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Patients with asthma but especially with Samter's triad are significantly more likely to have a recurrence of nasal polyps and undergo a second surgery following recurrence. In patients with severe CRSwNP, in whom the current standard of care including topical and oral corticosteroids, antibiotics and surgical procedures fail to control the disease, biologics can open new perspectives in treatment. They allow avoiding the possible adverse events resulting from repeated use of systemic corticosteroids and surgery. These biologics have a high impact on type 2 immune reaction and lead to a reduction of IgE as well as of local mucosal eosinophil migration and activation, resulting in a significant effect on nasal polyps, smell, quality of life and asthma comorbidity.Inverted papilloma of middle ear is an extremely rare lesion of the respiratory epithelium that normally occurs in the nasal cavity and paranasal sinuses. [https://www.selleckchem.com/products/salinosporamide-a-npi-0052-marizomib.html check details] So far less than 17 cases were described in literature. A 45-year-old patient was admitted in our Department with hearing loss, otorrhea and pulsing tinnitus on the right ear. The clinical examination showed a granulation tissue on the right eardrum. No tumor formation was seen in the nasal cavity. The MRI showed a tissue formation in the tympanic cavity with an extension in the middle cranial fossa. A mastoidectomy with antrotomy and duraplasty was performed. The histological diagnosis was inverted papilloma of the middle ear. In a second step occurred an eradication of the tumor with a subtotal petrosectomy. The etiology of the inverted papilloma of the middle ear is unknown. Our case is so far the 18nd case described.Our experience has shown that the eradication of the tumor with a subtotal petrosectomy resulted as reasonable procedure. A long-term follow-up is suggested in order to detect possible recurrence or malignant transformation.A breakpoint in a portable near-infrared spectroscopy (NIRS) derived deoxygenated haemoglobin (deoxy[Hb]) signal during an incremental VO2max running test has been associated with the second ventilatory threshold (VT2) in healthy participants. Thus, the aim was to examine the association between this breakpoint (NIRS) and VT2 in well-trained runners. Gas exchange and NIRS data were collected during an incremental VO2max running test for 10 well-trained runners. The breakpoint calculated in oxygen saturation (StO2) and the VT2 were determined and compared in terms relative to %VO2max, absolute speed, VO2, and maximum heart rate (HRmax). There were no significant differences (p&gt;0.05) between the breakpoint in StO2 and VT2 relative to %VO2max (87.00±6.14 and 88.28 ± 3.98 %), absolute speed (15.70±1.42 and 16.10±1.66 km·h-1), VO2 (53.71±15.17 and 54.66±15.57 ml·kg-1·min-1), and%HRmax (90.90±4.17 and 91.84±3.70%). There were large and significant correlations between instruments relative to%VO2max (r=0.68, p less then 0.05), absolute speed (r=0.86, p less then 0.001), VO2 (r=0.86, p less then 0.001), and %HRmax (r=0.69; p less then 0.05). A Bland and Altman analysis of agreement between instruments resulted in a mean difference of - 1.27±4.49%, -0.40±0.84 km·h-1,-0.90±3.07 ml·kg-1·min-1, and - 0.94±3.14 for %VO2max, absolute speed, VO2, and %HRmax, respectively. We conclude that a portable NIRS determination of the StO2 breakpoint is comparable with VT2 using gas exchange and therefore appropriate for use in determining exercise training above VT2 intensity. This is the first study to analyze the validity with the running mode using a NIRS portable device.We analyzed whether male Spanish elite soccer players live longer than the general population. Secondly, we compared their mortality with a cohort of soccer players who continued working as soccer elite coaches after retirement. Using age and calendar-date adjusted life tables, we analyzed the mortality hazard ratio of 1333 Spanish male players born before 1950, and who played in elite leagues from 1939, compared with the Spanish population. Using Cox proportional hazards model we compared their mortality with a cohort of 413 players who continued as coaches. Players showed significantly lower mortality than the general population, but this advantage decreased with advanced age, disappearing after 80 years. Coaches showed a similar pattern. Comparing players versus coaches, date of birth and years as professional were associated with survival, but debut age and player position were not. Unadjusted median survival time was 79.81 years (IQR 72.37-85.19) for players and 81.8 years (IQR 74.55-86.73) for coaches. Kaplan-Meier estimator adjusted for covariables showed no difference between cohorts (p=0.254). In conclusion, former Spanish male players showed lower mortality than the general population, but this effect disappeared after 80 years of age. Continuing their career as coaches after retirement from playing did not confer major benefits.Psychodynamic psychotherapy has a long tradition in the treatment of depression. Its effectiveness lies, according to previous studies on the same level as other bonafide therapies. The review first presents the guideline recommendations for the therapy od depression in Germany. Furthermore, classical and modern psychodynamic models of depression are introduced. From these, general and specific therapeutic aspects are derived. The presentation of the therapeutic approach begins with a section on how to deal with acutely depressive patients. In this regard, contextual factors such as medication and social support measures are described as well as how to deal with suicidal tendencies. In addition, typical pitfalls in dealing with these patients are described. In a further section, two particularly typical personality constellations in depressive patients are addressed (avoiding versus ambivalent-preoccupied patterns). These are derived from traditional models of depression as well as from clinical attachment research. Finally, measures for relapse prophylaxis and possible maintenance therapy strategies are presented.Vaccinations are the gold-standard in order to prevent dangerous infectious diseases. Within 12 months since the RNA sequence of SARS-COV2 has been published already two RNA vaccines against COVID-19 have been licensed and are broadly used in many relevant parts of the world. Matching the challenge of an unprecedented global pandemic unique collaborative approaches have made available several vaccines based on a variety of technological platforms that are under current development. This article explains the characteristics, biology and pharmacology of subunit-vaccines, inactivated and attenuated vaccines, Virus-like-Particle vaccines, recombinant strategies based on adenoviral vectors and newly developed and first time in human licensed RNA-vaccines that came into scope recently. Allergic reactions against the vaccine and its components have been reported but are yet uncommon, however need good documentation such as other side-effects and immune-phenomena. In rare cases where allergy against vaccine components such as PEGs is considered, such PEGs can be tested using a skin-prick test.