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Πέμπτη 25 Μαρτίου 2021

Benign connective and soft‐tissue neoplasms of the oral and maxillofacial region: Cross‐sectional study of 1066 histopathological specimens

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Abstract

Background

Benign connective and soft‐tissue neoplasms (CSTNs) are unusual in the head and neck region. The aim of the present study was to evaluate the demographic and clinicopathological features of these neoplasms.

Methods

A cross‐sectional study was conducted of cases diagnosed as benign CSTNs, with data collected from biopsy records. The chi‐square test was used. A p‐value <0.05 was considered indicative of statistical significance.

Results

Among the 38 119 specimens, 1066 (2.79%) were benign CSTNs: 369 fibroblastic/myofibroblastic, 250 adipocytic, 179 vascular, 130 neural, 94 osseous/cartilaginous, 19 muscular, and two fibrohistiocytic. Most patients were female (62.8%) and white‐skinned (45.8%). Mean age was 42 years. The tongue (25.2%) was the most affected site for extraosseous neoplasms.

Conclusion

This study had the largest sample of benign oral and maxillofacial CSTNs. Although these tumors have similar clinical features, the characterization and differentiation detailed here may help clinicians with regards to the correct diagnosis.

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Speech and language characteristics in Smith–Magenis syndrome: Case report

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Message:

Smith-Magenis syndrome (SMS) is a developmental disorder that affects many parts of the body. The major features of this condition include mild to moderate intellectual disability , delayed speech and language skills, distinctive facial features, sleep disturbances, and behavioral problems.

Smith-Magenis syndrome | Genetic and Rare Diseases ...

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Publication date: Available online 24 March 2021

Source: Revista de Logopedia, Foniatría y Audiología

Author(s): Elena Garayzábal Heinze, Irene Hidalgo de la Guía, Kriscia Gobi Rosa, Célia Maria Giacheti, Natalia Freitas Rossi

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Incorporating Virtual Reality to Improve Otolaryngology Resident Wellness: One Institution's Experience

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Objective

Burnout is defined as work‐related emotional exhaustion, depersonalization, and decreased sense of accomplishment. Virtual reality (VR) has emerged as an effective treatment modality for various conditions related to anxiety, however, few studies have assessed its role for stress management in residents. We hypothesize that VR‐based mindfulness meditation can reduce resident burnout in real‐world settings.

Study Design

Prospective randomized crossover trial.

Methods

Resident participants completed the validated Maslach Burnout Inventory (MBI). One group used a VR‐based meditation app; the second group received no intervention. After a 2‐month rotation, all subjects completed an MBI and crossed over to the other arm. Wilcoxon rank‐sum tests were used to compare MBI scores before and after intervention, and to compare results by gender and postgraduate year. Mann‐Whitney U tests were used to assess qualitative differences between participants.

Results

Eighteen residents completed the study. Five participants were female and 13 were male. Weekly use of VR‐guided meditation and paced breathing was associated with a significant decrease in emotional exhaustion (P = .009), and on subgroup analysis, male gender specifically was associated with a decrease in emotional exhaustion (P = .027). In the post‐intervention survey, 42.9% subjects reported that VR encouraged them to employ paced breathing techniques, 71.4% reported that they would use the technology if regularly available, and 21.4% reported they would use paced breathing in the future.

Conclusion

VR‐based therapy may serve as a successful tool in stress management and reduce the rate of burnout among otolaryngology residents.

Level of Evidence

N/A Laryngoscope, 2021

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Obstructive Sleep Apnea in Children Under 3 Years of Age

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Objective

To identify predictors of severe obstructive sleep apnea (OSA) in children under 3 years of age and to compare demographics, comorbidities, and polysomnographic characteristics of infants and toddlers with OSA.

Study Design

Retrospective case series

Methods

We examined children under 3 years of age who had polysomnogram between August 2012 and March 2020. Demographics, clinical, and polysomnographic parameters were compared in children age 0–1 versus 1–3 years and 0–2 versus 2–3 years and severe versus mild–moderate OSA. Univariate analysis was used to compare age groups; multiple logistic regression for predictors of severe OSA. Significance was set at P < .05.

Results

Of the 413 children, 267 (65%) were male and 131 (32%) obese. The population included Hispanic (41%), African American (28%), and Caucasian (25%) children. A total of 98.5% had OSA and 35% had severe OSA. Children under 1 year of age more commonly had gastroesophageal reflux disease (GERD) (38% vs. 23%; P = .014); tonsillar hypertrophy was more common in children over 2 years of age (56% vs. 34%, P = .001). Down syndrome (odds ratio (OR): 3.16, 95% confidence interval (CI) = 1.14–8.68, P = .026) and tonsillar hypertrophy (OR: 1.97, 95% CI = 1.28–3.02, P = .002) were predictors of severe OSA.

Conclusion

Children under 3 years of age with OSA are more likely to be male and have GERD. Down syndrome and tonsillar hypertrophy are predictors of severe OSA, and children with these conditions should be prioritized for polysomnography.

Level of Evidence

4. Laryngoscope, 2021

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Comprehensive Analysis of Factors Affecting Cochlear Size: A Systematic Review and Meta‐analysis

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Objectives

To determine the cochlea's average size in humans and evaluate the relationships between certain covariates and cochlear size.

Methods

A systematic search on articles on cochlear size and published in English was conducted using Cochrane, PubMed, Web of Science, and Scopus databases up to September 15, 2020. Data were pooled using random‐effects with three models. The effect of demographic, clinical, and measurement‐related parameters was specifically analyzed. Meta‐regression and subgroup analyses were conducted. The overall effect estimation was made for outcomes.

Results

The meta‐analysis included 4,708 cochleae from 56 studies. The overall length of the organ of Corti was 32.94 mm (95% confidence interval [CI]: 32.51–33.38). The first and second models revealed that age, gender, country, continent, measurement method (direct, indirect), measured structure ("A" value, cochlear lateral wall), origin (in vivo, in vitro), and type (histology specimens, plastic casts, imaging) of the cochlear material did not affect the cochlear size. However, study populations (general population, patients with a cochlear implant, and patients with congenital sensorineural hearing loss [CSNHL]) were found to affect the outcomes. Compared to the other populations, patients with CSNHL had shorter cochleae. Therefore, we developed a third model and found that the general population and patients with cochlear implants did not differ in cochlear size.

Conclusion

This meta‐analysis investigated the factors that could affect the cochlear size and found that patients with CSNHL had significantly shorter cochleae, whereas other covariates had no significant effect. Laryngoscope, 2021

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Assessment of Visual and Brainstem Auditory Evoked Potentials in Patients with Hashimoto's Thyroiditis

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J Immunol Res. 2021 Mar 3;2021:3258942. doi: 10.1155/2021/3258942. eCollection 2021.

ABSTRACT

BACKGROUND: The present study was aimed to evaluate parameters of visual and brainstem auditory evoked potentials (VEP, BAEP) in euthyreotic Hashimoto's thyroiditis (HT) patients without central nervous system involvement.

METHODS: 100 HT patients (92 women, 8 men), mean age 46.9 years, and 50 healthy controls. They underwent a neurological examination, thyroid hormone levels, thyroid autoantibody titers, and brain imaging. Latencies and amplitudes of the N75, P100, and N145 component of VEP and the I-V components of BAEP were analyzed.

RESULTS: The neurological examination revealed in 31 patients signs of increased neurovegetative excitability. Brain resonance imaging showed no abnormalities in HT patients. The mean P100, relative P100, and N145 VEP latencies were significantly longer, and P100 amplitude significantly higher in HT patien ts than the controls. HT patients also had a longer mean wave BAEP V latency and mean wave III-V and I-V interpeak latencies, and significantly lower mean wave I and V amplitudes. Abnormal VEP and BAEP were recorded in 34% of the patients. There were no statistically significant correlations between the mean VEP parameters and thyroid profile and the applied dose of L-thyroxine. There was a relationship between the level of TSH and the wave BAEP III-V interpeak latency.

CONCLUSIONS: There were changes in the brain's bioelectrical activity in one-third of the patients with HT without nervous system involvement. The increased amplitude of the VEP may indicate increased cerebral cortex activity. Disorders of the brain's bioelectrical activity in the course of HT may be associated with an autoimmune process.

PMID:33763490 | PMC:PMC7946475 | DOI:10.1155/2021/3258942

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Identification of miR-145 as a regulator of the cardiomyocyte inflammatory response and oxidative stress under hyperglycemia

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Exp Ther Med. 2021 May;21(5):467. doi: 10.3892/etm.2021.9898. Epub 2021 Mar 8.

ABSTRACT

The current study aimed to explore the effects of microRNA (miR)-145 on the inflammatory response and oxidative stress (OS) in high glucose (HG)-induced cardiomyocytes, as well as the specific mechanism underlying this action. H9c2 cells were treated with 33 mmol/l glucose (HG group) or cotreated with 24.5 mmol/l mannitol and 5.5 mmol/l glucose (hypertonic group), and the expression levels of miR-145 and ADP ribosylation factor 6 (ARF6) were detected. The cells were transfected with pcDNA3.1-ARF6, miR-145 mimics or corresponding negative controls prior to the assessment of cell survival rate. Levels of lactate dehydrogenase (LDH), reactive oxygen species (ROS) and malondialdehyde (MDA), as well as the activities of superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx), and the levels of IL-6, TNF-α and monocyte chemoattractant protein-1 (MCP-1) were subsequently determined. The apoptotic rate of H9c2 cells was examined by flow cytometry. The interaction between miR-145-ARF6 was predicted and confirmed by luciferase reporter assays. In the HG group, miR-145 expression was significantly decreased and ARF6 expression significantly increased compared with controls. Furthermore, the levels of inflammatory factors (IL-6, TNF-α and MCP-1), LDH, ROS and MDA were significantly elevated in the HG group compared with controls. Significantly decreased SOD, CAT and GPx activities and significantly increased numbers of apoptotic cells were observed in the HG group compared with controls. The cells transfected with miR-145 mimics exhibited significantly decreased LDH, ROS and MDA levels, significantly increased antioxidant enzyme activities and significantly decreased apoptotic rates compared with controls, while the opposite results were observed in cells transfected with pcDNA3.1-ARF6. Moreover, co-transfection with miR-145 mimics and pcDNA3.1-ARF6 exacerbated the inflammatory response and OS injury in HG-induced cardiomyocytes compared with cells transfected with miR-145 mimics alone. Furthermore, miR-145 negatively targeted ARF6. miR-145 attenuated the HG-induced inflammatory response and OS injury in cardiomyocytes by negatively regulating ARF6, which may contribute to providing a theoretical basis for the treatment of diabetic cardiomyopathy.

PMID:33763154 | PMC:PMC7983182 | DOI:10.3892/etm.2021.9898

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Regulatory effect of mitoQ on the mtROS-NLRP3 inflammasome pathway in leptin-pretreated BEAS-2 cells

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Exp Ther Med. 2021 May;21(5):466. doi: 10.3892/etm.2021.9897. Epub 2021 Mar 8.

ABSTRACT

Obese asthma is a phenotype of asthma whose occurrence is gradually increasing in both adults and children. The majority of studies have demonstrated that obesity is a major risk factor for asthma and the effect of obesity on the lungs is considerable. NOD-, LRR- and pyrin domain-containing protein 3 (NLRP3) inflammasome has been previously demonstrated to serve a role in obese asthma mediated by mitochondrial reactive oxygen species (mtROS). The aim of the present in vitro study was to investigate the effect of leptin on airway epithelial cells and the protective effect of the mitochondrial-targeted antioxidant mitoquinone (mitoQ). Human normal bronchial epithelial cell lines BEAS-2 cells were used and divided into 6 groups: Control group (negative control), DMSO group (solvent control), lipopolysaccharide (LPS) group (positive control), LPS + mitoQ group, Leptin group and Leptin + mitoQ group. CCK8 assay was used to establish the optimal concentration and incubation time of the drugs. mitoTracker probe and mitoSOX reagent were used to detect the integrity of mitochondrial membranes and the content of mtROS. mRNA expression levels were detected by reverse transcription-quantitative PCR analysis. It was revealed that the mitochondrial membrane was disrupted in the Leptin group, which recovered after treatment with mitoQ. As a result, the production of mitochondrial reactive oxygen species (mtROS) in the Leptin group was significantly increased (P<0.01), but following treatment with mitoQ, this overproduction of mtROS was significantly decreased to normal levels (P<0.01). Furthermore, the expression levels of NOD-, LRR- and pyrin domain-containing protein 3 NLRP3 and caspase-1 mRNA in the leptin-pretreated BEAS-2 cells were significantly increased compared with those in the control group (P<0.01), while they wer e decreased following mitoQ treatment (P<0.01). Taken together, these data suggested that leptin may promote airway inflammation partially through upregulating the mtROS-NLRP3 inflammasome signaling pathway in airway epithelial cells and mitoQ may be a potential treatment for obese asthma.

PMID:33763153 | PMC:PMC7983181 | DOI:10.3892/etm.2021.9897

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Management of primary ciliary dyskinesia

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Via hno

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HNO. 2021 Mar 24. doi: 10.1007/s00106-021-01037-w. Online ahead of print.

NO ABSTRACT

PMID:33763740 | DOI:10.1007/s00106-021-01037-w

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Clinicopathological and immunohistochemical behavior of ductal carcinoma of the salivary and lacrimal gland in a Mexican Mestizo population

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Eur Arch Otorhinolaryngol. 2021 Mar 24. doi: 10.1007/s00405-021-06757-x. Online ahead of print.

ABSTRACT

PURPOSE: Salivary gland tumors are rare and include benign and malignant entities with different behavior and prognosis. Salivary gland carcinoma accounts for 0.2% of all cancers and 5-9% of head and neck carcinomas. We aim to describe the clinicopathological characteristics and discuss the immunohistochemical findings of salivary ductal carcinoma.

METHODS: We obtained 17 cases (2.3%) of salivary ductal carcinoma (SDC) from 727 patients with parotid tumors at our cancer center from a database covering a 22-year period (1996-2018). Two pathologists confirmed the diagnosis and excluded 6 cases. Eleven cases were assessed by immunohistochemistry (IHC) for HER2, estrogen receptor (ER), progesterone receptor (PR), androgen receptor (AR), mammaglobin, P53, GATA3, S100, cytokeratins (7,8,14,18, and 20), P63, PAX8, calponin, and SOX10 .

RESULTS: Eleven SDC cases were in advanced stage, and 80% had metastasis. All cases were surgically treated, and 40% received different adjuvant chemotherapy regimens. we found that most patients were dead of disease. The histological and immunohistochemical analysis showed that 70% of cases were high-grade, 40% were positive for HER2, and 50% for AR. Moreover, a high Ki-67 proliferative index was detected in all cases. We observed luminal differentiation in 50% of cases.

CONCLUSION: SDC is a rare entity and survival is very poor. It is histologically similar to ductal carcinoma of the breast. However, important differences exist that help to distinguish them in case of synchronous cancers. The clinical behavior of SDC seems to be more aggressive and IHC analysis is useful for designing therapies.

PMID:33763743 | DOI:10.1007/s00405-021-06757-x

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Epicutaneously sensitized food‐induced anaphylaxis is ameliorated with “oral tolerance” to antigen

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Abstract

Food allergy is an antigen‐specific immunological adverse reaction after exposure to a given food. Multiple clinical studies showed that oral immunotherapy (OIT) is effective for the prevention and treatment for food allergy that is developed in infants and children. However, the effectiveness of OIT for epicutaneously sensitized food allergy remains unclear. Previously, we established a mouse model of epicutaneous‐sensitized food allergy. In this model, systemic allergic reaction including intestinal and skin symptoms, such as anaphylaxis, was observed. We treated this model with OIT in two ways (OIT before sensitization or OIT during the sensitization phase) and evaluated the preventive effect of both methods. OIT before sensitization significantly ameliorated mast cell degranulation in sensitized skin, but there was no decrease in rectal temperatures or in mast cell degranulation in the jejunum. However, OIT administered during the sensitization phase significantly ameliora ted the decrease in rectal temperature and mast cell degranulation in the skin and jejunum. OIT before sensitization increased the regulatory T cells in mesenteric lymph node (MLN), but not in the spleen, and it reduced antigen‐specific IgG, but not IgE, production compared with the non‐OIT control. However, OIT during sensitization caused a greater increase in regulatory T cells in both the MLN and spleen and reduced antigen‐specific IgE and IgG generation compared with the non‐OIT control group. Thus, OIT during the sensitization phase was effective for the prevention of epicutaneous‐sensitized food allergy.

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