Ali A. Melliti, Raymond Van de Berg, Evangelos Anagnostou
et al.
BackgroundPatients with vestibular and ocular motor disorders often perceive oscillopsia, diplopia or visual hallucinations as their chief complaint. However, they often struggle with verbalizing these subjective ocular motor and visual-perceptual signs precisely, which complicates a correct diagnostic classification of the suspected pathogenic mechanism.MethodsIn this multinational and cross-cultural feasibility study, a novel pictogram-based scale of 10 common ocular motor and visual-perceptual symptoms (called Pictogram Ocular Motor and Visual-Perceptual Symptom Scale, POVSS) was developed and validated. Healthcare professionals with or without expertise in neuro-ophthalmology and neuro-otology, representing a broad range of nationality and primary languages, were asked to match pictograms with medical symptoms (specialists) or a simple English symptom description (non-specialists).ResultsA total of 174 participants (112 specialists, 62 non-specialists) from 30 nationalities evaluated the POVSS. On average, specialists reached a score of 9.7 out of 10 (SD = 0.5; 95% CI: 9.6–9.8) in matching symptoms and pictograms. Non-specialists achieved a mean score of 7.9 (SD = 2.3; 95% CI: 7.3–8.5) in accurately matching pictograms to simple English descriptions. In the specialist group, all pictograms met the common ISO quality standards, whereas in the non-specialist group, 8 out of 10 met the standards. While a significant difference in performance was found between the two groups, success rates did not differ between male and female participants.ConclusionVisual-perceptual symptoms originating from common vestibular and ocular motor disorders could be reliably identified using the POVSS by healthcare professionals, independent of participant nationality, or gender. Further research is needed to test the clinical applicability of the POVSS in different patient care settings.
Brenton T. Bicknell, Nicholas J. Rivers, Adam Skelton
et al.
Abstract Objective To develop and evaluate the effectiveness of domain‐specific customization in large language models (LLMs) by assessing the performance of the ENT GPT Assistant (E‐GPT‐A), a model specifically tailored for otolaryngology. Study Design Comparative analysis using multiple‐choice questions (MCQs) from established otolaryngology resources. Setting Tertiary care academic hospital. Methods Two hundred forty clinical‐vignette style MCQs were sourced from BoardVitals Otolaryngology and OTOQuest, covering a range of otolaryngology subspecialties (n = 40 for each). The E‐GPT‐A was developed using targeted instructions and customized to otolaryngology. The performance of E‐GPT‐A was compared against top‐performing and widely used artificial intelligence (AI) LLMs, including GPT‐3.5, GPT‐4, Claude 2.0, and Claude 2.1. Accuracy was assessed across subspecialties, varying question difficulty tiers, and in diagnostics and management. Results E‐GPT‐A achieved an overall accuracy of 74.6%, outperforming GPT‐3.5 (60.4%), Claude 2.0 (61.7%), Claude 2.1 (60.8%), and GPT‐4 (68.3%). The model performed best in allergy and rhinology (85.0%) and laryngology (82.5%), whereas showing lower accuracy in pediatrics (62.5%) and facial plastics/reconstructive surgery (67.5%). Accuracy also declined as question difficulty increased. The average correct response percentage among otolaryngologists and otolaryngology trainees was 71.1% in the question set. Conclusion This pilot study using the E‐GPT‐A demonstrates the potential benefits of domain‐specific customizations of language models for otolaryngology. However, further development, continuous updates, and continued real‐world validation are needed to fully assess the capabilities of LLMs in otolaryngology.
Juliana Gutschow Gameiro, Jussi Virtanen, Liam Lee
et al.
Summary: The olfactory epithelium (OE) contains stem cells capable of generating olfactory sensory neurons throughout life, making it a valuable model for studying epithelial neurogenesis. We present a protocol to develop a highly robust 3D mouse organoid model from OE cells. We describe a workflow for dissecting murine OE and subsequent organoid culturing. We also provide guidance on how to perform immunostaining of the organoids. This protocol has been validated for mice and does not require fluorescence-activated cell purification.For complete details on the use and execution of this protocol, please refer to Gameiro et al.1 : Publisher’s note: Undertaking any experimental protocol requires adherence to local institutional guidelines for laboratory safety and ethics.
Recent advancements in medical management, endoscopic sinus surgery, and biologics have significantly improved outcomes for patients with chronic rhinosinusitis (CRS). However, long-term recurrence is frequently observed following endoscopic sinus surgery, with symptoms worsening after biologics are discontinued. Consequently, refractory or recurrent CRS remains a significant challenge, causing a substantial healthcare burden. In this review, we provide current insights into mucosal inflammatory memory, a potential mechanism leading to CRS recurrence. Given that both immune and non-immune cells in the sinonasal mucosa play critical roles in the pathophysiology of CRS, a deeper understanding of the mechanisms underlying mucosal inflammatory memory in various cellular components of sinonasal tissue could aid in the management of refractory CRS. We describe and discuss the latest knowledge regarding the novel concept of inflammatory memory, including both adaptive immune memory and trained immunity. Additionally, we summarize the pathogenic memory features of the sinonasal mucosa cellular components in the context of CRS.
Yonca Coluk, Emine Gulceri Gulec Peker, Sembol Yildirmak
et al.
Abstract Background Chronic Rapid eye movement (REM) sleep deprivation has been associated with various cardiovascular alterations, including disruptions in antioxidant defense mechanisms, lipid metabolism, and inflammatory responses. This study investigates the therapeutic potential of green tea extract (GTE) in mitigating these adverse effects. Methods A total of 24 male Wistar albino rats were used in this study and divided into the control group (n = 8), Chronic-REM Sleep Deprivation (CRSD) Group (n = 8) and Chronic-REM SD + Green Tea 200 (CRSD + GTE200) Group (n = 8). After 21 days, a comprehensive analysis of paraoxonase (PON1), arylesterase (ARE), malondialdehyde (MDA), glutathione (GSH), nitric oxide (NOx), proinflammatory cytokines, and lipid profiles in aortic tissue, heart tissue, and serum was conducted in a sleep-deprived rat model. Results Chronic REM sleep deprivation led to a significant reduction in PON1 and ARE levels in aortic (p = 0.046, p = 0.035 respectively) and heart tissues (p = 0.020, p = 0.019 respectively), indicative of compromised antioxidant defenses. MDA levels increased, and NOx levels decreased, suggesting oxidative stress and impaired vascular function. Lipid profile alterations, including increased triglycerides and total cholesterol, were observed in serum. Elevated levels of inflammatory cytokines (IL-6 and TNF-alpha) further indicated an inflammatory response (p = 0.007, p = 0.018 respectively). GTE administration demonstrated a protective role, restoring antioxidant enzyme levels, suppressing lipid peroxidation, and improving NOx levels. Conclusion These findings suggest the therapeutic potential of GTE in alleviating the cardiovascular impairments of chronic REM sleep deprivation, emphasizing its candidacy for further clinical exploration as a natural intervention in sleep-related disorders and associated cardiovascular risks.
Nor Azirah Salahuddin, Saravana Selvi Sanmugam, Azreen Zaira Abu Bakar
et al.
Branchial cleft cysts generally occur unilaterally at the lateral aspect of the neck. Bilateral branchial cysts are rare and may have familial associations. We report a rare case of non-syndromic bilateral branchial cyst in a 23-year-old woman who presented with chronic bilateral, progressively enlarging painless neck swellings. Complete surgical excision of the bilateral cyst was done. A histopathological examination confirmed the diagnosis. Precise diagnosis with early and complete surgical excision of branchial cysts may help prevent recurrence and other complications.
Marta Alvarez de Linera-Alperi, Octavio Garaycochea, Diego Calavia
et al.
Benign paroxysmal positional vertigo (BPPV) is one of the most common disorders that causes dizziness. The incidence of horizontal semicircular canal (HSC) BPPV ranges from 5% to 40.5% of the total number of BPPV cases diagnosed. Several studies have focused on establishing methods to treat BPPV caused by the apogeotropic variant of the HSC, namely, the Appiani maneuver (App). In 2016, a new maneuver was proposed: the Zuma e Maia maneuver (ZeM), based on inertia and gravity. The aim of this study is to analyze the efficacy of App versus ZeM in the resolution of episodes of BPPV produced by an affectation of the horizontal semicircular canal with apogeotropic nystagmus (Apo-HSC). A retrospective, quasi-experimental study was conducted. Patients attended in office (November 2014–February 2019) at a third-level hospital and underwent a vestibular otoneurology assessment. Those who were diagnosed with Apo-HSC, treated with App or ZeM, were included. To consider the efficacy of the maneuvers, the presence of symptoms and/or nystagmus at the first follow up was studied. Patients classified as “A” were those with no symptoms, no nystagmus; “A/N+”: no symptoms, nystagmus present during supine roll test; “S”: symptoms present. Previous history of BPPV and/or otic pathology and calcium levels were also compiled. From the 54 patients included, 74% were women. The average age was 69. Mean follow-up: 52.51 days. In those patients without previous history of BPPV (<i>n</i> = 35), the probability of being group “A” was 63% and 56% (<i>p</i> = 0.687) when treated with App and ZeM, respectively, while being “A/N+” was 79% and 87% for App and ZeM (<i>p</i> = 0.508). Of the 19 patients who had previous history of BPPV, 13% and 64% were group “A” when treated with App and ZeM (<i>p</i> = 0.043), and 25% and 82% were “A/N+” after App and ZeM, respectively (<i>p</i> = 0.021). In conclusion, for HSC cupulolithiasis, ZeM is more effective than App in those cases in which there is a history of previous episodes of BPPV (“A”: 64% (<i>p</i> = 0.043); “A/N+”: 82% (<i>p</i> = 0.021)).
Koichiro Asano, Mayumi Tamari, Torsten Zuberbier
et al.
In October 2021, researchers from the German Society of Allergy and Clinical Immunology (DGAKI) and from the Japanese Society of Allergology (JSA) focused their attention on the pathological conditions and modifiers of various allergic diseases. Topics included 1) the pathophysiology of IgE/mast cell-mediated allergic diseases; 2) the diagnosis and prevention of IgE/mast cell-mediated diseases; 3) the pathophysiology, diagnosis, and treatment of eosinophilic airway diseases; and 4) host–pathogen interaction and allergic diseases. This report summarizes the panel discussions, which highlighted the importance of recognizing the diversity of genetics, immunological mechanisms, and modifying factors underlying allergic diseases.
Alvaro Torres-Gomez, Alvaro Torres-Gomez, Tara Fiyouzi
et al.
Activation of the integrin phagocytic receptors CR3 (αMβ2, CD11b/CD18) and CR4 (αXβ2, CD11c/CD18) requires Rap1 activation and RIAM function. RIAM controls integrin activation by recruiting Talin to β2 subunits, enabling the Talin-Vinculin interaction, which in term bridges integrins to the actin-cytoskeleton. RIAM also recruits VASP to phagocytic cups and facilitates VASP phosphorylation and function promoting particle internalization. Using a CRISPR-Cas9 knockout approach, we have analyzed the requirement for RIAM, VASP and Vinculin expression in neutrophilic-HL-60 cells. All knockout cells displayed abolished phagocytosis that was accompanied by a significant and specific reduction in ITGAM (αM), ITGAX (αX) and ITGB2 (β2) mRNA, as revealed by RT-qPCR. RIAM, VASP and Vinculin KOs presented reduced cellular F-actin content that correlated with αM expression, as treatment with the actin filament polymerizing and stabilizing drug jasplakinolide, partially restored αM expression. In general, the expression of αX was less responsive to jasplakinolide treatment than αM, indicating that regulatory mechanisms independent of F-actin content may be involved. The Serum Response Factor (SRF) was investigated as the potential transcription factor controlling αMβ2 expression, since its coactivator MRTF-A requires actin polymerization to induce transcription. Immunofluorescent MRTF-A localization in parental cells was primarily nuclear, while in knockouts it exhibited a diffuse cytoplasmic pattern. Localization of FHL-2 (SRF corepressor) was mainly sub-membranous in parental HL-60 cells, but in knockouts the localization was disperse in the cytoplasm and the nucleus, suggesting RIAM, VASP and Vinculin are required to maintain FHL-2 close to cytoplasmic membranes, reducing its nuclear localization and inhibiting its corepressor activity. Finally, reexpression of VASP in the VASP knockout resulted in a complete reversion of the phenotype, as knock-ins restored αM expression. Taken together, our results suggest that RIAM, VASP and Vinculin, are necessary for the correct expression of αMβ2 and αXβ2 during neutrophilic differentiation in the human promyelocytic HL-60 cell line, and strongly point to an involvement of these proteins in the acquisition of a phagocytic phenotype.
P. Papagiannopoulos, C. Tong, Hannah J. Brown
et al.
1 Department of Otorhinolaryngology – Head and Neck Surgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA 2 Rush Medical College, Rush University Medical Center, Chicago, Illinois, USA 3 Department of Otorhinolaryngology – Head and Neck Surgery, University of California Irvine, Irvine, California, USA 4 Department of Otorhinolaryngology–Head and Neck Surgery, Rush University Medical Center, Chicago, Illinois, USA 5 Department of Neurosurgery, University of Pennsylvania, Philadelphia, Pennsylvania, USA 6 Department of Neurosurgery, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania, USA
Adriana Tresso, Gustavo José Luvizutto, Rodrigo Bazan
et al.
ABSTRACT Purpose: this study aimed to verify the occurrence of abnormal vectoelectronystagmography findings in patients with temporomandibular disorders (TMDs). Methods: in this cross-sectional study, patients diagnosed with TMDs underwent an otorhinolaryngological examination, audiological evaluation, and balance and vestibular function examinations, using vectoelectronystagmography. The tests performed were 1) spontaneous nystagmus, 2) saccadic movements, 3) pendular tracking, 4) optokinetic nystagmus gain and velocity, 5) rotational chair testing, and 6) post-caloric vertigo and the direction and velocity of the slow component of nystagmus. Results: thirty patients were selected (22 females and 8 males) with mean age of 30.8(14.9 years. Sensorineural hearing loss was seen in four patients (13.3%); the other patients (86.7%) had results within the normal range at all frequencies. Five patients (16.7%) showed abnormalities on the Romberg test and seven (23.3%) on the Tandem test. Abnormalities on the caloric test were seen in 40.0% of patients. More prevalence of headache (p<0.0001) and tinnitus (p<0.0001) was observed in patients with unilateral hyperreflexia, and dizziness, depression, anxiety, gait imbalance and falls in patients with bilateral hyperreflexia. Conclusion: patients with TMDs may present vectoelectronystagmography abnormalities characterized by unilateral or bilateral hyperreflexia and unilateral hyporeflexia of post-caloric nystagmus.
To evaluate the clinical effects of health care reorganization because of COVID‐19, in a non‐red zone Italian referral department of Otorhinolaryngology.
A. Ovchinnikov, N. Miroshnichenko, Yu. O. Nikolaeva
According to WHO almost half of the population undergoing infectious diseases of the upper respiratory tract one third of which is inflammatory diseases of the pharynx. This article presents the therapy issue of patients with sore throat due to acute pharyngitis and/or acute tonsillitis of non-streptococcal etiology based on our own experience and literature data. Observational study was carried out at the Otorhinolaryngology department of MSUMD n.a. A.I. Evdokimov in order to evaluate efficacy and tolerability of complex local drug Doritricin. The study involved 52 patients, objective and subjective manifestations of the disease were evaluated. Obtained data indicate the effectiveness and safety of Doritricin, as well as the possibility of reducing the number of drugs used during treatment.
Enrico Fazio, Monir Abousiam, Arianna Caselli
et al.
Enrico Fazio, Monir Abousiam, Arianna Caselli, Remo Accorona, Aurel Nebiaj, Ignazio Ermoli, Bettina Erckert, Luca Calabrese, and Luca Gazzini Division of Otorhinolaryngology and Service of Speech and Language Therapy, “San Maurizio” Hospital, Bolzano, Italy; and Department of Otorhinolaryngology–Head and Neck Surgery, Fondazione Istituti di Ricovero e Cura a Carattere Scientifico Ca’ Granda, Ospedale Maggiore Policlinico, Milano, Italy
Isabelle Gengler, James C. Wang, Marlene M. Speth
et al.
Abstract Objective The ongoing pandemic of coronavirus disease (2019 coronavirus disease [COVID‐19]), caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS‐CoV‐2) virus, is highly contagious with high morbidity and mortality. The role of the nasal and paranasal sinus cavities is increasingly recognized for COVID‐19 symptomatology and transmission. We therefore conducted a systematic review, synthesizing existing scientific evidence about sinonasal pathophysiology in COVID‐19. Study Design Systematic review. Methods Systematic searches were performed of all indexed studies in PubMed/Medline and Cochrane databases through 28 March 2020 and studies searchable on preprints.com (including ArXiv and Scilit repositories) through 30 March 2020. Data extraction focused on sinonasal pathophysiology in COVID‐19. Results A total of 19 studies were identified. The sinonasal cavity may be a major site of infection by SARS‐CoV‐2, where susceptibility genes required for infection are expressed at high levels and may be modulated by environmental and host factors. Viral shedding appears to be highest from the nose, therefore reflecting a major source for transmission. This has been highlighted by multiple reports of health care‐associated infection (HAI) during rhinologic procedures, which are now consequently considered to be high risk for SARS‐CoV‐2 transmission to health care workers. While sinonasal symptomatology, such as rhinorrhea or congestion, appears to be a rarer symptom of COVID‐19, anosmia without nasal obstruction is reported as highly specific predictor of COVID‐19+ patients. Conclusion Sinonasal pathophysiology is increasingly important in our understanding of COVID‐19. The sinonasal tract may be an important site of infection while sinonasal viral shedding may be an important transmission mechanism—including HAI. Anosmia without nasal obstruction may be a highly specific indicator of COVID‐19. Level of Evidence 2a.
Santosh Kumar Swain, Smrutipragnya Samal, Jatindra Nath Mohanty
et al.
Abstract Background Nasopharyngeal carcinoma (NPC) is an extremely rare malignant lesion among the pediatric age group. The relative rarity of pediatric NPC makes the diagnosis difficult. This rarity is often associated with delayed diagnosis which may lead to advanced loco-regional disease. Here, we study the clinical presentations, investigations, and treatment of nasopharyngeal carcinoma in the pediatric age group in a non-endemic region. Result This is a retrospective study where 21 pediatric patients were enrolled with age under 18 years. They were managed at a tertiary care teaching hospital between December 2010 and January 2019. Majority of the patients in this study were boys (66.7%). All children diagnosed with NPC were treated with radiotherapy covering entire nasopharynx and some children with chemotherapy. Until the patient is in a late stage, most children diagnosed with NPC were presenting with symptoms of neck mass (90.5%), bleeding from the nose (66.7%), nasal blockage (57.1%), and hearing loss (47.6%). Pathological report revealed WHO type III in the majority of the patients. All patients were treated with radiotherapy to primary and enlarged neck nodes. Conclusion Children with NPC have excellent survival except for those with distant metastatic disease. NPC in the pediatric age is usually not suspected clinically until patient in late stage. The TNM staging has the most relevant prognostic factor. Unfortunately, NPC tends to be locally advanced at the time of diagnosis in the pediatric age group and is sometimes associated with distant metastasis. In our study, most children were diagnosed with NPC along with neck node enlargement and were treated with radiotherapy. The diagnosis of pediatric NPC should prompt timely treatment.
Two isoforms of the 70-kDa ribosomal protein S6 kinase, S6K1 and S6K2, have been identified and are considered key downstream effectors of the mTOR signaling pathway, which is involved in tumor growth and progression. However, their biological roles in the tumor microenvironment are poorly understood. In this study, utilizing tumor xenograft models in S6k1−/− and S6k2−/− mice, we show that loss of S6K1 but not S6K2 in the tumor stroma suppresses tumor growth, accompanied by attenuated tumor angiogenesis. We found that while S6K1 depletion had no effect on the proangiogenic phenotype of endothelial cells, the growth and angiogenesis of tumor xenografts were significantly reduced in wild-type mice upon reconstitution with S6K1-deficient bone marrow cells. Furthermore, upon S6K1 loss, induction of both mRNA and protein levels of Hif-1α and those of the downstream target, Vegf, was compromised in bone marrow–derived macrophages stimulated with lactate. These findings indicate that S6K1 but not S6K2 contributes to establishing a microenvironment that favors tumor growth through mediating angiogenesis, and suggest that attenuated tumor angiogenesis upon loss of S6K1 in the tumor stroma is, at least in part, attributable to impaired upregulation of Vegf in tumor-associated macrophages.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens