burden, risk factors for the development of AR, allergy testing modalities, treatment, and other conditions/comorbidities associated with AR. CONCLUSION: This critical review of the AR literature has identified several strengths; providers can be confident that treatment decisions are supported by rigorous studies. However, there are also substantial gaps in the AR literature. These knowledge gaps should be viewed as opportunities for improvement, as often the things that we teach and the medicine that we practice are not based on the best quality evidence. This document aims to highlight the strengths and weaknesses of the AR literature to identify areas for future AR research and improved understanding. more...
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- 2018
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10. 国际过敏与鼻科学共识声明 : 变应性鼻炎
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Sarah K. Wise, Sandra Y. Lin, Elina Toskala, Richard R. Orlandi, Cezmi A. Akdis, Jeremiah A. Alt, Antoine Azar, Fuad M. Baroody, Claus Bachert, G. Walter Canonica, Thomas Chacko, Cemal Cingi, Giorgio Ciprandi, Jacquelynne Corey, Linda S. Cox, Peter Socrates Creticos, Adnan Custovic, Cecelia Damask, Adam DeConde, John M. DelGaudio, Charles S. Ebert, Jean Anderson Eloy, Carrie E. Flanagan, Wytske J. Fokkens, Christine Franzese, Jan Gosepath, Ashleigh Halderman, Robert G. Hamilton, Hans Jürgen Hoffman, Jens M. Hohlfeld, Steven M. Houser, Peter H. Hwang, Cristoforo Incorvaia, Deborah Jarvis, Ayesha N. Khalid, Maritta Kilpeläinen, Todd. T. Kingdom, Helene Krouse, Desiree Larenas‐Linnemann, Adrienne M. Laury, Stella E. Lee, Joshua M. Levy, Amber U. Luong, Bradley F. Marple, Edward D. McCoul, K. Christopher McMains, Erik Melén, James W. Mims, Gianna Moscato, Joaquim Mullol, Harold S. Nelson, Monica Patadia, Ruby Pawankar, Oliver Pfaar, Michael P. Platt, William Reisacher, Carmen Rondón, Luke Rudmik, Matthew Ryan, Joaquin Sastre, Rodney J. Schlosser, Russell A. Settipane, Hemant P. Sharma, Aziz Sheikh, Timothy L. Smith, Pongsakorn Tantilipikorn, Jody R. Tversky, Maria C. Veling, De Yun Wang, Marit Westman, Magnus Wickman, Mark Zacharek, Ear, Nose and Throat, and AII - Inflammatory diseases more...
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Otorhinolaryngology ,1107 Immunology ,Immunology and Allergy - Published
- 2018
11. Immunotherapy
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Cecelia Damask
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Allergy ,Allergen immunotherapy ,medicine.medical_treatment ,medicine.disease_cause ,Allergic sensitization ,03 medical and health sciences ,0302 clinical medicine ,Allergen ,immune system diseases ,otorhinolaryngologic diseases ,medicine ,030212 general & internal medicine ,Risk factor ,Sensitization ,business.industry ,Allergic asthma ,General Medicine ,Immunotherapy ,respiratory system ,medicine.disease ,respiratory tract diseases ,medicine.anatomical_structure ,030228 respiratory system ,Otorhinolaryngology ,Immunology ,business - Abstract
Polysensitization, sensitization to more than one allergen, is a common feature of patients with allergic rhinitis, and may be a risk factor for subsequent development of allergic diseases, especially allergic asthma. However, a polysensitized patient does not necessarily have polyallergy, a documented, causal relationship between exposure to 2 or more specific, sensitizing allergens and the subsequent occurrence of relevant clinical symptoms of allergy. Allergen immunotherapy treatment strategy for the polysensitized patient in Europe is to treat the single or 2 most clinically relevant allergen(s), whereas patients in the United States are usually treated for all potential clinically relevant allergens. more...
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- 2017
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12. The use of fractional exhaled nitric oxide is valuable in select asthmatic patients
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Cecelia Damask
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medicine.medical_specialty ,Pathology ,Nitric Oxide ,Asthma care ,03 medical and health sciences ,0302 clinical medicine ,Disease severity ,medicine ,Humans ,Asthmatic patient ,030212 general & internal medicine ,Intensive care medicine ,Asthma ,business.industry ,food and beverages ,respiratory system ,medicine.disease ,Steroid responsive ,Response to treatment ,Respiratory Function Tests ,respiratory tract diseases ,Breath Tests ,030228 respiratory system ,Otorhinolaryngology ,Eosinophilic inflammation ,Exhaled nitric oxide ,Surgery ,business - Abstract
Purpose of review Clinical management of asthma is challenging and measuring fractional exhaled nitric oxide (FeNO) can be another tool to assist in meeting this challenge. Recent findings Asthma is a heterogeneous condition. There are many different phenotypes. FeNO can help the physician identify which patients have eosinophilic inflammation and would potentially respond to corticosteroid therapy. Summary FeNO is a complement to standard asthma care. FeNO can be used in the initial diagnosis of asthma and aid in stratification of which patients would be steroid responsive but also for assessment of disease severity, response to treatment, and compliance. more...
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- 2016
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13. Clinical Practice Guideline: Hoarseness (Dysphonia) (Update)
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Seth R. Schwartz, Steven W Strode, German P Digoy, Cecelia Damask, Helene J. Krouse, Scott McCoy, Marshall E. Smith, Libby J. Smith, Peak Woo, Rita R. Patel, Robert J. Stachler, David O. Francis, Daniel R. Ouellette, Lorraine C. Nnacheta, and Charles Charlie W Reavis more...
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medicine.medical_specialty ,education.field_of_study ,Laryngology ,Voice therapy ,business.industry ,Population ,Guideline ,Laryngitis ,medicine.disease ,Spasmodic dysphonia ,03 medical and health sciences ,0302 clinical medicine ,Quality of life (healthcare) ,Otorhinolaryngology ,030220 oncology & carcinogenesis ,otorhinolaryngologic diseases ,medicine ,Surgery ,Voice change ,medicine.symptom ,030223 otorhinolaryngology ,Intensive care medicine ,business ,education - Abstract
Objective This guideline provides evidence-based recommendations on treating patients who present with dysphonia, which is characterized by altered vocal quality, pitch, loudness, or vocal effort that impairs communication and/or quality of life. Dysphonia affects nearly one-third of the population at some point in its life. This guideline applies to all age groups evaluated in a setting where dysphonia would be identified or managed. It is intended for all clinicians who are likely to diagnose and treat patients with dysphonia. Purpose The primary purpose of this guideline is to improve the quality of care for patients with dysphonia, based on current best evidence. Expert consensus to fill evidence gaps, when used, is explicitly stated and supported with a detailed evidence profile for transparency. Specific objectives of the guideline are to reduce inappropriate variations in care, produce optimal health outcomes, and minimize harm. For this guideline update, the American Academy of Otolaryngology-Head and Neck Surgery Foundation selected a panel representing the fields of advanced practice nursing, bronchoesophagology, consumer advocacy, family medicine, geriatric medicine, internal medicine, laryngology, neurology, otolaryngology-head and neck surgery, pediatrics, professional voice, pulmonology, and speech-language pathology. Action Statements The guideline update group made strong recommendations for the following key action statements (KASs): (1) Clinicians should assess the patient with dysphonia by history and physical examination to identify factors where expedited laryngeal evaluation is indicated. These include, but are not limited to, recent surgical procedures involving the head, neck, or chest; recent endotracheal intubation; presence of concomitant neck mass; respiratory distress or stridor; history of tobacco abuse; and whether the patient is a professional voice user. (2) Clinicians should advocate voice therapy for patients with dysphonia from a cause amenable to voice therapy. The guideline update group made recommendations for the following KASs: (1) Clinicians should identify dysphonia in a patient with altered voice quality, pitch, loudness, or vocal effort that impairs communication or reduces quality of life (QOL). (2) Clinicians should assess the patient with dysphonia by history and physical examination for underlying causes of dysphonia and factors that modify management. (3) Clinicians should perform laryngoscopy, or refer to a clinician who can perform laryngoscopy, when dysphonia fails to resolve or improve within 4 weeks or irrespective of duration if a serious underlying cause is suspected. (4) Clinicians should perform diagnostic laryngoscopy, or refer to a clinician who can perform diagnostic laryngoscopy, before prescribing voice therapy and document/communicate the results to the speech-language pathologist (SLP). (5) Clinicians should advocate for surgery as a therapeutic option for patients with dysphonia with conditions amenable to surgical intervention, such as suspected malignancy, symptomatic benign vocal fold lesions that do not respond to conservative management, or glottic insufficiency. (6) Clinicians should offer, or refer to a clinician who can offer, botulinum toxin injections for the treatment of dysphonia caused by spasmodic dysphonia and other types of laryngeal dystonia. (7) Clinicians should inform patients with dysphonia about control/preventive measures. (8) Clinicians should document resolution, improvement or worsened symptoms of dysphonia, or change in QOL of patients with dysphonia after treatment or observation. The guideline update group made a strong recommendation against 1 action: (1) Clinicians should not routinely prescribe antibiotics to treat dysphonia. The guideline update group made recommendations against other actions: (1) Clinicians should not obtain computed tomography (CT) or magnetic resonance imaging (MRI) for patients with a primary voice complaint prior to visualization of the larynx. (2) Clinicians should not prescribe antireflux medications to treat isolated dysphonia, based on symptoms alone attributed to suspected gastroesophageal reflux disease (GERD) or laryngopharyngeal reflux (LPR), without visualization of the larynx. (3) Clinicians should not routinely prescribe corticosteroids for patients with dysphonia prior to visualization of the larynx. The policy level for the following recommendation about laryngoscopy at any time was an option: (1) Clinicians may perform diagnostic laryngoscopy at any time in a patient with dysphonia. Disclaimer This clinical practice guideline is not intended as an exhaustive source of guidance for managing dysphonia (hoarseness). Rather, it is designed to assist clinicians by providing an evidence-based framework for decision-making strategies. The guideline is not intended to replace clinical judgment or establish a protocol for all individuals with this condition, and it may not provide the only appropriate approach to diagnosing and managing this problem. Differences from Prior Guideline (1) Incorporation of new evidence profiles to include the role of patient preferences, confidence in the evidence, differences of opinion, quality improvement opportunities, and any exclusion to which the action statement does not apply (2) Inclusion of 3 new guidelines, 16 new systematic reviews, and 4 new randomized controlled trials (3) Inclusion of a consumer advocate on the guideline update group (4) Changes to 9 KASs from the original guideline (5) New KAS 3 (escalation of care) and KAS 13 (outcomes) (6) Addition of an algorithm outlining KASs for patients with dysphonia. more...
- Published
- 2018
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14. Update on eosinophilic esophagitis
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Cecelia Damask
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medicine.medical_specialty ,business.industry ,Proton Pump Inhibitors ,Eosinophilic Esophagitis ,Disease ,respiratory system ,medicine.disease ,Dermatology ,Diagnosis, Differential ,Otorhinolaryngology ,medicine ,Humans ,Eosinophilia ,Surgery ,medicine.symptom ,Eosinophilic esophagitis ,business - Abstract
The prevalence of eosinophilic esophagitis (EoE) is increasing. It is important for practitioners to be aware of the disease and its presenting symptoms.It is important to distinguish EoE from proton-pump inhibitor (PPI)-responsive esophageal eosinophilia. Patients with PPI-responsive esophageal eosinophilia exhibit symptoms of esophageal dysfunction (often with endoscopic findings suggestive of EoE) with esophageal eosinophilia that responds to PPI treatment.EoE was identified as a 'new disease' over 20 years ago. Two consensus articles have since been published (as well as an evidence-based approach to the diagnosis and management) highlighting diagnostic criteria, treatment options and potential complications of untreated disease. There is still much that needs to be learned and there are still many controversies left unanswered. No cure has been identified for EoE. Current therapy revolves around diet restriction and use of steroids to reduce the number of eosinophils in the esophagus and improve symptom control. Possibly future research will identify new targets for treatment that hopefully will lead to new treatment options for patients suffering with this disease as well as nonendoscopic methods to monitor treatment response. more...
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- 2015
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15. Immunotherapy: Treating with Fewer Allergens?
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Cecelia, Damask
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Europe ,Desensitization, Immunologic ,Humans ,Allergens ,Patient Participation ,Rhinitis, Allergic ,United States - Abstract
Polysensitization, sensitization to more than one allergen, is a common feature of patients with allergic rhinitis, and may be a risk factor for subsequent development of allergic diseases, especially allergic asthma. However, a polysensitized patient does not necessarily have polyallergy, a documented, causal relationship between exposure to 2 or more specific, sensitizing allergens and the subsequent occurrence of relevant clinical symptoms of allergy. Allergen immunotherapy treatment strategy for the polysensitized patient in Europe is to treat the single or 2 most clinically relevant allergen(s), whereas patients in the United States are usually treated for all potential clinically relevant allergens. more...
- Published
- 2017
16. Food Allergy
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William R. Reisacher, Maria C Veling, Cecelia Damask, and Karen H. Calhoun
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medicine.medical_specialty ,Allergy ,business.industry ,MEDLINE ,Disease ,Atopic dermatitis ,medicine.disease ,Otorhinolaryngology ,Food allergy ,Epidemiology ,Immunology ,Humans ,Medicine ,Surgery ,State of the science ,business ,Food Hypersensitivity ,Asthma - Abstract
In the past several years, food allergies have taken center stage in the media and have become a topic of great concern for our patients and their families. Whether or not this is due to a rise in the prevalence of food allergies or just a heightened awareness, it is our responsibility as clinicians and scientists to critically analyze the current evidence available concerning the epidemiology, manifestations, diagnosis, and management of this disease. In 2010, the National Institute of Allergy and Infectious Diseases (NIAID) published guidelines concerning the diagnosis and management of food allergies. Since 2009, the Allergy, Asthma and Immunology Committee of the American Academy of Otolaryngology-Head and Neck Surgery has sponsored a miniseminar titled, "Food Allergy: State of the Science." This commentary focuses on the highlights from the 2010 meeting and provides some thoughts on what this latest publication means to otolaryngologists. more...
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- 2011
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17. Studying Life Effects & Effectiveness of Palatopharyngoplasty (SLEEP) Study
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Douglas M. Sorensen, Mary Mitskavich, Bruce R. Gordon, Richard Lenz, Joseph W. Giebfried, Jennifer Lynch, F. P.J. Langford, Nicole Maronian, Michael G. Stewart, Lionel M. Nelson, Stefan M. Zechowy, Karen H. Calhoun, Mark Reinke, Steven Y. Park, Cecelia Damask, Philip T. Ho, Regina P. Walker, James Jarrett, David L. Witsell, Mark D. Gibbons, David C. Brodner, Kenneth Hodge, Richard L. Scher, Alan Kominsky, Robert E. Harley, James E. Kallman, Kristine Schulz, Kathleen Yaremchuk, Michael Y. Parker, Jonas T. Johnson, Bevan Yueh, Eric J. Kezirian, Timothy L. Smith, David I. Astrachan, Gary A. Buxa, B. Tucker Woodson, Sean Houston, John R. Morris, Dwight Ellerbe, Jordan C. Stern, Richard W. Waguespack, Ofer Jacobowitz, Milesh M. Patel, Jonathan D. McGinn, John R. Houck, David B. Wexler, Wayne Harsha, Larry A. Zieske, David L. Steward, Maureen T. Hannley, Edward M. Weaver, Samuel Welch, Frederic W. Schmidt, John S. Donovan, Andrew R. Gould, and David R. Bruce more...
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Adult ,Male ,medicine.medical_specialty ,Adolescent ,medicine.medical_treatment ,Palatopharyngoplasty ,Audiology ,Article ,Young Adult ,Quality of life ,Surveys and Questionnaires ,medicine ,Humans ,Sleep study ,Aged ,Sleep Apnea, Obstructive ,business.industry ,Uvulopalatopharyngoplasty ,Sleep apnea ,Middle Aged ,medicine.disease ,Otorhinolaryngologic Surgical Procedures ,Tonsillectomy ,Obstructive sleep apnea ,Treatment Outcome ,Uvula ,Otorhinolaryngology ,Multicenter study ,Quality of Life ,Physical therapy ,Pharynx ,Female ,Surgery ,Palate, Soft ,business - Abstract
To test the hypothesis that uvulopalatopharyngoplasty (UPPP) improves sleep apnea-related quality of life (measured on the Functional Outcomes of Sleep Questionnaire [FOSQ]) at 3-month follow-up. Secondary objectives were to test (1) the stability of the outcomes at 6 months, (2) the effect on global sleep apnea quality-of-life change, and (3) the effect on sleep apnea symptoms.Multicenter, prospective, longitudinal case series.Diverse university- and community-based otolaryngology practices.The cohort included 68 patients from 17 practices, with a mean ± standard deviation age of 44 ± 12 years and mean apnea-hypopnea index of 35 ± 32 events/hour. All patients underwent UPPP, defined as an open procedure modifying the shape and size of the palate, pharynx, and uvula, with or without tonsillectomy. Baseline data were collected on site before surgery, and outcome data were collected by mail 3 and 6 months after surgery, with follow-up rates of 51% and 50%, respectively.FOSQ scores improved from 14.3 ± 3.4 (scale 5-20, normal ≥17.9) at baseline to 17.2 ± 2.7 at 3 months (mean improvement 2.9; 95% confidence interval, 1.8-4.0; P.001) and 17.5 ± 2.5 at 6 months (mean improvement 3.1; 95% confidence interval, 2.0-4.2; P.001). All quality-of-life and symptom measures improved significantly at 3 and 6 months (all P.05).This prospective, multicenter, university- and community-based study provides evidence that UPPP significantly improves disease-specific quality of life and sleep apnea symptoms in patients with sleep apnea. Validity may be limited by significant loss to follow-up and absence of an unoperated control group. more...
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- 2011
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18. Food Allergy 2014: State of the Science
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Cecelia Damask, Karen H. Calhoun, William R. Reisacher, and Maria C Veling
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medicine.medical_specialty ,Allergy ,business.industry ,Treatment options ,medicine.disease ,Scientific evidence ,Otorhinolaryngology ,Food allergy ,Family medicine ,medicine ,Surgery ,Immunologic Reactions ,Food science ,State of the science ,Oral tolerance ,Head and neck ,business - Abstract
Program Description:This miniseminar includes 3 didactic lectures, an audience-interactive section, and Q&A. The lectures will focus on why food allergies develop by taking a critical look at the latest scientific evidence available in the literature, the role of oral tolerance in human evolution, and the relationship of failure to achieve oral tolerance on the health of the individual, relevant immunology, nonimmunologic food reactions versus immunologic reactions, both IgE-mediated and non–IgE-mediated, current methods of diagnosing food allergies, cutting-edge strategies such as component-resolved testing, skin and in vitro methods versus double-blind, placebo-controlled food challenge. Treatment options for food allergy will also be discussed.Educational Objectives:(1) Evaluate the scientific basis of IgE- and non–IgE-mediated food allergy. (2) Describe the manifestations of food allergy in the head and neck region. (3) Use the currently available treatments for food allergy as well as future directions. more...
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- 2014
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19. Food Allergy 2013: State of the Science
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William R. Reisacher, Karen H. Calhoun, Cecelia Damask, and Maria C Veling
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medicine.medical_specialty ,Allergy ,business.industry ,medicine.disease ,Scientific evidence ,Otorhinolaryngology ,Food allergy ,Family medicine ,medicine ,Surgery ,Food science ,Immunologic Reactions ,State of the science ,Oral tolerance ,business - Abstract
Program Description:This miniseminar includes didactic lectures, an audience-interactive section, and Q&A. The lectures will focus on why food allergies develop by taking a critical look at the latest scientific evidence available in the literature, the role of oral tolerance in human evolution, and the relationship of failure to achieve oral tolerance on the health of the individual, relevant immunology, non-immunologic food reactions versus immunologic reactions, both immunoglobulin E (IgE)-mediated and non-IgE-mediated, current methods of diagnosing food allergies, cutting-edge strategies such as component-resolved testing, skin and in vitro methods versus double-blind, placebo-controlled food challenge.Educational Objectives:1) Analyze the literature comparing different methods for diagnosing food allergy. 2) Evaluate the scientific basis of IgE and non-IgE mediated food allergy. 3) Describe the currently available treatments for food allergy as well as future directions. more...
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- 2013
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20. Food Allergy 2012: State of the Science
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Cecelia Damask, William R. Reisacher, Karen H. Calhoun, and Maria C Veling
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Otorhinolaryngology ,business.industry ,Food allergy ,Environmental health ,Medicine ,Surgery ,Food science ,State of the science ,business ,medicine.disease - Published
- 2012
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21. Food Allergy 2011: State of the Science
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Cecelia Damask, William R. Reisacher, Karen H. Calhoun, and Maria C Veling
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medicine.medical_specialty ,Allergy ,business.industry ,Nausea ,digestive, oral, and skin physiology ,Disease ,medicine.disease ,Dermatology ,Diarrhea ,Otorhinolaryngology ,Migraine ,Food allergy ,medicine ,Surgery ,Food science ,medicine.symptom ,business ,Anaphylaxis ,Asthma - Abstract
Program Description: Food allergies are difficult for the patient to understand and challenging for the clinician to treat. The CDC has recently reported that the prevalence of reported food allergies increased 18% over the past 10 years in children under 18. In addition, children with food allergies are 2 to 4 times more likely to suffer from asthma and other allergies. Allergic reactions to foods can produce life-threatening anaphylaxis, but have also been associated with other head and neck problems such as Meniere’s disease, migraine headache, chronic rhinitis, and chronic serous otitis media. There is a wide range of symptoms attributed to food allergies, such as nausea, cramping, diarrhea, dermatitis, urticaria, asthma, and joint pain. However, despite the fact that otolaryngologists see a large number of patients with food allergies, diagnosis and treatment strategies still remain controversial. The first part of the miniseminar will focus on the scientific basis of food allergies by taking a criti... more...
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- 2011
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22. Food Allergy 2009: State of the Science
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Karen H. Calhoun, Cecelia Damask, William R. Reisacher, and Richard C. Haydon
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Otorhinolaryngology ,business.industry ,Food allergy ,Environmental health ,Medicine ,Surgery ,State of the science ,business ,medicine.disease - Published
- 2009
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23. Food Allergy 2010: State of the Science
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Cecelia Damask, William R. Reisacher, Richard C. Haydon, and Karen H. Calhoun
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Otorhinolaryngology ,Food allergy ,business.industry ,Environmental health ,medicine ,Surgery ,Food science ,State of the science ,medicine.disease ,business - Published
- 2010
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