From the Guidelines
The management of sinusitis should prioritize clinical diagnostic criteria over radiographic imaging, with antibiotics reserved for cases of acute bacterial sinusitis that do not improve within 10 days of onset or worsen after initial improvement, as recommended by the clinical practice guideline update on adult sinusitis 1.
Cause and Pathogenesis
The cause of sinusitis varies, but generally involves viral or bacterial infections that trigger an inflammatory response in the sinuses, leading to swelling and blockage of the sinus channels.
- Viral infections are the most common cause of sinusitis, with bacteria being a less common but more serious cause.
- The pathogenesis of sinusitis involves the infection of the sinuses, which can lead to inflammation, swelling, and blockage of the sinus channels.
Management
The management of sinusitis typically follows a stepwise approach, beginning with history and physical examination, followed by appropriate diagnostic testing and treatment tailored to the specific condition.
- Clinical diagnostic criteria should be used to diagnose acute sinusitis, with radiographic imaging reserved for cases where complications or alternative diagnoses are suspected 1.
- Antibiotics should be reserved for cases of acute bacterial sinusitis that do not improve within 10 days of onset or worsen after initial improvement.
- Treatment approaches may include medications, such as pain relievers and decongestants, as well as lifestyle modifications, such as nasal irrigation and humidification.
Imaging and Lab Findings
Imaging findings provide visual evidence of structural abnormalities in the sinuses, while laboratory findings offer objective data to support the diagnosis.
- CT imaging of the sinuses is the preferred modality for evaluating suspected complications of acute bacterial sinusitis, such as orbital or intracranial involvement 1.
- Laboratory findings, such as blood tests and microbiology results, can help identify the underlying cause of sinusitis and guide treatment.
- The integration of clinical presentation with imaging and laboratory data allows for accurate diagnosis and effective management of sinusitis.
From the FDA Drug Label
The FDA drug label does not answer the question.
From the Research
Cause and Pathogenesis
- The renin-angiotensin-aldosterone system plays a key role in the development of hypertension, with angiotensin-converting enzyme (ACE) inhibitors being a common treatment option 2, 3.
- ACE inhibitors work by inhibiting the conversion of angiotensin I to angiotensin II, resulting in vasodilation, natriuresis, and decreased sympathetic activity, ultimately leading to a reduction in blood pressure 4.
Management
- ACE inhibitors are considered a first-line treatment for hypertension, along with thiazide diuretics, calcium channel blockers, and angiotensin receptor blockers (ARBs) 2, 4.
- The choice between ACE inhibitors and ARBs depends on individual patient factors, with ACE inhibitors being preferred in patients with certain comorbidities, such as heart failure or chronic kidney disease 5, 3.
- ACE inhibitors have been shown to reduce mortality and morbidity in patients with hypertension, although the evidence for ARBs is less clear 5, 3.
Imaging and Lab Findings
- There is no direct evidence in the provided studies regarding specific imaging or lab findings for hypertension or the use of ACE inhibitors.
- However, it is likely that imaging and lab tests, such as blood pressure monitoring, electrocardiograms, and blood tests, are used to diagnose and monitor hypertension, as well as to assess the effectiveness of ACE inhibitors and other treatments 6.
Comparison of ACE Inhibitors and ARBs
- Studies have compared the efficacy and tolerability of ACE inhibitors and ARBs, with some finding no significant difference in terms of mortality and cardiovascular outcomes 5.
- However, ACE inhibitors may have a slightly higher risk of adverse effects, such as cough and angioedema, compared to ARBs 5, 4.
- The choice between ACE inhibitors and ARBs ultimately depends on individual patient factors and the specific clinical context 5, 4, 3.