Cevc Gregor
Allergy Rhinol (Providence). 2017 Jun 1;8(2):45-52. doi: 10.2500/ar.2017.8.0206.
The time course of rhinovirus positive and negative rhinosinusitis has not been quantified yet, which aggravates proper selection and justification of the optimum treatment for this illness. Such quantitative information would facilitate an early and proper identification of the disease and its differentiation from acute bacterial rhinosinusitis, and could diminish harmful overuse of antibiotics, arguably driven by patients' want for attention and the treating physicians' inability to offer an adequate verbal comfort in its stead.
Extraction of the quantitative information needed to identify rhinovirus positive or negative rhinosinusitis and to allow selection of the most appropriate treatment from the published time dependence of individual clinical symptoms of the disease.
Scrutiny (and modeling) of temporal evolution of all noteworthy symptoms of rhinosinusitis with a simple mathematical expression that relies on two adjustable parameters per symptom (and potentially a general time offset as an extra adjustable parameter).
Adverse effects of rhinosinusitis can be grouped according to the sequence of their exponential appearance and ∼2.6 times slower exponential disappearance, rhinovirus negative rhinosinusitis generally improving ∼25% faster and being ∼40% less severe. The major early local symptoms (throat soreness and scratchiness, headache) vanish with a half-life of ∼1.8 days, whereas further local symptoms take ∼1.6 times longer to disappear. At least 50-60% improvement of two prominent early symptoms, sore throat and sneezing (but not of nasal discharge, cough, and hoarseness) by day 5 of the disease implies a nonbacterial origin of rhinitis and should exclude use of antibiotics.
Temporal evolution of all rhinosinusitis symptoms is qualitatively similar, which makes the early symptom decay a good proxy for, and predictor of, the disease perspective. Knowing a symptom intensity at just three to four time points suffices for reconstructing its entire time course and total intensity or gravity. This permits an easy and early identification of rhinosinusitis, and its plausible differentiation from acute bacterial rhinosinusitis, disease treatment optimization, and corresponding clinical trials simplification and/or shortening.
鼻病毒阳性和阴性鼻窦炎的病程尚未得到量化，这使得针对该疾病的最佳治疗方法的合理选择和论证变得更加困难。此类量化信息将有助于早期准确识别该疾病，并将其与急性细菌性鼻窦炎区分开来，还可以减少抗生素的有害过度使用，这可能是由患者渴望得到关注以及治疗医生无法提供充分的言语安慰所致。
从已发表的该疾病个体临床症状的时间依赖性中提取识别鼻病毒阳性或阴性鼻窦炎所需的量化信息，并据此选择最合适的治疗方法。
用一个简单的数学表达式仔细研究（并建模）鼻窦炎所有显著症状的时间演变，每个症状依赖两个可调参数（可能还有一个通用的时间偏移作为额外的可调参数）。
鼻窦炎的不良反应可根据其指数出现顺序和指数消失速度慢约2.6倍进行分组，鼻病毒阴性鼻窦炎通常改善速度快约25%，严重程度低约40%。主要的早期局部症状（喉咙酸痛和瘙痒、头痛）的消失半衰期约为1.8天，而其他局部症状消失所需时间长约1.6倍。在疾病第5天时，至少50 - 60%的两个突出早期症状（喉咙痛和打喷嚏，但不包括流鼻涕、咳嗽和声音嘶哑）有所改善，这意味着鼻炎的非细菌性起源，应避免使用抗生素。
所有鼻窦炎症状的时间演变在质量上相似，这使得早期症状的消退成为疾病前景的良好代表和预测指标。仅在三到四个时间点了解症状强度就足以重建其整个病程以及总强度或严重程度。这有助于轻松早期识别鼻窦炎，并将其与急性细菌性鼻窦炎进行合理区分，优化疾病治疗，简化和/或缩短相应的临床试验。
