Wednesday, November 26, 2014

How Would CRISP Help Patients of Chronic Rhinosinusitis ?

How Would CRISP Help Patients of Chronic Rhinosinusitis ?

Recently, Geisinger Health System, John Hopkins Bloomberg School of Public Health, the Northwestern Medicine® Sinus and Allergy Centre, and the University of Chicago formed Chronic Rhinosinusitis Integrative Studies Program (CRISP) in the United States of America. The collective program would conduct research studies to understand the disease and develop effective methods of the treatment, benefiting the patients. CRISP received the program project grant (P01) to study the disease that is common in America but current knowledge of which is still rudimentary. The program would estimate remission, prevalence, and incidence of chronic rhinosinusitis (CRS) based on studies involving samples from general population representing the complete CRS spectrum.

Goals of Chronic Rhinosinusitis Integrative Studies Program

  • To understand genetic polymorphism associated with severity and susceptibility of CRS
  • To find costs and characteristics of the disease
  • To identify the factors exacerbating stubborn CRS
  • How do immunological factors affect CRS?
  • To study environmental risks of the disorder

Composition of Chronic Rhinosinusitis Integrative Studies Program


CRISP consists of five groups of collaborative studies and research work:
Core A focuses on administration.
Core B, Clinical, Laboratory, and Data Management Core
CRS Epidemiology Project: The Geisinger Health Systems (G.H.S.) would use new approaches to appraise epidemiology of the disease in more than 300,000 primary care patients in Pennsylvania.
CRS Immunology and Exacerbation Mechanism Project would collaborate with the epidemiology project at Northwestern University (1) to study the pathogens exacerbating the disease and (2) to define scope of autoimmunity in severity of the disease. The immunology project would also assess the role of autoimmunity and B lineage cells in the CRS etiology. 
CRS Genetics Project: The University of Chicago would conduct research studies (1) to find genes associated with the disease and (2) to understand relationship between the genetics and severity and various states of the disorder. The university would use the epidemiology project controls and samples collected from 2,000 patients to understand the genetics. 
The epidemiology and immunology projects would develop a new “systems genetics discovery platform” that would be used for identifying gene candidates.

Benefits of CRISP

The resultant improved fundamental knowledge about sub-phenotypes of CRS would help researchers in identifying cellular and molecular mechanisms and genetic susceptibilities causing and exacerbating the symptoms of the disease.  The understanding would facilitate development of therapies that are more effective than the existing ones.

Thursday, July 24, 2014

Thirteen Facts about Penicillium

Thirteen Facts about Penicillium, the Source of Modern Antibiotics

The world antibiotic consists of two Greek words “anti” and “bios” that mean “against” and “life” respectively. Antibiotics are the natural or artificial substances that can check or destroy the growth of harmful bacteria and thereby help in treating bacteria caused infections. Penicillin is probably the oldest and the most popular source of antibiotics.  But do you know?

  1. Alexander Fleming, a bacteriologist from Scotland, observed and reported merits of penicillin in 1928. He reported that Staphylococcus aureus died when came in contact of Penicillium notatum (P. chrysogenum), a green colour mould. This observation is one of the greatest feats of scientific community of the twentieth century.
  2. A decade later Ernst Chain (British), Howard Florey (Australia), and Norman Heatley worked on the observations made by Fleming. These scientists grew, extracted, and purified penicillin to use as a drug.
  3. The scientists faced three major problems while experimenting with penicillin: poor stability of penicillin at high and low pH levels, small level of production, and its fondness for surface culture.
  4. The city of Peoria in Illinois (U.S.A.) was the first place where the Northern Regional Research Laboratory (N.R.R.L.) produced penicillin at large scale.
  5. For penicillin production, locally available substances were used in both countries England and America. Yeast was used in England, whereas corn steep liquor solution was used in the U.S.A.  The liquor solution was more effective. The extract from penicillin moulds grown in the solution was successfully used in treating the World War II soldiers.
  6. The first penicillin-based injectable antibiotic for medicinal use was introduced in 1941.
  7. In 1945, Alexander Fleming, Ernst Boris Chain, and Howard Walter Florey won Nobel Prize in Medicine for discovering penicillin.
  8. Penicillium is a genus consisting of green or blue mould fungi found in asexual forms. The genus grows on fabrics, foodstuff, and leather.
  9. Penicillium is used for making cheeses, organic acid, and antibiotics. Penicillium is widely found in soil.
  10. Penicillin can be divided into two groups: natural and semi-synthetic. The natural penicillin forms during fermentation of the mould. The semi-synthetic penicillin features artificially modified six-aminopenicillanic acid.
  11. Since an antibiotic can be modified, a variety of penicillin is generated for different medicinal uses.
  12. The only natural penicillin that is still available in medical laboratories is Penicillin G. However, poor acid-stability of the penicillin limits its therapeutic use.
  13. The fungi’s conidiophores resemble a paintbrush. Therefore, the Latin word “penicillus,” which means paintbrush, is used to describe the fungi.

Tuesday, June 10, 2014

Penicillium, the Source of Modern Antibiotics

Thirteen Facts about Penicillium, the Source of Modern Antibiotics

The world antibiotic consists of two Greek words “anti” and “bios” that mean “against” and “life” respectively. Antibiotics are the natural or artificial substances that can check or destroy the growth of harmful bacteria and thereby help in treating bacteria caused infections. Penicillin is probably the oldest and the most popular source of antibiotics.  But do you know?
  1. Alexander Fleming, a bacteriologist from Scotland, observed and reported merits of penicillin in 1928. He reported that Staphylococcus aureus died when came in contact of Penicillium notatum (P. chrysogenum), a green colour mould. This observation is one of the greatest feats of scientific community of the twentieth century.
  2. A decade later Ernst Chain (British), Howard Florey (Australia), and Norman Heatley worked on the observations made by Fleming. These scientists grew, extracted, and purified penicillin to use as a drug.
  3. The scientists faced three major problems while experimenting with penicillin: poor stability of penicillin at high and low pH levels, small level of production, and its fondness for surface culture.
  4. The city of Peoria in Illinois (U.S.A.) was the first place where the Northern Regional Research Laboratory (N.R.R.L.) produced penicillin at large scale.
  5. For penicillin production, locally available substances were used in both countries England and America. Yeast was used in England, whereas corn steep liquor solution was used in the U.S.A.  The liquor solution was more effective. The extract from penicillin moulds grown in the solution was successfully used in treating the World War II soldiers.
  6. The first penicillin-based injectable antibiotic for medicinal use was introduced in 1941.
  7. In 1945, Alexander Fleming, Ernst Boris Chain, and Howard Walter Florey won Nobel Prize in Medicine for discovering penicillin.
  8. Penicillium is a genus consisting of green or blue mould fungi found in asexual forms. The genus grows on fabrics, foodstuff, and leather.
  9. Penicillium is used for making cheeses, organic acid, and antibiotics. Penicillium is widely found in soil.
  10. Penicillin can be divided into two groups: natural and semi-synthetic. The natural penicillin forms during fermentation of the mould. The semi-synthetic penicillin features artificially modified six-aminopenicillanic acid.
  11. Since an antibiotic can be modified, a variety of penicillin is generated for different medicinal uses.
  12. The only natural penicillin that is still available in medical laboratories is Penicillin G. However, poor acid-stability of the penicillin limits its therapeutic use.
  13. The fungi’s conidiophores resemble a paintbrush. Therefore, the Latin word “penicillus,” which means paintbrush, is used to describe the fungi.


Monday, May 5, 2014

New management guidelines for acute bacterial sinusitis in children: Part I

New management guidelines for acute bacterial sinusitis in children: Part I

In July 2013, the American Academy of Pediatrics (AAP) updated “Clinical Practice Guidelines for the Diagnosis and Management of Acute Bacterial Sinusitis in Children aged 1-18.” The new guidelines were published in Pediatrics, the academy’s journal. Highlights of the guidelines are summarized in two articles.

Observations made in the new guideline document

  • Acute bacterial sinusitis (ABS) is a common complication of allergic inflammation or viral upper respiratory infection (URI).


  • Approximately seven percent of young patients getting treatment for respiratory problems have acute sinusitis symptoms.

Why ABS and viral URI are confused with each other?

The membranes lining the sinus cavities, the nose, the middle ear, the oropharynx, and the nasopharynx are continuous. These membranes are called mucosae in medical terminology.
An inflamed nasal mucosa is a main symptom of a viral URI. However, generally the inflammation is also observed in the paranasal sinus and middle ear membranes. Therefore, confusion arises and an imaging scan was recommended earlier for correct diagnosis.

Which clinical observations indicate acute bacterial sinusitis?

According to the new guidelines, a child having an acute infection of the upper respiratory channel suffers from ABS if the following sinusitis symptoms are present:
  1. Persistent illness: persistent nasal discharge, cough during daytime, or both for over ten days without any improvement,
  2. Worsening course: A new beginning or worsening of fever, daytime cough, or nasal discharge after some improvement, or
  3. Severe onset: Purulent nasal discharge and high fever (equal to or more than 102.2 degree Fahrenheit or 39 degree Celsius) for minimum of three consecutive days. Purulent discharge means colored, opaque, and thick discharge.

Do the guidelines recommend imaging of paranasal sinuses to differentiate between a simple viral URI and ABS?

The new guidelines do not recommend the imaging of the sinuses because the images of the young patients suffering from the URI would be abnormal due to overlapping in the findings associated with the two diseases. Especially, imaging is not required in case of uncomplicated ABS.
The recommendation protects children from harmful effects of exposure to radiation, saves money, and prevents false-positive diagnosis.

When to use a contrast-enhanced computed tomography (CT) and / or magnetic resonance imaging (MRI) with contrast scan of the sinuses?

A CT scan is required if the patient also have problems of the central or orbital nervous system. The scan helps in identifying the lesion and the progression, enabling to assess the surgical requirements.

Monday, March 24, 2014

Treating chronic sinus infection

10 questions about Sinuwave used for treating chronic sinus infection

What is Sinuwave™ Photodisinfection System?

Innovative and easy-to-use , a non-antibiotic treatment, uses antimicrobial photodynamic therapy (aPDT).  The system uses photodisinfection principles to treat chronic sinus infection.
The system is designed by the U.S. based Sinuwave Technologies Corporation.

What is aPDT?

aPDT is a brief process consisting of the following steps:
The therapy uses safe laser light to activate a topical photo sensitizer featuring ultra-pure Methylene Blue (MeBlue).
The custom coaxial irrigation catheter irrigates the sensitizer onto the affected paranasal sinus tissues and sticks to the pathogens residing on the membranes (mucosae).
The custom balloon catheter delivers activated light to the sinus membranes without causing any pain.

How does aPDT help?

aPDT plays multiple roles. For example, the therapy
    1. destroys various drug-resistant biofilms occupying the paranasal sinus membranes,
    2. eliminates planktonic viruses, fungi, and bacteria,
    3. removes protease and other local exotoxins,
    4. reduces inflammatory response,
    5. provides instant relief via vasoconstriction of the tissues, and
    6. improves activation of neutrophil.

Does aPDT encourage growth of “photo-resistant” bacteria?

Repeated a PDT does not make bacteria “photo-resistant” probably because the therapy uses a different mechanism than an oral antibiotic therapy to destroy the fungal and bacterial cells. In photodynamic technique, aPDT-induced oxygen radicals and singlet oxygen perforate the cell wall. The perforation damages cells and leads to protein inactivation and membrane lysis.

How are photodisinfection and antibiotics different?

Photodisinfection technique destroys microbes as soon as the light is activated. The non-antibiotic treatment therefore offers fast relief. On the other hand, antibiotics take hours or even days in resolving the symptoms.

Is photodisinfection a proven treatment?

Instant anti-inflammatory and antimicrobial effects of photodisinfection have been confirmed during testing.

How much log reduction in bacteria load did photodisinfection demonstrate during the tests?

Photodisinfection technology showed four-log reduction (99.99%) in bacteria in different systems although two-log reduction (99%) is enough for the chronic sinus infection treatment. Sinuwave would also demonstrate 4-log reduction.

When is used?

The treatment is used for the patients who do not respond to surgical and medical options.
The system reduces the sinusitis leading to formation of polymicrobial biofilms that are resistant to antibiotics. Just one treatment reduces the biofilm formation by 99.9%.

Is e an approved treatment?

Canada has approved Sinuwave. Clinical trials are in progress at the Canadian University of Montreal.

What are the benefits?

    1. Sinuwave would reduce the pain and pathogens such as fungi, viruses, and bacteria that are resistant to antibiotic.  
    2. The treatment would not require patient compliance.
    3. Sinuwave would not lead to drug interactions.

Friday, March 7, 2014

Chinese formula for sinusitis treatment

Sinusitis can be cured with a new Chinese formula


Sinusitis can be cured, as medical community continues to develop new and better meds. For instance, Lu Yubin, an expert of oriental medicine and acupuncture, created a new formula Sinusolve to treat acute sinusitis. The new formula was published in June 2002 issue of The Journal of Chinese Medicine.

What is Sinusolve?


Sinusolve is based on traditional Chinese medicine (T.C.M.) principles. The new formula is an improvisation of the existing formulas such as Xin Yi San, Yin Qiao San, and Huo Dan Wan.

Yubin has taken into account various sinus related aspects that are generally neglected. For example, (1) heat accumulated in the gall bladder moves to the head and (2) toxic heat buildup in the nasopharynx trigger sinus disorders.

Does the formula use more than one herb group?


Sinusolve consists of five different types of herbs:
  1. Herbs that disperse gall bladder and liver heat
  2. Herbs used for toxic heat removal
  3. Herbs that free exogenous pathogens
  4. Herbs promoting blood flow
  5. Herbs used for dispersing lung-qi (In traditional Chinese medicine, “qi” refers to physiological functions)

How many herbs are used in the formula?


The formula uses the following ten herbs in different amounts.


How effective is the formula?


In view of good results during testing, Yubin believes that acute sinusitis can be cured with Sinusolve. Improvement generally begins within two-three days of administering the medicine.

Thursday, February 13, 2014

Sinus headache symptoms vary from those of cluster, migraine, and tension headaches

Sinus headache symptoms vary from those of cluster, migraine, and tension headaches


We have earlier compared sinus headache symptoms with that of cluster, migraine, and tension headaches in three separate articles. This article reviews causes, symptoms, occurrences, and other aspects of all the four disorders simultaneously for better understanding.



The above table clearly shows overlapping in various aspects of the headaches. So, do not self-diagnose, meet your doctor to understand the headache symptoms. If the doctor says that you have sinus headache symptoms, follow the prescription to treat your paranasal sinuses.