Hereditary angioedema (HAE) causes recurring swelling attacks, leading to substantial disease burden. This real-world, retrospective study aimed to evaluate HAE attack rates before and after berotralstat initiation stratified by patients’ baseline attack frequency. Specialty Pharmacy data from Optime Care, Inc. (12/2020–01/2024), the sole berotralstat dispenser in the United States, were analyzed. Eligible patients had ≥ 2 berotralstat dispensings (first = index) and ≥ 1 self-assessment of attacks at baseline (90-days pre-index) and follow-up (first-to-last dispensing). Patients were classified by HAE type (based on laboratory measurements) and baseline attacks (≥ 5, 2–4, 1, and 0 attacks/month). Follow-up attack rates were compared with baseline using mean differences, confidence intervals, and P-values. Among those with 0 baseline attacks/month, proportions with 0 follow-up attacks/month were assessed. Of 390 eligible patients with HAE with C1 esterase inhibitor (C1INH) deficiency (HAE-C1INH) and 311 with HAE with normal C1INH (HAE-nC1INH), most were female (64.1
Aims and Backgrounds Postoperative care in rhinoplasty is a critical determinant of surgical success, complication prevention, and patient satisfaction. Despite advances in operative technique, variability in postoperative management remains a significant contributor to suboptimal outcomes and revision surgery. This chapter aims to define the essential components of effective postoperative care and emphasize the role of structured systems in protecting surgical results and guiding patient recovery. Current and Future Development Key elements of postoperative management are reviewed, including standardized follow-up schedules, pain control with opioid-sparing strategies, antibiotic stewardship, corticosteroid use, saline irrigations, nasal support techniques, activity modification, and patient education. Emerging evidence regarding non-steroidal anti-inflammatory drugs, isotretinoin use, topical antibiotics, and adjunctive therapies is discussed. Special considerations for revision rhinoplasty, complex grafting, and patients with comorbid conditions such as obstructive sleep apnea are highlighted. The importance of consistent documentation, photography, and communication is emphasized to support both clinical decision-making and patient reassurance. Conclusion and Clinical Relevance There is no universal postoperative pathway in rhinoplasty; however, comprehensive preoperative preparation and structured postoperative systems consistently improve outcomes. Surgeons who prioritize postoperative care as an extension of the operation itself are better positioned to minimize complications, manage expectations, and achieve durable, high-quality results.
Introduction: Hereditary angioedema (HAE) is a rare genetic disorder characterized by unpredictable, painful swelling attacks that significantly impair patients' quality of life (QoL). Clinical trials of lanadelumab led to its approval for long-term prophylaxis in patients with HAE; however, real-world data on long-term lanadelumab use in patients with HAE are limited. This analysis describes real-world outcomes of patients with HAE who have received lanadelumab as long-term prophylaxis for ≥3 years. METHODS:From January 2023 to January 2024, investigators collected data from the Adelphi Wave II Disease Specific Programme™, a real-world, cross-sectional survey of physicians and their patients with HAE in the USA. Physicians retrospectively reported attack frequency, attack severity, and QoL before lanadelumab initiation, at 12, 24, and 36 months post initiation, and at the time of the survey. RESULTS:Physicians reported data on 51 patients who had received lanadelumab for ≥3 years. Before lanadelumab initiation, physicians reported attack severity as mild in 49.0% of patients and very severe in 8.2%; at 36 months post lanadelumab initiation, 62.5% of patients experienced mild attacks and none experienced very severe attacks in the preceding year. The proportion of patients experiencing ≥1 attack per month on average decreased from 54.0% before lanadelumab initiation to 9.8% at the time of the survey. The proportion of patients with good or excellent QoL increased from 68.6% before lanadelumab initiation to 88.2% at the time of the survey. CONCLUSION:In this real-world HAE study, patients treated with lanadelumab for ≥3 years experienced improvements in attack frequency, disease severity, and QoL. .
Obstructive sleep apnoea syndrome (OSAS) is a complex, multifaceted disorder with multisystem implications. Its prevalence has increased significantly over the past two decades, leading to major adverse economic and social consequences. Despite this, OSAS remains underdiagnosed and undertreated globally, placing a substantial direct and indirect burden on healthcare systems. This underscores the need for a smarter, knowledge-based management approach. The proposed interdisciplinary approach (IDA) not only facilitates timely diagnosis and treatment of various systemic comorbidities associated with OSAS but also enhances the outcomes and success rates of both non-surgical and surgical treatments for the syndrome.
Surgical treatment of cholesteatoma requires a highly individualized approach, balancing disease eradication with hearing preservation, and necessitates thorough patient counseling on expected auditory outcomes and options for rehabilitation. The choice between canal wall up and canal wall down mastoidectomy can influence hearing outcomes. Hearing rehabilitation options following cholesteatoma surgery include air- and bone-conduction devices and are individualized for the patient. Assistive listening devices such as frequency modulation systems, hearing loops, and Bluetooth technology are critical for enhancing speech understanding in noisy environments for patients who employ various hearing rehabilitation methods and require further advanced solutions.
