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Rhinolaryngoscopy for the Allergist
Published in Pudupakkam K Vedanthan, Harold S Nelson, Shripad N Agashe, PA Mahesh, Rohit Katial, Textbook of Allergy for the Clinician, 2021
Jerald W Koepke, William K Dolen
Routine upper airway examination usually consists of inspection of the anterior nares with an otoscope or nasal speculum and examination of the pharynx with a tongue depressor. The otoscope permits only limited examination of the proximal structures. The traditional speculum and head mirror allow examination of large portions of the nasal cavity as well as part of the nasopharynx. Use of a tongue depressor permits evaluation of parts of the posterior pharyngeal wall, and an indirect mirror examination allows a more complete inspection of the nasopharynx, hypopharynx and the glottic structures. These conventional examination skills do not permit examination of the recessed structures of the upper airway, such as the sinus ostia, sphenoethmoidal recess and Eustachian tube ostium, and they are difficult to master.
The respiratory system
Published in Peter Kopelman, Dame Jane Dacre, Handbook of Clinical Skills, 2019
Peter Kopelman, Dame Jane Dacre
The nose comprises the external nose and the two nasal cavities (Fig. 3.1). The external nose is given its pyramidal shape by the nasal septum, which articulates with the frontal bone. The nasal cavities form the first part of the respiratory passage and extend from the anterior nares or nostrils to the nasopharynx. The nares are lined with respiratory epithelium, with some olfactory epithelium. The cavities are separated by a midline septum, formed from septal cartilage. The lateral wall of the nose has a large surface area due to the presence of three bony projections – the nasal conchae.
Classification and clinical features
Published in Aparna Palit, Arun C. Inamadar, Systemic Sclerosis, 2019
Aparna Palit, Arun C. Inamadar
The transverse diameter of the anterior nose, which is normally a pyramidal structure, is reduced and gives rise to a “pinched” appearance (Figure 3.11). The anterior nares become oblong and narrow, rather than the usual triangular shape. The tip of the nose is pointed forwards, which gives rise to a beaked appearance; better appreciable in side-profile (Figure 3.12). The normal concave contour of the philtrum is effaced giving rise to a flat area between columella of the nose and vermillion border of the upper lip (Figure 3.13).
A review of a diazepam nasal spray for the treatment of acute seizure clusters and prolonged seizures
Published in Expert Review of Neurotherapeutics, 2021
Lindsay M. Higdon, Michael R. Sperling
One challenge, in addition to the aforementioned issues, relates to the small surface area (~160 cm2) of the nasal cavity, which can accommodate only approximately 200 µL of solution. Ideally, any dose should have a lower volume. Any excess will drain into the nasopharynx and be swallowed or lost from leakage through the anterior nares [3,4,6]. A dropper or squeeze bottle may not disperse the drug evenly to deliver a specified dose and could cause drug leakage as well. Hence, a different approach must be used. The commercially approved IN diazepam formulation delivers 100 µL in a spray from a single-dose pump. This device has been used for other medications and has been proven to disperse nasal medication evenly. Moreover, it is easy to use with one hand by either patient or caregiver and is portable [4].
Low prevalence of multi-resistant bacteria in undergraduate dental students; an observational case-control multi-centre study in Europe
Published in Journal of Oral Microbiology, 2021
C.M.C. Volgenant, M.A. Hoogenkamp, G. Dahlén, S. Kalfas, S. Petti, J.J. De Soet
Each participant received a questionnaire to collect demographic data. Questions on antibiotic use, hospital visits, patient treatment status and living in the vicinity of a livestock were asked to assess possible cofounders. After completion of the survey form, the students were carefully instructed on how to take the clinical sample. Three sites, each with a separate sterile cotton swab (Sarstedt, Nümbrecht, Germany), were sampled: (1) the interdigital folds between the ring- and little-finger on their dominant hand, (2) both anterior nares of their nose and (3) the dorsum of their tongue. Samples were immediately transported to a microbiology laboratory, and cultured in 500 µl Tryptic Soy Broth (TSB, BD, Sparks Glencoe, MD, USA). Cultures were stored at −80°C and stored until further analyses after the addition of 500 µl 60% (v/v) glycerol (Merck, Darmstadt, Germany). All culturing on solid media and in TSB were performed under aerobic conditions at 37°C for either 24 or 16 hours, respectively.
Novel strategies for rapid identification and susceptibility testing of MRSA
Published in Expert Review of Anti-infective Therapy, 2020
Masako Mizusawa, Karen C Carroll
S. aureus is asymptomatically colonized on human skin and mucous membranes, and common colonization sites include nares, throat, axilla, groin, perineum, and rectum [21–23]. The most frequent carriage sites are anterior nares, and they serve as the main reservoir of the spread of S. aureus. Nasal carriage has been shown to be a risk factor for subsequent S. aureus infections in patients undergoing surgeries [24], hemodialysis [25], and intensive care unit treatment [26]. In the health-care settings, S. aureus is mainly transmitted from patient to patient through contaminated hands of health-care personnel, but also by direct contact with contaminated objects and surfaces [8]. Infections due to MRSA have been associated with higher mortality rates, higher readmission rates, longer hospital stay, and increased health-care costs [17,27–29].