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Current Management of Nasal Polyposis

Nasal Polyps – The Current Management Process

Current Management of Nasal Polyposis
Hi friends

We got few requests from some readers to write an article about Nasal Polyps recently, so we decided to do some research and to cover this condition in details.

Firstly, known as the most common of the benign intranasal tumors, nasal polyps are small nasal sacs filled with fluid. These small sacs are made up of plasma cells, lymphocytes, eosinophils, and mast cells. A ciliated airway epithelium surrounds the sacs.

Around 2% of the population suffers from nasal polyps. People of all ages can present with polyps, however the chance increases with age, and peaks at 50 years. Whilst both males and females can have nasal polyps, the male to female ratio is at least 2:1. Nasal polyps is classified as a physical finding with causes and conditions, it is not classified as a disease. Approximately 25-30% of people who present with nasal polyps are asthma sufferers, and around 12% are patients with aspirin intolerance.

Nasal polyps relate to various other conditions as follows; present in 20% of cystic fibrosis patients, present in approximately 33% of patients with aspirin intolerance, present in 2% of chronic rhinosinusitis patients, present in 7% of asthma sufferers, present in 50% of Churg Strauss Syndrome (the eosinophilic vasculitis), present in most patients with allergic fungal sinusitis, present in various ciliary motility disorders such as Kartagener’s Syndrome, present in various genetic syndromes like Young’s Syndrome, present in 0.1% of children. When nasal polyps are seen in a child under 16 years of age, evaluation should include a sweat chloride test.

As previously noted, nasal polyps shows a direct relation to asthma and aspirin intolerance. When these three factors show together, they are known as the aspirin triad, or Samter’s Syndrome. It is estimated to be prevalent in 20% of severe asthma patients, and 2-3% of general asthma patients. Typical patients show the following conditions; middle-aged, white, shows vasomotor rhinitis, has perennial bronchial asthma, eosinophilia, presents negative skin tests to atopic allergens, aspirin (and other related chemicals) intolerant. In general, the reaction starts from 15 to 180 minutes following ingestion. The reaction is characterized by severe rhinorrhea, macular erythema, nausea, vomiting, diarrhea, and cramps in the intestines. These symptoms are followed by an acute bronchial asthma attack. Recovery time for most patients is 2 hours.

Although the above facts are known, the specific etiology of polyps is still currently unknown. Possible mechanisms contributing to the development of nasal polyps include the following: infection, allergy, mucopolysaccharide abnormality, sensitivity to a certain drug, autonomic imbalance, enzyme abnormality, histamine, proto-oncogene and mechanical obstruction. It appears that allergy and infection are currently viewed as the most likely causes.

Most patients firstly complain of nasal obstruction, many also mention allergic complaints such as sneezing, watery rhinorrhea and itchy eyes. Headache, postnasal drip and asthma are also commonly noted. When asked, others mention insomnia as a symptom. Acute infections present pain in the patient. Some patients have middle ear pathology, or have developed rhinitis medicamentose from the use of chronic vasoconstrictor. A high percentage of patients have previously had nasal surgery.

Despite being the most common of the benign intranasal tumors, diagnosis can include meningoceles or meningomyeloceles, possibly projecting through the nose by means of a dermoid cyst or a cribriform plate defect. Tumors such as squamous cell carcinomas and inverted papillomas can also show symptoms similar to nasal polyps. Neoplasms, however, are generally firm and bleeding tends to be spontaneous.

When it comes to treating nasal polyps, medical or surgical management is used, at times treatment requires a combination of them both. Eliminating the polyps and rhinitis symptoms, is the ultimate goal of treatment. Treatment also aims to restore nasal breathing and olfaction, and to provide a preventive measure, without the unneeded removal of sinus pathology. Since many patients are free of symptoms, even though their CT scan shows sinus opacification, complete removal of sinus pathology does not appear to be a realistic treatment plan.

Where a patient complains of a disruption to their quality of life, surgery is considered as a treatment option, particularly for patients who have not seen results from substantial medical therapy, or patients with a contraindication to an area of medical therapy. Since surgery is elective, many understand it to be a feature of a continuum of therapy, rather than independent of medical treatment. It should be noted that surgical removal of nasal polyps does not always prove to be the solution. Where a patient also presents with asthma, the decision of surgery should be carefully considered, often with a need to increase steroid doses if the decision goes ahead.

The follow-up of patients who underwent endoscopic sinus surgery for nasal polyps, has been documented in several series. Such studies have varied from 100 patients to as many as 250, follow-up has varied from 18 months to 4 years after surgery. Treatment outcome is generally assessed by analyzing the patient satisfaction, based on relief of symptoms. Assessment also takes into account an examination of the sinonasal area. Where follow-up was between 1-4 years, 80-90% of patients showed a symptom improvement, however this percentage drops when considering patients who are completely symptom free. Objective evidence has also presented, in patients with an improvement in nasality of speech and an unilateral reduction of airflow resistance.

Reviewing 120 patients who underwent endoscopic sinus surgery, Kennedy reports that 28% had diffuse polyposis and 31% suffered from polyps which arose from the middle meatus. His findings showed that the preoperative level of the disease, was the key predictor of symptom improvement. Underlying conditions, such as Samter’s triad or asthma, may have an influence on the severity. The finding that such patients have a tendency to fare worse, has been noted by other researchers. Patients who are surgical patients, and suffer from nasal polyps, often have a much more complex disease involvement.

Taking all factors into consideration, it could be said that certainly nasal polyps are the most common benign intranasal tumor. Whilst their specific etiology is not known, there is an association with other diseases. A continuum of medicine and surgery are seen to be the general treatment path, however surgery is recommended only in patients who present with a severe condition or have failed to see results from substantial medical therapy. Treatment focuses on controlling the condition.

Disclaimer: This information is from documents that were prepared by resident physicians for presentation and discussion at a conference held at Baylor College of Medicine in Houston, Texas. This material should not be used as a basis for treatment decisions, and is not a substitute for professional consultation and/or peer-reviewed medical literature.

Best Soccer Drills

Some Of The Best Soccer Drills For Your Young Team


Best Soccer DrillsOne of the most challenging aspects of being a coach, is keeping your athletes busy the whole time that they are in the learning mode. Many times a coach of young children will expect the kids to wait in a long line for their one pass, three pitches, or their one shot at the hoop.

But, what would really be the best thing is to divide the children up into lots of small lines, enlist the help of several parents, or more advanced kids, and have each station practicing a different skill that’s necessary to play the game. Then, the children only wait short periods of time before they practice each drill. The children will learn way more, be kept busy the whole time, and never be in trouble for talking too much or get rowdy while waiting.

Soccer is a sport that lends itself to lots of different kinds of drills, and when the children master all the combinations of skills they become more advanced players. Let’s take a look at some of the best soccer drills that you can use as a coach.

Firstly, one of the best soccer drills is going to be a scoring drill. You line the children up over to one side of the goal and then bounce them a pass that they then need to control, dribble and score. You should mix these passes up so some of them are too high, some too low, some to the right, and some to the left, so that the children get accustomed to taking any pass the comes their way dribble and then score.

This particular drill is especially valuable when combined with goalies that are trying to defend against these numerous and sometimes wildly entertaining kicks. So, if you can get a parent to help you out on the goalie end, then rotate the children through one line where they try to score, and then through the other line where they attempt to block the score so you keep them busy, and they’ll be having a good time.

Another one of the best soccer drills is to be able to dribble the ball under control from one point on the field to the other without losing it.

At the start you’ll just need lots of soccer balls and have each child dribble the ball down the field and then score, keeping the line moving rapidly at all times. As their skills advance it’s a good idea to take some traffic cones, or even plastic chairs will work, then have the children work their way down the field and go around each cone while maintaining control.

Again, it’s important to keep the line moving so that the children don’t get bored and start to push and shove.

Each one of these types of drills can be done with a different soccer skill and help of a willing parent. By keeping the students moving, constantly doing different skills repetitively, by the end of the day their skills will increase and they’ll be happy with the good amount of energy they just invested.

For more great soccer drills you can have a look at the video below or to check our review on the Epic Soccer Training if you want to take the soccer game of your young team for the next level.

Have a great day!

Exercises To Jump Higher

Intense Exercises To Jump Higher – 4 Great Options

Exercises To Jump HigherSome of the most intense exercises to jump higher have a direct association with some science in the type of training done to give the leg muscle the necessary power and life for a higher jump. A higher jump has little to do with have the proper footwear that claims to have some added “magical lift”. The truth is that getting that high vertical jump or even the forward stride jump needs lots of exercises under proper training.

This post will highlight some of the exercises that anyone seeking to gain an extra lift and power in his or her jump can easy do and see real results.

Box Squats

This exercise pays a particular attention to the hamstrings, which are necessary muscles for a faster run and higher jump. They help build huge legs in terms of muscle.

The training involves the use of weights place over the shoulder at the back of the neck with an adequate arm support. A box ranging between 1 – 6 inches in height is placed between the legs that are hip-width apart and the person squats down until they lightly seat on the box, while support the pressure of the weights with the legs.

It follows the same principles of the basic squat exercises to jump higher.

Depth Jumps

The exercises work best using only your body weight. You will still need a box of around 16 – 25 inches or more in height and you will have to jump off the box and then immediately take a power jump the very second your feet touch the ground.

Doing the routine repeatedly will activate the muscles that enable them to achieve a faster contraction when you take a quick hard upward leap.

Tuck Jumps

These exercises use your body weight. They are simple to execute and are intense impact exercises to jump higher. To do the routine, go down to a squat position, only this will have your knees as close to your chest as possible then take a powerful leap into the air.

Make sure you keep your balance when you back on the ground and go down to the prior position and take several other similar leaps. Once you are fully in tune with the routine, you can add few hurdles.

Start with low heights working your way up a few inches higher after every hurdle you tackle using the tuck jumps.

Step Ups

This exercise will give a good focus on the hamstrings and calf muscles. For these exercises to jump higher, you will need to use something with well grounded. A solidly and strong chair can work. Just place it against the work.

You will fit the left leg and place it on chair and using it as your elevation point pulling your full body weight off the ground. Switch your legs once you are in mid-air for the right leg to land on the chair and the left on the ground.

Repeat this routine for around 20 – 30 jumps. You can also try place the left leg on the chair but this time you will just use the power in the left leg for an upward thrust. It should stay in contact with chair as you bring up the right leg and bend it while you are in mid-air. Go back down and repeat the same action again. Do this 10 – 15 times before you switch to the right leg.

These exercises to jump higher can help you in many different sports, such as basketball, soccer, volleyball and more. If you are looking for a complete vertical jump program that will help you to maximize your results then we will recommend you checking our Vert Shock Program review and to learn about a proven vertical jump program by two experts.

You can also check the attached video below for few more exercises to jump higher which can be useful for you.

We wish you the best!

Rita and Alex


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