Search Results (3,937)

Background/Objectives: Diffuse sinonasal exophytic papillomas (DSNEPs) are rare entities, with similarities to recurrent respiratory papillomatosis (RRPs). DSNEP treatment is usually based on surgical excision, but the recurrence rate is high. Bevacizumab injections have been increasingly used as an adjuvant option for RRP, but their role in DSNEP treatment remains unknown. The current study describes the preliminary experience, safety profile, and exploratory outcomes of sublesional bevacizumab injections following surgical excision. Methods: We undertook a retrospective, single-centre study of a cohort of patients diagnosed with DSNEP between 2011 and 2018. All patients were treated with surgical excision and sublesional bevacizumab injections. The effect of bevacizumab was evaluated using a severity score developed to quantify lesion size and the extent of affected areas in each patient. Results: Seven patients diagnosed with DSNEP were treated. All patients were male, with a median age at diagnosis of 42 years [38–44.5]. Human papillomavirus (HPV) DNA was detected in all patients: HPV-11 in six cases (85.7%) and HPV-6 in one case (14.3%). Bevacizumab was injected into the submucosa of their surgical sites. The median follow-up was 55.5 months [40.85–82.73]. Most patients (85.72%) presented recurrence, with a median of 3 years [1.5–4]. A statistically significant reduction in the severity score was observed (p = 0.017), although this finding cannot be attributed solely to bevacizumab due to study design limitations. No relevant complications were reported. Conclusions: Nasal sublesional bevacizumab injections were well tolerated and feasible as an adjuvant approach to DSNEP. Larger prospective studies are needed to confirm its safety and assess its potential benefit. Full article

Background/Objectives: Individual responses to CFTR modulators vary widely among people with cystic fibrosis (pwCF), underscoring the need for functional approaches that provide biological context alongside genotype-based therapy selection. Nasal epithelial cultures provide an individual-specific model for theratyping, but most studies rely on freshly isolated cells, restricting repeated testing and long-term sample use. In this study, we tested whether CFTR modulator responses measured in biobanked nasal cells were associated with real-world clinical outcomes. Methods: Cryopreserved nasal epithelial cells from 23 pwCF were differentiated at the air–liquid interface and assessed for CFTR modulator-responsive ion transport using Ussing chambers. In vitro responses were correlated with 6-month changes in sweat chloride concentration (SCC), FEV₁, and BMI. Results: Cryopreserved cultures retained donor-specific CFTR modulator responsiveness. Modulator-induced forskolin/IBMX-stimulated currents correlated with changes in SCC (R = −0.512). CFTR inhibitor-sensitive currents correlated with FEV₁ (R = 0.564). Associations between forskolin/IBMX-stimulated currents and FEV₁ were positive but did not reach statistical significance using two-tailed analysis. BMI changes showed no significant association. Conclusions: Biobanked nasal epithelial cultures preserve clinically relevant CFTR modulator responses at the cohort level, supporting their use as functional assays for population-level assessment in cystic fibrosis. This cryopreservation-based strategy enables repeated testing and may expand access to theratyping beyond freshly obtained samples. Full article

Objective: To assess whether chronic rhinosinusitis (CRS) severity is associated with obstructive sleep apnea (OSA) in adult people with cystic fibrosis (pwCF). Methods: We conducted a retrospective single-center study of 44 adults with CF who underwent overnight polysomnography (PSG), Epworth Sleepiness Scale (ESS) assessment, and sinus computed tomography (CT). CRS severity was quantified using the Lund–Mackay score (LMS) and the main nasal cavity score (MNCS). OSA was defined by Apnea–Hypopnea Index (AHI) thresholds per American Academy of Sleep Medicine criteria. Results: Participants had a mean age of 31.1 ± 8.4 years and a mean percent predicted FEV1 of 51.8 ± 15.7. Sinus CT showed radiological evidence of CRS in all participants. Mean AHI was 5.3 ± 4.4/h; 48% had AHI ≥ 5/h. There were no significant differences between pwCF with and without OSA in age, sex, BMI, lung function, total sleep time, sleep efficiency, or ESS score (all p > 0.05). Mean LMS and MNCS did not differ between OSA and non-OSA groups (both p > 0.05), and neither score correlated with PSG parameters or ESS (all p > 0.05). Receiver operating characteristic (ROC) analysis demonstrated low discriminative ability of LMS and MNCS for predicting OSA (AUCs < 0.70, p < 0.05). Conclusions: In this cohort of adults with CF, CT-based CRS severity was not associated with OSA. Given the substantial prevalence of OSA observed, PSG screening should be considered irrespective of CRS severity. Full article

Background: Naegleria fowleri is a free-living amoeba that inhabits warm freshwater and causes primary amoebic meningoencephalitis (PAM), a rapidly fatal infection with >95% mortality. Due to the lack of early diagnosis and effective therapy, preventive vaccination represents a promising strategy. Methods: This study evaluated short- and long-term immune protection in BALB/c mice (20 mice per group) immunized intranasally with total N. fowleri extract co-administered with cholera toxin (CT). Mice were challenged with a lethal dose of trophozoites either 24 h (short-term) or three months (long-term) after the fourth immunization; the latter group received a booster 24 h before challenge. Serum and nasal washes were analyzed for IgA and IgG antibodies by immunoblot, and lymphocyte subsets from nasal-associated lymphoid tissue (NALT) and nasal passages (NPs) were characterized by flow cytometry. Results: Immunization conferred complete (100%) survival in the 24 h group and 60% protection in the 3-month group, whereas all control mice died. Immunoblotting showed that IgA and IgG antibodies recognized major N. fowleri antigens of 37, 45, 48 and 19, 37, and 100 kDa, respectively. Flow cytometry revealed increased activated and memory B lymphocytes, dendritic cells, and expression of CCR10, integrin α4β1, and FcγRIIB receptors, particularly in the 24 h group. Conclusions: Intranasal immunization with N. fowleri extract plus CT elicited both systemic and mucosal immune responses capable of short- and long-term protection. These findings highlight the potential of this immunization strategy as a foundation for developing effective vaccines against PAM. Full article

Background/Objective: Nasal pressure injuries following non-invasive ventilation (NIV) have remained a common complication. Available evidence on injury severity characteristics, timing, and predictors of progression to moderate–severe injury, especially in large cohorts, is limited. The objective was to assess the incidence, characteristics and risk factors for nasal pressure injuries among neonates on NIV in a large tertiary neonatal intensive care unit (NICU). Methods: This retrospective observational study recruited all infants who experienced nasal pressure injury while on NIV from March 2018 to November 2022. The severity of the injury was categorized by the Fischer classification. Demographics, perinatal, respiratory, and device-related factors were examined. Multivariable logistic regression revealed independent predictors of moderate to severe injury. Results: There were 237 nasal injury episodes in 226 infants (0.406 per 100 device-days), considering 17,004 NICU admissions and 58,363 NIV device-days. Most injuries were mild (Stage I 81%) while 19% were moderate–severe (Stage II–III). Early injuries (≤3 days after NIV) were present in 83.5% of patients and were often related to the nasal bridge. In particular, late-onset injuries (>3 days) were more likely in infants with previous injury, exposure to postnatal steroids, longer prior intubation, or septal involvement. Moreover, multivariable analysis identified three specific independent predictors of moderate–severe injury previous nasal injury (aOR 6.25, 95% CI 1.11–35.35), septal or combined bridge/septum involvement (aOR 2.98, 95% CI 1.04–8.43), and prolonged period of positive pressure ventilation at birth (aOR 1.23 per minute, 95% CI 1.04–1.45). Conclusions: Most nasal pressure injuries seen during NIV are mild and early; however, recurrence, septal involvement, and prolonged resuscitative ventilation markedly increase the risk of severe injury. Improving surveillance on early NIV use, monitoring of septal pressure points, and proactive interventions with interface management will aid in minimizing preventable nasal morbidity. Full article

Background: Non-absorbable polyvinyl alcohol sponges (Merocel) are widely used in otolaryngology for nasal and ear packing but are prone to bacterial colonization and biofilm formation, which may increase infection risk and drive frequent use of systemic antibiotics. Sustained-release drug delivery systems enable prolonged local antiseptic activity at the site of packing while minimizing systemic exposure. Methods: We developed a sustained-release varnish containing chlorhexidine (SRV-CHX) and coated sterile Merocel sponges. Antibacterial, in vitro, activity against Staphylococcus aureus and Pseudomonas aeruginosa was evaluated using kinetic diffusion assays on agar, optical density (OD₆₀₀) measurements of planktonic cultures, drop plate, ATP-based viability assays, biofilm analysis by MTT metabolic assay, crystal violet bio-mass staining, high-resolution scanning electron microscopy (HR-SEM), and spinning disk confocal microscopy. Results: SRV-CHX-coated sponges produced sustained zones of inhibition on agar plates for up to 37 days against S. aureus and 39 days against P. aeruginosa, far exceeding the usual 3–5 days of clinical sponge use. Planktonic growth was significantly reduced compared with SRV-placebo, and a bactericidal effect persisted for up to 16 days for S. aureus and 5 days for P. aeruginosa before becoming predominantly bacteriostatic. Biofilm formation was markedly inhibited, with suppression of metabolic activity and biomass for at least 33 days for S. aureus and up to 16 days for P. aeruginosa. HR-SEM and confocal imaging confirmed sparse, discontinuous biofilms and predominance of non-viable bacteria on SRV-CHX-coated sponges compared with dense, viable biofilms on the placebo controls. Conclusions: Coating Merocel sponges with SRV-CHX provides prolonged antibacterial and anti-biofilm activity against clinically relevant pathogens. This strategy may reduce dependence on systemic antibiotics and improve infection control in nasal and ear packing applications in otolaryngology. Full article

Chronic rhinitis is induced by endotype-diverse inflammatory processes, which complicates effective therapeutic management. According to the current principles of personalized medicine, which also apply to the management of rhinological disorders, the best therapeutic results can be achieved after targeted treatment preceded by analysis of the patient’s endotype. Analysis of immune and cellular mechanisms allows for the use of biological treatment, and its effects provide new information on inflammatory processes in the nasal mucosa. The effects of biological treatment may be particularly interesting in the case of mixed endotypes, which pose a difficult therapeutic challenge. In eosinophilic asthma co-occurring with allergic rhinitis, as well as in eosinophilic asthma associated with non-allergic rhinitis, eosinophils represent a key effector cell population driving the underlying type 2-mediated inflammatory response. The aim of this study is to analyze the efficacy of anti-IL5 or anti-ILR5 therapy in patients with severe eosinophilic asthma and persistent allergic or non-allergic rhinitis. Methods: In this single-center real-life study, the authors analyzed the effects of biological treatment on rhinological symptoms in patients over the age of 18 with severe uncontrolled eosinophilic bronchial asthma with coexisting persistent allergic or non-allergic rhinitis treated with mepolizumab or benralizumab. In all patients, the otolaryngologist performed anterior rhinoscopy. Evaluation of rhinological symptoms and quality of life in patients treated with anti-IL5 or anti-IL5 therapy before and six months after biological treatment was performed using the TNSS and SNOT-22 scales. Results: In total, 67 patients with eosinophilic severe bronchial asthma were included in the study; among them 39 (58.2%) suffered from persistent allergic rhinitis and 28 (41.8%) suffered from chronic non-allergic rhinitis. After six months of treatment, higher absolute differences for SNOT and TNSS were observed in the persistent allergic rhinitis group. Conclusions: Biological treatment with mepolizumab and benralizumab may reduce the severity of rhinological symptoms in both endotypes of inflammation. However, higher therapeutic benefits were observed in patients with co-existing persistent allergic rhinitis. It was demonstrated that, in addition to IgE-mediated responses, the eosinophil represented an important component of the inflammatory reaction in allergic rhinitis. Full article

Background/Objectives: To thoroughly compare acoustic rhinometry (AR) with computed tomography (CT) cross-sectional areas that are approximately perpendicular to the direction of the nasal airflow (CT-CSA). Methods: We retrospectively examined subjects scheduled for functional nasal surgery, along with preoperative CT and AR. CT-CSAs were assessed in several nasal planes in the first 5 cm of the nasal airway. Area sizes and distances of the CT-CSAs from the columella served to create a CT curve analogous to the AR curve. AR curves were digitized. We examined the correlation and agreement (using the Bland–Altman method) between CT curves and digitized AR curves, as well as between selected CT-CSAs and the first two-encountered AR minimal cross-sectional areas (AR-MCA₁ and AR-MCA₂). Correlation was investigated by univariate analysis of variance and Pearson’s correlation. Agreement was examined by the Bland–Altman method. Results: In 33 subjects, the correlation of digitized AR with CT was moderate (r = 0.76; p < 0.001). AR, in general, underestimated the actual nasal area by 15%. AR-MCA₁ and AR-MCA₂ were closest to the CT-CSA of the nasal valve and the incisive canal, respectively. We noted a mainly moderate correlation between the CT-CSA of the nasal valve and AR-MCA₁ (all r > 0.59; all p < 0.001) in contrast to the weaker correlations between the CT-CSA of the incisive canal and AR-MCA₂. Conclusions: AR may underestimate the actual nasal area by 15%. AR-MCA₁ and AR-MCA₂ were closest to the CT-CSA of the nasal valve and the incisive canal, respectively. Full article

Pneumonia caused by the facultative intracellular pathogen Rhodococcus equi stands out as one of the most significant infections associated with a notably high mortality rate in foals worldwide. Limited therapeutic options and inadequate control and prevention measures result in substantial economic losses, underscoring the need for enhanced interventions. A cross-sectional, multi-province study was conducted on racehorse-breeding farms in Türkiye to estimate prevalence and index virulence, assess relatedness, and summarize antimicrobial susceptibility within a farm management context. Nasal and fecal swabs and environmental samples (soil and water) were cultured and confirmed; virulence was assessed with vapA-specific PCR, genetic relationship determined with PFGE, and antimicrobial susceptibility using disk diffusion. R. equi was detected in 10% of nasal swabs, 22.9% of fecal swabs, 29.4% of soil samples, and 5.9% of water samples; 46.2% of confirmed isolates were vapA-positive. Susceptibility patterns were favorable overall, with frequent ampicillin resistance, infrequent resistance to macrolides and rifampin, rare multidrug resistance, and no vancomycin resistance was detected. PFGE demonstrated substantial genotypic diversity, with 12 clusters and 29 distinct pulsotypes. Farm-level observations were exploratory. More frequent mechanical paddock cleaning coincided with the absence of foal deaths, and vapA-positive isolates were observed on farms with prior infection. Taken together, these findings support routine paddock hygiene, prompt isolation of clinically affected foals, culture-guided therapy, and continued surveillance, and they indicate a need for longitudinal and genomic studies to evaluate the impact. Full article

Exposure to plant protection products (pesticides) is common among agricultural workers and may represent an underrecognized cause of mucocutaneous disease. We conducted a descriptive cross-sectional survey in agricultural communities in southern Thailand (August–November 2025) to estimate the prevalence, clinical characteristics, and dermatology-specific quality-of-life impact of pesticide-attributed symptoms. Agricultural workers with pesticide use or exposure within the preceding 12 months were recruited via convenience sampling; participants provided consent and completed standardized interviewer-administered questionnaires assessing demographics, pesticide exposure history and application practices, personal protective equipment (PPE) use, self-reported cutaneous and mucosal symptoms (ocular and oral/nasal), and the Dermatology Life Quality Index (DLQI). Of the 354 eligible individuals, 228 participated in the study, and 226 were included in the analyses. The median age was 54 years (interquartile range [IQR], 15), and 82.7% were male. Overall, 14.6% reported pesticide-attributed cutaneous symptoms, 5.3% reported ocular mucosal symptoms, and 0.4% reported oral/nasal mucosal symptoms. Cutaneous manifestations were predominantly symptoms occurring after exposure, with pruritic, erythematous eruptions affecting the arms and hands that typically resolved within 1–7 days after cessation of exposure. Among symptomatic participants, the median DLQI was 0.5 (IQR 3.0); however, DLQI scores were significantly higher among participants who reported pesticide-attributed cutaneous symptoms (p < 0.001) and ocular symptoms (p < 0.001). These findings suggest that pesticide-associated mucocutaneous effects are generally mild yet clinically meaningful, underscoring the need to strengthen PPE training, risk communication, and occupational health surveillance in agricultural settings. Full article

Downtime, also known as an animal avoidance period, refers to a 24–72 h period during which individuals who have had contact with one animal species avoid subsequent contact with other susceptible species. This scoping review critically evaluated the effectiveness of downtime as a biosecurity measure. Peer-reviewed studies were identified and analysed using three electronic databases (Pubmed, Web of Science and Scopus). Two experimental studies directly evaluated downtime, nine additional articles examined human nasal carriage of pathogens after exposure to infected animals and seven articles evaluated the effectiveness of hygiene-based biosecurity measures targeting indirect mechanical pathogen transmission via humans (n = 14 unique articles in total; topical overlap noted where studies contributed to multiple categories). No evidence indicated an added benefit of downtime over other, more evidence-based measures such as hand hygiene, changing of clothes and boots and showering. While certain studies were able to identify the nasal carriage of pathogens, only one study indicated possible consequent transmission to naïve animals. This limited and species-specific evidence base reveals a critical gap between policy recommendations and scientific support for downtime. Based on these results, no clear benefit or necessity of downtime over other measures have been identified, other than its ability to deter unnecessary visitors, but these do not outweigh the impracticalities associated with an ‘animal avoidance period’. Resources and policy efforts should therefore shift from enforcing downtime toward ensuring and verifying adherence to fundamental hygiene measures. Full article

Staphylococcus aureus has been recognized as an important foodborne pathogen and methicillin-resistant S. aureus (MRSA) can cause fatal infections worldwide. Of great concern is that MRSA have been found in animals and non-healthcare settings; however, knowledge about the prevalence and genetic characteristics of S. aureus, especially MRSA from animals, retail meats and market shared shopping vehicles in the same district, is limited. In this study, we collected 423 samples including handrail swabs (n = 226) of shopping trolleys and baskets from 18 supermarkets, retail meats (n = 137) and swine nasal swabs (n = 60) between 2018 and 2020 in China. S. aureus isolates were isolated and identified by PCR, and then the mecA was used to confirm the MRSA. The antibiotic resistance and virulence genes among S. aureus were also analyzed, followed by whole genome sequencing (WGS). S. aureus isolates were widely distributed in shared shopping vehicles (8.0%, 18/226), retail meats (14.6%, 20/137) and swine (18.3%, 11/60). In total, 49 S. aureus were obtained and 20 of the 49 isolates were MRSA. We firstly reported a high prevalence of MRSA in shared shopping vehicles (7.5%, 17/226), followed by raw meats (2.2%, 3/137), and 44.4% (8/18) of the 18 supermarkets possessed MRSA-positive shopping vehicles. All 20 MRSA isolates were SCCmec IVa MRSA clones. Enterotoxin genes (sea/seb) associated with S. aureus food poisoning were present in 45.0% of the 20 S. aureus isolates from retail meats and 25.0% of the 20 MRSA isolates carried enterotoxin genes. Retail meats in this study carried ST6-MRSA, a common ST type of S. aureus from food-poisoning outbreaks in China. WGS showed that the MRSA from meats harbored enterotoxin gene sea and immune evasion genes (sak and scn) associated with human infections, and were clustered with previously reported MRSA isolates from animals and humans. The MRSA isolates carrying multiple virulence genes from shopping vehicles were also clustered with previously reported MRSA isolates from humans and animals, suggesting that the exchange of MRSA isolates might occur among different niches. Our results highlighted the risk of retail meats and shared shopping vehicles in spreading antimicrobial-resistant pathogens including MRSA. To our knowledge, this is the first report of the wide spread of MRSA in shared shopping vehicles in China. Full article

Highly pathogenic avian influenza (HPAI) H5N1 clade 2.3.4.4b viruses spread efficiently via migratory wild birds and increasingly infect mammals. The leopard cat (Prionailurus bengalensis) is an endangered mesopredator in South Korea that frequents wetland–forest ecotones and overlaps with wild waterbirds, placing it at risk of exposure. We describe a fatal HPAI H5N1 infection in a free-ranging leopard cat detected through national wildlife surveillance during a period of widespread H5N1 activity in wild birds along the East Asian–Australasian Flyway. The animal showed acute neurological and respiratory signs and died shortly after rescue. H5 viral RNA was detected by RT-qPCR in all examined tissues, with the highest load in the brain, and infectious virus was isolated from the brain, bronchoalveolar lavage fluid, and nasal swab. Pathology revealed acute serofibrinous pneumonia, severe nonsuppurative meningoencephalitis, necrotizing vasculitis with thrombosis, and necrotizing enteritis with secondary mesenteritis. Immunohistochemistry demonstrated abundant viral antigen in nasal and olfactory epithelium, olfactory bulb, neurons, endothelial cells, and bronchial and bronchiolar epithelium, supporting combined olfactory and hematogenous dissemination. This clinicopathological description expands the spectrum of HPAI-associated lesions in felids and underscores the value of wild carnivores as bioindicators of avian influenza spillover in a One Health context. Full article

Over the past two decades, Light Detection and Ranging (LiDAR) technology has evolved from early National Aeronautics and Space Administration (NASA)-led airborne laser altimetry into commercially mature systems that now underpin vegetation remote sensing across scales. Continuous advancements in laser engineering, signal processing, and complementary technologies—such as Inertial Measurement Units (IMU) and Global Navigation Satellite Systems (GNSS)—have yielded compact, cost-effective, and highly sophisticated LiDAR sensors. Concurrently, innovations in carrier platforms, including uncrewed aerial systems (UAS), mobile laser scanning (MLS), Simultaneous Localization and Mapping (SLAM) frameworks, have expanded LiDAR’s observational capacity from plot- to global-scale applications in forestry, precision agriculture, ecological monitoring, Above Ground Biomass (AGB) modeling, and wildfire science. This review synthesizes LiDAR’s cross-domain capabilities for the following: (a) quantifying vegetation structure, function, and compositional dynamics; (b) recent sensor developments encompassing ALS discrete-return ${(ALS}_D)$, and ALS full-waveform $\left({ALS}_{FW}\right)$, photon-counting LiDAR (PCL), emerging multispectral LiDAR (MSL), and hyperspectral LiDAR (HSL) systems; and (c) state-of-the-art data processing and fusion workflows integrating optical and radar datasets. The synthesis demonstrates that many LiDAR-derived vegetation metrics are inherently transferable across domains when interpreted within a unified structural framework. The review further highlights the growing role of artificial-intelligence (AI)-driven approaches for segmentation, classification, and multitemporal analysis, enabling scalable assessments of vegetation dynamics at unprecedented spatial and temporal extents. By consolidating historical developments, current methodological advances, and emerging research directions, this review establishes a comprehensive state-of-the-art perspective on LiDAR’s transformative role and future potential in monitoring and modeling Earth’s vegetated ecosystems. Full article

Influenza D virus (IDV), an emerging orthomyxovirus with zoonotic potential, infects diverse hosts, causes respiratory disease, and remains poorly characterized in China despite its global expansion. From October 2023 to January 2025, we collected 563 nasal swabs from cattle across 28 farms in Jilin Province, Northeast China, and identified seven IDV-positive samples (1.2%), recovering two viable isolates (JL/YB2024 and JL/CC2024). Full-genome sequencing revealed complete, stable seven-segment genomes with high nucleotide identity (up to 99.9%) to contemporary Chinese D/Yamagata/2019 strains and no evidence of reassortment. Maximum-likelihood and time-resolved Bayesian phylogenies of 231 global hemagglutinin-esterase-fusion (HEF) sequences placed the Jilin isolates within the East Asian D/Yamagata/2019 clade and traced their most recent common ancestor to approximately 2017 (95% highest posterior density: 2016–2018), suggesting a cross-border introduction likely associated with regional cattle movement. No IDV was detected in parallel surveillance of swine, underscoring cattle as the principal reservoir and amplifying host. Bayesian skyline analysis demonstrated a marked decline in global IDV genetic diversity during 2020–2022, coinciding with livestock-movement restrictions imposed during the COVID-19 pandemic. Collectively, these findings indicate that IDV circulation in China is sporadic and geographically localized, dominated by the D/Yamagata/2019 lineage, and shaped by multiple independent incursions rather than a single emergence. Both the incorporation of IDV diagnostics into routine bovine respiratory disease surveillance and cattle-import quarantine programs, and the adoption of a One Health framework to monitor potential human spillover and future viral evolution, were recommend. Full article