Sandy Hazko, Amed Ahmed, Robert Michael Hermann
et al.
<i>Background and Objectives</i>: This study aims to investigate the impact of hemoglobin (Hb) level changes during radiochemotherapy (RCT) on the survival of patients with locally advanced head and neck squamous cell carcinoma (HNSCC). <i>Materials and Methods</i>: A retrospective analysis was conducted on 97 patients with HNSCC, treated with definitive RCT between January 2016 and October 2021. Hb levels were monitored weekly during RCT. Kaplan–Meier and Cox regression analysis were performed. <i>Results</i>: There was a significant association between Hb levels at the end of RCT and overall survival (<i>p</i> < 0.01). Initial Hb levels and Hb level changes were not significantly associated with survival. In multivariate analysis, a lower body mass index (BMI) and Hb levels at week six were identified as significant prognostic factors. <i>Conclusions</i>: At the end of RCT, rather than baseline levels or changes during treatment, Hb levels are a significant prognostic factor for overall survival in patients with HNSCC.
Sleep plays a crucial role in restoring and repairing the body, consolidating memory, regulating emotions, maintaining metabolic and so on. Sleep deprivation is known to impair cognitive functions. In this study, we investigated the mechanisms underlying memory impairment induced by sleep deprivation through a combined metabolomic and transcriptomic analysis of hippocampus. Eight-week-old mice were selected as the study subjects and the sleep deprivation chamber was used to establish a sleep deprivation model. Novel object recognition tests (NOR), and Y-maze tests were used to assess the behavioral outcomes in mice. The hippocampus were extracted and studied using the untargeted metabolomics or transcriptomics high-throughput sequencing method. An integrative analysis was conducted to elucidate the metabolic and genetic changes. Behavioral tests showed that sleep-deprived mice exhibited memory impairment. Metabolomic analysis identified 84 differentially expressed metabolites (DEMs), including 12 under the positive ion mode and 72 under the negative ion mode. The analysis revealed that sleep deprivation caused abnormalities in several metabolic pathways, with particularly pronounced effects observed in glycerophospholipid metabolism, linoieic acid metabolism, alanine, aspartate, glutamate metabolism, taurine and hypotaurine metabolism, and purine metabolism. While transcriptomic analysis releaved 97 differentially expressed genes (DEGs) (51 were down-regulated and 46 were up-regulated DEGs). Integrative analysis of the metabolomic and transcriptomic identified profiles showed that sleep deprivation may regulate taurine and hypotaurine metabolism and sphingolipid metabolism, there by influencing memory. Our results prompt severe metabolic disturbances occur in the hippocampus with sleep deprivation in mice, which can provide a basis for the mechanism research.
Abstract Background The tumor microenvironment (TME) supplies critical metabolites that support cancer cell survival and progression. Adipocytes support tumor progression by secreting free fatty acids (FFAs) and adipokines; however, the role and mechanisms underlying lipid droplet (LD) release from adipocytes remain elusive. Methods Using two nasopharyngeal carcinoma (NPC) cell lines and primary human pre-adipocytes (HPA), we evaluate the effect of LDs on cell growth, proliferation, colony formation, and migration. We also assess the roles of LD on the tumor progression in vivo. Using RNA-seq analysis, we elucidate the effect of hypoxic NPC cell-derived exosomes (H-exo) on the gene expression profile of adipocytes. By co-culture system, we investigated the effect of vacuolar protein sorting 4 homolog B (VPS4B)-annexin A5 (ANXA5) interaction on adipocyte LD maturity and release. Results Herein, we report that LDs, rather than FFAs, are the primary lipid form transferred from adipocytes to NPC cells, enhancing cancer progression. NPC cells internalize LDs directly via macropinocytosis, while H-exo induces oxidative stress and membrane fluidity in adipocytes, leading to LD release. Transcriptomic and proteomic analyses reveal that VPS4B triggers LD release by interacting with ANXA5, and low LKB1 in H-exo enhances VPS4B O-linked N-acetylglucosamine (O-GlcNAc) modification through the inhibition of serine/threonine kinase 11 (STK11/LKB1)-AMP-activated protein kinase (AMPK) pathway and activation of the hexosamine biosynthesis pathway (HBP) flux. Conclusions This study uncovers critical mechanisms of LD transfer in the TME, suggesting new therapeutic avenues in NPC.
Neoplasms. Tumors. Oncology. Including cancer and carcinogens
Zhi-qiang Zhang, Jing-yang Li, Hongyou Wang
et al.
BackgroundHearing loss (HL) is a significant public health concern, particularly among older adults, where it ranks as the third most common cause of years lived with disability (YLD) globally. This study aims to comprehensively analyze the burden of HL among individuals aged 60 years and older from 1990 to 2021, utilizing data from the Global Burden of Disease (GBD) database.MethodsWe employed a variety of analytical approaches, including descriptive analysis, Joinpoint regression, age-period-cohort analysis, decomposition analysis, and predictive modeling. The study examined trends in incidence, prevalence, and disability-adjusted life years (DALYs) across different socio-demographic index (SDI) quintiles, regions, and genders.ResultsOur findings reveal significant increases in age-standardized rates (ASR) of HL and YLDs over the study period (EAPC = 0.13 and 0.14, respectively), with notable disparities across SDI categories. The burden of HL was highest in low SDI countries, where socio-economic factors severely impacted access to hearing care. Gender differences were pronounced, with males exhibiting higher prevalence rates than females. Predictive analysis indicates a continued rise in HL cases and associated YLDs (projected to reach 46.9 million YLDs by 2040), emphasizing the urgent need for targeted public health interventions.ConclusionThe increasing burden of HL among older adults necessitates enhanced awareness, early detection, and improved access to hearing care services, particularly in low and middle-income countries. Addressing these disparities is crucial for mitigating the socio-economic impacts of HL and improving the quality of life for affected individuals.
Aarushi Wadhawan, Nikhil Arora, Ashiya Goel
et al.
Introduction:
Primary hyperparathyroidism due to parathyroid adenoma commonly causes raised serum calcium and focal giant cell lytic lesions in bones known as Brown’s tumors. It is more common in females in the post-menopausal age group.
Case Report:
We report a case of a 29-year-old female patient with Brown’s tumor maxilla in a clinical setting of normocalcemic primary hyperparathyroidism. The patient presented to us with facial and palatal swelling for which FNAC was done. Cytology revealed hemosiderin-laden macrophages suspicious for Brown’s tumor. On further imaging studies such as CT Neck, Tc99 Sestamibi scan, and other biochemical tests like parathyroid hormone assay and serum calcium level, the diagnosis of a hyperfunctioning parathyroid gland with normal calcium level was made. Parathyroidectomy was performed and parathyroid adenoma came out to be the primary pathology. On post-operative follow up there was regression of the swelling on the face and palate relieving the patient symptomatically.
Conclusion:
The diagnostic suspicion of primary hyperparathyroidism should be kept in mind whenever a young female presents with suspected Brown’s tumor, even with normal serum calcium levels, for appropriate management. Ours was a highly uncommon case that was a diagnostic challenge and had a successful treatment outcome. Very few such cases have been reported in the literature to date to the best of our knowledge.
Carolina Cozzi-Machado, Fátima Rosana Albertini, Silvana Silveira
et al.
Introduction Obstructive sleep apnea (OSA) is defined as intermittent partial or complete collapse of the upper airway during sleep. It is a common condition in childhood, with an incidence ranging from 1.2% to 5.7%, and it can harm several aspects of children's life, such as cognitive, metabolic and cardiovascular functions, among others.
Background and Objectives Since the introduction of nasal valve surgery, trends in septoplasty and inferior turbinate surgery (ITS) have changed in Korea. However, a detailed analysis of these changes has yet to be conducted. Methods Data on septoplasty and ITS performed from 2010 to 2022 were extracted from the Health Insurance Review and Assessment Service (HIRA) Bigdata Open portal and trends were analyzed. Analyses according to the type of medical institution, patient sex and age, and the specialty of the surgeon were also conducted. Results The frequency of both septoplasty and ITS gradually decreased from 2012 to 2017, which marked the low point, and the frequency of these procedures gradually increased thereafter. In 2010, 41.5% of septoplasty procedures were performed in general hospitals, 7.3% in hospitals, and 47.3% in clinics. However, the proportion of these procedures performed in general hospitals subsequently decreased, while the corresponding proportion in hospitals and clinics increased. Both septoplasty and ITS were performed more than twice as often in men than in women. The number of patients under the age of 19 decreased, while the number of female patients aged 20–29 increased. The number of septoplasty procedures performed by plastic surgeons increased. Conclusion Since the introduction of nasal valve surgery, the number of septoplasty procedures performed by plastic surgeons has increased.
Abstract Background RNA N6-methyladenosine (m6A) regulators are considered post-transcriptional regulators that affect several biological functions, and their role in immunity, in particular, is emerging. However, the role of m6A regulators in respiratory allergic diseases remains unclear. Therefore, we aimed to investigate the role of key m6A regulators in mediating respiratory allergic diseases and immune microenvironment infiltration characteristics. Methods We downloaded gene expression profiles of respiratory allergies from the Gene Expression Omnibus (GEO) database and we performed hierarchical clustering, difference analysis, and construction of predictive models to identify hub m6A regulators that affect respiratory allergies. Next, we investigate the underlying biological mechanisms of key m6A regulators by performing PPI network analysis, functional enrichment analysis, and immune microenvironment infiltration analysis. In addition, we performed a drug sensitivity analysis on the key m6A regulator, hoping to be able to provide some implications for clinical medication. Results In this study, we identified four hub m6A regulators that affect the respiratory allergy and investigated the underlying biological mechanisms. In addition, studies on the characteristics of immune microenvironment infiltration revealed that the expression of METTL14, METTL16, and RBM15B correlated with the infiltration of the mast and Th2 cells in respiratory allergy, and METTL16 expression was found to be significantly negatively correlated with macrophages for the first time (R = -0.53, P < 0.01). Finally, a key m6A regulator, METTL14, was screened by combining multiple algorithms. In addition, by performing a drug sensitivity analysis on METTL14, we hypothesized that it may play an important role in the improvement of allergic symptoms in the upper and lower airways with topical nasal glucocorticoids. Conclusions Our findings suggest that m6A regulators, particularly METTL14, play a crucial role in the development of respiratory allergic diseases and the infiltration of immune cells. These results may provide insight into the mechanism of action of methylprednisolone in treating respiratory allergic diseases.
Shih-Lung Chen, Shy-Chyi Chin, Yu-Chien Wang
et al.
Deep neck infection (DNI) is a severe disease affecting the deep neck spaces, and is associated with an increased risk of airway obstruction. Lemierre’s syndrome (LS) refers to septic thrombophlebitis of the internal jugular vein after pharyngeal infection, and is linked with high morbidity and mortality. Both diseases begin with an oropharyngeal infection, and concurrence is possible. However, no studies have examined the risk factors associated with co-existence of LS and DNI. Accordingly, this study examined a patient population to investigate the risk factors associated with concurrent DNI and LS. We examined data from a total of 592 patients with DNI who were hospitalized between May 2016 and January 2022. Among these patients, 14 had concurrent DNI and LS. The relevant clinical variables were assessed. In a univariate analysis, C-reactive protein (odds ratio (OR) = 1.004, 95% CI: 1.000–1.009, <i>p</i> = 0.045), involvement of multiple spaces (OR = 23.12, 95% CI: 3.003–178.7, <i>p</i> = 0.002), involvement of the carotid space (OR = 179.6, 95% CI: 22.90–1409, <i>p</i> < 0.001), involvement of the posterior cervical space (OR = 42.60, 95% CI: 12.45–145.6, <i>p</i> < 0.001) and <i>Fusobacterium necrophorum</i> (<i>F. necrophorum</i>, OR = 288.0, 95% CI: 50.58–1639, <i>p</i> < 0.001) were significant risk factors for concurrent DNI and LS. In a multivariate analysis, involvement of the carotid space (OR = 94.37, 95% CI: 9.578–929.9, <i>p</i> < 0.001), that of the posterior cervical space (OR = 24.99, 95% CI: 2.888–216.3, <i>p</i> = 0.003), and <i>F. necrophorum</i> (OR = 156.6, 95% CI: 7.072–3469, <i>p</i> = 0.001) were significant independent risk factors for concurrent LS in patients with DNI. The length of hospitalization in patients with concurrent LS and DNI (27.57 ± 14.94 days) was significantly longer than that in patients with DNI alone (10.01 ± 8.26 days; <i>p</i> < 0.001), and the only pathogen found in significantly different levels between the two groups was <i>F. necrophorum</i> (<i>p</i> < 0.001). Involvement of the carotid space, that of the posterior cervical space and <i>F. necrophorum</i> were independent risk factors for the concurrence of DNI and LS. Patients with concurrent LS and DNI had longer hospitalization periods than patients with DNI alone. Furthermore, <i>F. necrophorum</i> was the only pathogen found in significantly different levels in DNI patients with versus those without LS.
Mehdi Hasnaoui, Asma Ben Mabrouk, Jihene Chelli
et al.
Introduction: Necrotising otitis externa (NOE) is a rare infection of the ear canal with frequent bone erosion. This study’s objective is to describe the different features of NOE as well as its management in an ear-nose-throat department. We also tried to identify the particularities of the fungal infection. Patients and methods: It is an observational cohort that included all the patients hospitalised for the management of NOE. The study was carried out in the ear-nose-throat Department of Mahdia University Hospital in Tunisia between January 2006 and december 2019. Results: A total of 40 patients were included. The mean age was 65 ± 12.9 years and the sex ratio was 0.9. Ninety percent of the patients included were diabetics. The most common signs found were oedema of the external canal (97.5%) and auricular discharge (92.5%). The main pathogen isolated was Pseudomonas aeruginosa (61.7%). Fungi were isolated in 9 cases (26.47%). Computed tomography was performed for 32 patients (80%). Bone erosion was seen in 26 cases (81.3%). The main complications were cerebral venous thrombosis, retropharyngeal abscess and cerebral empyema. Thirty one patients received only antibiotics, 2 received only antifungal treatment, and 7 received both antibiotics and antifungal treatment. All patients had a favorable outcome. Univariate analysis showed a higher median erythrocyte sedimentation rate was associated with fungal infections. No other differences were noted. Conclusion: Our management protocol seems to be efficient since all patients had initial favorable outcome. A higher median erythrocyte sedimentation rate was associated with fungal infections.
Background: Brain functional alterations have been observed in children with congenital sensorineural hearing loss (CSNHL). The purpose of this study was to assess the alterations of regional homogeneity in children with CSNHL.Methods: Forty-five children with CSNHL and 20 healthy controls were enrolled into this study. Brain resting-state functional MRI (rs-fMRI) for regional homogeneity including the Kendall coefficient consistency (KCC-ReHo) and the coherence-based parameter (Cohe-ReHo) was analyzed and compared between the two groups, i.e., the CSNHL group and the healthy control group.Results: Compared to the healthy controls, children with CSNHL showed increased Cohe-ReHo values in left calcarine and decreased values in bilateral ventrolateral prefrontal cortex (VLPFC) and right dorsolateral prefrontal cortex (DLPFC). Children with CSNHL also had increased KCC-ReHo values in the left calcarine, cuneus, precentral gyrus, and right superior parietal lobule (SPL) and decreased values in the left VLPFC and right DLPFC. Correlations were detected between the ReHo values and age of the children with CSNHL. There were positive correlations between ReHo values in the pre-cuneus/pre-frontal cortex and age (p < 0.05). There were negative correlations between ReHo values in bilateral temporal lobes, fusiform gyrus, parahippocampal gyrus and precentral gyrus, and age (p < 0.05).Conclusion: Children with CSNHL had RoHo alterations in the auditory, visual, motor, and other related brain cortices as compared to the healthy controls with normal hearing. There were significant correlations between ReHo values and age in brain regions involved in information integration and processing. Our study showed promising data using rs-fMRI ReHo parameters to assess brain functional alterations in children with CSNHL.
Abstract Background Recessive mutations in GJB2 is the most common cause of genetic hearing loss worldwide. The aim of this study is to determine the spectrum and frequency of GJB2 variants in Chinese Han deaf patients and to investigate the underlying causative genes in patients with mono-allelic GJB2 mutations. Methods We analyzed the mutation screening results of GJB2 in 1852 Chinese Han probands with apparently autosomal-recessive hearing loss in our laboratory. Targeted next-generation sequencing of 139 known deafness-related genes were performed in 44 probands with mono-allelic GJB2 mutations. Results Bi-allelic GJB2 mutations was identified in 25.65% of patients, in which the c.235delC (p.L79Cfs*3) mutation is the most frequent cause for both severe-to-profound (84.93%) and mild-to-moderate hearing loss (54.05%), while the c.109G > A (p.V37I) mutation is another frequent cause for mild-to-moderate hearing loss (40.54%). In 3.89% of patients only one mutant allele can be identified in GJB2. Targeted next generation sequencing in 44 such probands revealed digenic heterozygous mutations in GJB2/GJB6 and GJB2/GJB3 as the likely pathogenic mechanism in three probands. In 13 probands, on the other hand, pathogenic mutations in other deafness-associated genes (STRC, EYA1, MITF, PCDH15, USH2A, MYO15A, CDH23, OTOF, SLC26A4, SMPX, and TIMM8A) can be identified as the independent genetic cause, suggesting that the mono-allelic GJB2 mutations in those probands is likely co-incidental. Conclusions Our results demonstrated that GJB2 should be a primary target for mutation screening in Chinese Han deaf patients, and those with mono-allelic GJB2 mutations should be further screened by next generation sequencing.
Summary Group A β -hemolytic streptococcus (GAS) is an important pharyngotonsillitis etiologic agent. Correct etiologic diagnosis and early treatment prevent suppurative and non-suppurative complications of streptococcal pharyngotonsillitis; however, clinical diagnosis is not reliable. Within this context, rapid detection methods of GAS antigen are useful to diagnose this agent. Aim The objective of the present study was to determine sensitivity and specificity of rapid GAS antigen detection tests used in Brazil. Study design Clinical prospective. Method: Eighty-one patients with clinical diagnosis of acute pharyngotonsillitis seen at the otorhinolaryngology emergency department of the University Hospital, FMUSP, between May 2001 and April 2002 were submitted to two simultaneous collections of oropharyngeal material using swabs. The rapid GAS antigen detection test was compared to culture on blood agar, the gold standard for the diagnosis of this etiologic agent. Results Among the 81 patients studied, the rapid test was positive in 56% and negative in 44%. GAS growth in culture was observed in 40.7% of the patients. Sensitivity and specificity of the rapid test were, respectively, 93.9% and 68.7%, and the negative and positive predictive values were 94.2 and 67.4%, respectively. Conclusions: We concluded that high sensitivity of the test allows its use in the identification of patients with GAS. Rapid streptococcal antigen detection tests have been shown to be an important adjuvant tool in the etiologic diagnosis of pharyngotonsillitis.
Mahboobeh Adami Dehkordi, M. Javanbakht, Shima Sarfarazi Moghadam
et al.
Introduction: Tinnitus is a common complaint in patients referred to otorhinolaryngology clinics and is a condition where one hears a sound without any distinguishable external acoustic source or electrical stimulus. About 3-30% of adults experience different degrees of tinnitus during their life. This study aims to ascertain and compare personality traits between patients with tinnitus and a control group. Materials and Methods: In a case control study, 66 participants were assessed. The case group consisted of 33 patients who suffered from tinnitus for at least two months, in addition to 33 healthy volunteers who were selected among their family (preferably of the same age and sex). A standard demographic questionnaire and an Eyzenck personality questionnaire were filled for both groups. A tinnitus severity index (TSI) questionnaire was only filled for the case group. Data from each group was compared by Mann-Whitney U and Chi-Square tests. SPSS V.18 was the selected software. Results: Statistical analysis showed a meaningful difference in neuroticism (P=0.001) and extraversion (P=0.001) between the patients and the controls; however, there was no statistical difference between these groups regarding psychotism. Conclusion: Tinnitus can be associated with personality characteristics. This study showed that in patients with tinnitus, neuroticism increases and extraversion decreases. Considering the personality and psychotic traits observed in the patients with tinnitus, psychiatric consultation is recommended.
Liliane Aparecida Fagundes Silva, Kilza de Arruda Lyra e Silva, Seisse Gabriela Gandolfi Sanches
et al.
OBJETIVO: verificar a ocorrência de simetria maior ou igual à 70%, entre as orelhas, comparando os resultados da timpanometria nas frequências de 226 e 1000Hz com as respostas das emissões otoacústicas em neonatos. MÉTODOS: foram avaliados 39 neonatos, em média com 60 horas de vida, sendo 20 do sexo feminino e 19 do sexo masculino. Cada recém-nascido foi submetido à avaliação timpanométrica com as sondas de 226 e 1000 Hz, e avaliação das emissões otoacústicas transientes em ambas as orelhas. Os resultados foram submetidos a testes estatísticos. RESULTADOS: na análise da amostra pode-se observar ocorrência de simetria <70% nas respostas das emissões otoacústicas em 74,4% do total de neonatos. Por outro lado, na timpanometria, houve uma maior ocorrência de simetria ≥ 70%, tanto para sonda de 226 quanto para 1000Hz (76,9% e 84,6%, respectivamente). No que diz respeito ao gênero e orelha, as diferenças encontradas em cada teste não foram significantes, embora tenha sido observada maior amplitude de respostas de emissões otoacústicas na orelha direita. CONCLUSÃO: os resultados sugerem haver simetria no sistema auditivo em sua porção mais periférica, e início de assimetrias a partir da cóclea.