Hasil untuk "Otorhinolaryngology"

Hyunkyung Cha, Jina Won, Soo Min Kim et al.

Abstract Objectives Here, we characterised the diversity and persistence of immunological memory cells—particularly tissue‐resident memory T (TRM) and B (BRM) cells—in the nasopharyngeal lymphoid tissues of healthy vaccinated (HV) individuals and those who experienced SARS‐CoV‐2 breakthrough infection (BR). Methods Nasopharynx (NP) samples were obtained using brushing from HV and BR subjects. Immune cell populations were analysed using transcriptomic profiling and flow cytometry. Results Transcriptomic profiling revealed that the NP of SARS‐CoV‐2‐infected individuals exhibited distinctive signatures of lymphocyte‐mediated immunity, underscoring its role as a key site for viral invasion and immune activation. Effector memory CD4+ and CD8+ T (TEM) cells, along with non‐germinal center (GC) B cells, predominated in the NP. Although overall frequencies of memory T cells were comparable between HV and BR groups, CD4+ TEM and GC B cells were significantly enriched in the NP of BR individuals at least 1 year post infection. Notably, over 80% of CD4+ TEM and 40% of CD8+ TEM cells were TRM, and more than 30% of memory B cells exhibited a BRM phenotype. These populations of CD4+, CD8+ TRM and BRM persisted in the NP for over 2 years following SARS‐CoV‐2 infection or vaccination. In particular, CD4+ TRM cells were significantly more abundant and durably maintained in the NP mucosa of BR individuals. Conclusion Our findings identify the nasopharynx as a key site of long‐lived immunological memory, marked by persistent TRM and BRM cells after SARS‐CoV‐2 exposure.

Giovanna Rossi, Francesco Carlo Tartaglia, Nerina Denaro et al.

Human papillomavirus-positive (HPV+) oropharyngeal squamous cell carcinoma (OPSCC) is a peculiar entity, with distinct patient, tumor, and biological characteristics, and a different prognosis compared to HPV-negative (HPV-) OPSCC. Due to the rising incidence, there is a need to develop novel therapeutic approaches, especially considering the long-term morbidities of traditional treatments such as surgery and chemoradiotherapy. In this regard, therapeutic vaccines targeting HPV epitopes have been put at the forefront of the immunotherapeutic strategies for HPV+ OPSCC. Multiple clinical trials are investigating their efficacy and safety in the advanced setting, more frequently as a combination therapy. As for the early setting, HPV therapeutic vaccines could represent a strategy to further deepen responses and to facilitate de-escalation of standard treatment. This review aims to provide the clinician with useful and up-to-date information on the current advances in this field. To that end, we will provide the results of the main ongoing/completed clinical trials including patients with OPSCC, focusing on immunogenicity and clinical benefit, in both early and advanced setting. We will also map the challenges and limitations in this area to guide future research.

Vagner Antonio Rodrigues da Silva, Henrique Furlan Pauna, Guilherme Correa Guimarães et al.

Objective: To evaluate hearing outcomes and postoperative complications among patients with middle and external ear malformations undergoing active middle ear implantation with Vibrant Soundbridge® (VSB). Methods: Review of the literature. Studies published in English, Portuguese, or Spanish at the following databases: PubMed, MEDLINE, Scopus, Web of Science, EMBASE, and Cochrane Library were searched. The search strategy yielded a total of 141 potentially relevant studies. Of these, ten were included in this analysis. Results: The mean preoperative air conduction threshold was 66.7 ± 6.2 dB. The mean air-bone gap was 46 ± 7.7 dB. VSB implantation resulted in mean hearing gain of 40.5 ± 7.1 dB in the air-conduction thresholds among the evaluated frequencies. The speech recognition index if the Floating Mass Transducer (FMT) was placed in the short process was 86.0% ± 9.6%, with significant difference when compared to long process coupling (p = 0.035) and the round window coupling (p =  0.048). Conclusion: Bone conduction thresholds did not worsen in any of the studies included in the present review. VSB implantation resulted in a mean hearing gain of 40 dB at air conduction thresholds.

Xu Zhang, Chunhong Yu, Peng Wang et al.

The increasing prevalence of microplastics (MPs) in the environment has raised urgent concerns regarding their implications for human health. This comprehensive review integrates recent findings on the sources, classification, and pathways of MPs into the human body, highlighting their potential cellular toxicity and systemic health risks. We discuss the mechanisms by which MPs may induce inflammatory responses, oxidative stress, and cellular damage, thereby contributing to various diseases. Notably, we examine the synergistic effects of MPs in conjunction with other environmental pollutants, which may amplify their adverse health outcomes. This synthesis of current research underscores the critical need for multidisciplinary approaches to investigate the multifaceted interactions between MPs and human health, ultimately guiding future studies and informing public health strategies to mitigate exposure and associated risks.

Miaomiao Yu, Huan Cao, Jianwang Yang et al.

Emerging evidence suggests that circular RNAs (circRNAs) are involved in the regulation of tumourigenesis and progression of a variety of malignant tumours. In this study, we aimed to identify laryngeal squamous cell carcinoma (LSCC)-specific circRNAs and explore their biological functions and underlying molecular mechanisms. Employing microarray and qRT-PCR, hsa_circ_0000825 was found to be significantly increased in LSCC tissues versus para-cancerous tissues. High hsa_circ_0000825 expression was positively associated with advanced clinical stages, lymph node metastasis, and poor survival. Furthermore, the overexpression of hsa_circ_0000825 in TU177 and AMC-HN-8 cells promoted cell proliferation. Transwell assays showed enhanced migration and invasion of TU177 and AMC-HN-8 cells upon overexpression of hsa_circ_0000825. Conversely, the knockdown of hsa_circ_0000825 had the opposite effect. Xenograft tumours in BALB/c nude mice derived from hsa_circ_0000825-overexpressed TU177 cells showed greater volume and weight than those derived from control TU177 cells. Mechanistically, nuclear-cytoplasmic fractionation assay confirmed that hsa_circ_0000825 was mainly located in the cytoplasm of TU177 and AMC-HN-8 cells. The AGO2-RNA immunoprecipitation (RIP) assay revealed that hsa_circ_0000825 was significantly enriched in the AGO2-precipitated complex in both TU177 and AMC-HN-8 cells, suggesting that this circRNA may function via a competitive endogenous RNA (ceRNA) mechanism. Next, bioinformatics analysis, biotinylated-oligo pull-down assay and dual-luciferase reporter assay verified that miR-766 could be sponged by hsa_circ_0000825 and also target 3′UTR of HOXD10 mRNA. Moreover, miR-766 was shown to be involved in the pro-oncogenic effect of hsa_circ_0000825. This occurred via the mediation of hsa_circ_0000825-enhanced HOXD10 mRNA by the ceRNA mechanism in TU177 and AMC-HN-8 cells. Besides, RNA-binding protein (RBP) ELAVL1 interacted with hsa_circ_0000825 in TU177 and AMC-HN-8 cells, as revealed through bioinformatics analysis, biotinylated-oligo pull-down assays, and RIP assays. ELAVL1 knockdown decreased cell proliferation by 38 % and 34 % in hsa_circ_0000825-overexpressed TU177 and AMC-HN-8 cells (P < 0.05). Similarly, ELAVL1 was involved in the pro-migration and pro-invasion effects of hsa_circ_0000825 overexpression. In addition, comprehensive analysis of mRNA-seq in hsa_circ_0000825-overexpressed TU177 cells, as well as catRAPID and TCGA databases, suggested that ITGB2, HOXD10, and MTCL1 might be crucial downstream target mRNAs of ELAVL1 in LSCC, participating in the hsa_circ_0000825-ELAVL1 axis pro-oncogenic effect. Taken together, hsa_circ_0000825 plays a pro-oncogenic role in LSCC via the miR-766/HOXD10 axis and ELAVL1 and may serve as a promising specific biomarker and therapeutic target for LSCC.

Lionel Benchimol, Simon Dubois, Noemie Bricmont et al.

Primary ciliary dyskinesia (PCD) comprises a wide range of phenotypes related to the impaired function of epithelial cilia. Histologically altered or absent cilia lead to multiple and variable consequences at the clinical level. Several research and clinical interest have surrounded respiratory ciliated epithelium because of its key role in clearing mucus from the ear, nose, and respiratory tract. Our aim was to provide a current state of the art on the ENT signs and symptoms of primary ciliary dyskinesia and their practical management. We systematically searched the following databases from 2011 until 2021: Cochrane Central Register of Controlled Trials, PubMed, and ScienceDirect. The searches were performed by 2 independent investigators. After removing duplications, articles were selected after the evaluation of the publications by reading their titles and abstracts. Eventually, full-text reading took place. Early onset of upper and lower respiratory symptoms in a full-term born child is suggestive of ciliary dyskinesia, especially in the absence of a usual triggering factor (passive smoking, allergy). The cornerstone of care is improving mucociliary clearance, using nasal and sinus irrigations, autoinflaction devices for middle ear effusion, physiotherapy and/or physical exercise for upper airway recovery. Decongestants, mucolytics, steroids, and antihistamines are part of the therapeutic arsenal with a low level of evidence. Early eradication of airway infections should be based on bacteriological analysis. Surgical interventions are common and mainly aim at restoring drainage. in summary, PCD is associated with ENT manifestations from the first days of life. The key to management is restoring adequate drainage of the upper airway and ENT cavities, using medical and surgical interventions.

Xingxing Chen, Jun Wang, Xian Zhang et al.

Abstract Background With rapid urban sprawl, growing people are living in the vicinity of major roadways. However, little is known about the relationship between residential proximity to major roadways and hearing impairment (HI). Methods We derived data from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey, and included 13,775 participants aged 65 years or older. Multivariate logistic regressions were employed to examine the association between residential proximity to major roadways and HI. The effects of corresponding potentially modifiable factors were studied by three-way interaction analyses. Sensitivity analyses were performed to verify the robustness of the results. Results The prevalence of HI was 38.3%. Participants living near major roadways were more likely to have a higher socioeconomic status. An exposure-response relation between residential proximity to major roadways and HI was observed (P trend < 0.05). Compared with individuals living > 300 m away from major roadways, the adjusted odds ratios (OR) were 1.07 (95% CI: 0.96–1.24), 1.15 (95% CI: 1.07–1.34), and 1.12 (95% CI: 1.01–1.31) for those living 101–200 m, 50–100 m, and < 50 m away from the roadways, respectively. Particularly, the association was more pronounced among individuals exposed to carbon monoxide (CO) pollution or opening windows frequently (P interaction < 0.05). Three-way interaction analyses confirmed that participants exposed to CO pollution and frequently leaving windows open had the highest OR of 1.73 (95% CI: 1.58–1.89). Conclusions This nation-wide cohort study suggested that residential proximity to major roadways was significantly associated with an increased exposure-response risk of HI in Chinese older adults. Exposure to CO pollution and opening windows frequently might strengthen the relations.

Mario Andres Bustos Rubilar, Patricia Junge Cerda, Natalia Celedón Hidalgo

La vinculación de políticas públicas y el trabajo intersectorial entre salud, educación y servicios sociales ha cobrado relevancia en el abordaje temprano y biopsicosocial en personas con discapacidad. En el campo de la discapacidad auditiva infantil, existirían controversias en dicha vinculación debido a las discrepancias existentes entre los enfoques clínico y sociocultural, referentes incluso a las modalidades de acceso al lenguaje para esta población. Este estudio de tipo cualitativo analiza entrevistas semi-estructuradas buscando describir las percepciones de diferentes actores en País Vasco de España y Región Metropolitana de Chile. Fueron analizados 565 minutos de entrevistas de 27 participantes, a partir de 3 categorías emergentes: políticas y áreas existentes, intersectorialidad entre áreas, y servicio ofrecido por áreas. Los resultados muestran una percepción positiva sobre la vinculación política y trabajo intersectorial, pero persiste la preferencia del modelo biomédico y enfoque clínico de la discapacidad por sobre el modelo biopsicosocial y el desarrollo del enfoque sociocultural. Esto ocurriría toda vez que el éxito se asocia al desarrollo normal a través de la adquisición de la lengua oral por sobre la diversidad de otras intervenciones en esta población. Las percepciones de los profesionales de las áreas estudiadas difieren en torno a los logros considerados como indicadores de éxito. Un centro coordinador de políticas y trabajo intersectorial, junto con la determinación de momentos de mayor relevancia de cada área en el proceso de atención podrían beneficiar el trabajo hacia este grupo.

Ali Mussa, Ros Akmal Mohd Idris, Naveed Ahmed et al.

In recent years, the idea that Vitamin C (Vit-C) could be utilized as a form of anti-cancer therapy has generated many contradictory arguments. Recent insights into the physiological characteristics of Vit-C, its pharmacokinetics, and results from preclinical reports, however, suggest that high-dose Vit-C could be effectively utilized in the management of various tumor types. Studies have shown that the pharmacological action of Vit-C can attack various processes that cancerous cells use for their growth and development. Here, we discuss the anti-cancer functions of Vit-C, but also the potential for the use of Vit-C as an epigenetic regulator and immunotherapy enhancer. We also provide a short overview of the current state of systems for scavenging reactive oxygen species (ROS), especially in the context of their influencing high-dose Vit-C toxicity for the inhibition of cancer growth. Even though the mechanisms of Vit-C action are promising, they need to be supported with robust randomized and controlled clinical trials. Moreover, upcoming studies should focus on how to define the most suitable cancer patient populations for high-dose Vit-C treatments and develop effective strategies that combine Vit-C with various concurrent cancer treatment regimens.

James Bartram, Rebecca Green, Anna Paterson et al.

Malignant peripheral nerve sheath tumours are uncommon, aggressive tumours that are very rarely found in the head and neck. Whilst commonly associated with NF1 and radiotherapy, they can on occasion present sporadically. MPNSTs provide a challenge to the pathologist in diagnosis due to the often heterogeneous nature of their composition.A 60 year old man initially presented to primary care with a 2 cm neck mass, which was biopsied with fine needle aspiration, demonstrating spindle-shaped cells positive for S100 and SOX10 on immuneohistochemistry. By the time the patient presented to secondary care, the tumour had enlarged to 8 cm. Staging scans showed no evidence of metastasis. Surgery was carried out, after which histology was consistent with the diagnosis of MPNST. Histologically the tumour consisted of moderately atypical and pleomorphic spindle cells which in areas had a fascicular growth pattern. Four weeks post-operatively, a CT scan demonstrated pulmonary metastases, which progressed despite chemotherapy. The patient died 10 months after surgery.Rapid referral to secondary care of any quickly expanding neck mass must always be considered. Although extremely rare, a diagnosis of MPNST should be contemplated in the presence of a rapidly enlarging neck mass with nerve involvement, even in the absence of NF1. Histological diagnosis is key to accurate identification of MPNST, and surgery is by far the most effective treatment.

Todd Kanzara, Alasdair Ford, Elizabeth Fleming et al.

Mahboobeh Karimi-Galougahi, Ali Safavi Naeini, Nasim Raad et al.

Nathalia de Paula Doyle Maia, Karen de Carvalho Lopes, Fernando Freitas Ganança

Introduction: Sudden hearing loss is an otorhinolaryngological emergency that often leads to severe damage to the auditory and vestibular function. The vestibular evoked myogenic potential is a test that allows a noninvasive evaluation of the otolithic system function and vestibulospinal and vestibulo-ocular pathways. Objective: To evaluate the importance of vestibular evoked myogenic potential in determining the prognosis of patients with sudden hearing loss. Methods: A search for articles published up to December 2018 was performed in the PubMed, Cochrane, VHL and LILACS databases using MeSH descriptors. Retrospective and prospective articles were included containing cervical or ocular vestibular evoked myogenic potential in sudden hearing loss patients and information on associated vertigo and/or dizziness. Results: Sixteen of 62 initially selected articles met the inclusion criteria and were analyzed. Regarding the methodology of the evaluated studies, 8 studies were prospective, six were retrospective, one contained part of the data from a retrospective analysis and another part from a prospective analysis, and one study was cross-sectional. A total of 872 patients were evaluated (50.22% males and 49.77% females) with a mean age of 51.26 years. Four hundred and twenty-six patients (50.35%) had vertigo and/or dizziness associated with sudden hearing loss. The cervical vestibular evoked myogenic potential was performed in all studies, but only seven assessed the ocular vestibular evoked myogenic potential. The cervical vestibular evoked myogenic potential showed alterations in 38.65% of 846 evaluated ears, whereas ocular vestibular evoked myogenic potential showed alterations in 47.88% of 368 evaluated ears. The hearing recovery rate was analyzed by 8 articles, with 63.4% of 410 evaluated ears showing hearing recovery. Conclusions: The studies suggest that the assessment of the vestibular system using vestibular evoked myogenic potential seems to be important in the prognosis of sudden hearing loss. For better follow-up of patients with sudden hearing loss, the emphasis should not be limited to the cochlea, but also include the diagnosis and treatment of vestibular abnormalities, regardless of the presence of vertigo. Resumo: Introdução: A surdez súbita é uma emergência otorrinolaringológica que frequentemente cursa com graves danos à função auditiva e vestibular. O potencial evocado miogênico vestibular é um exame que permite a avaliação não invasiva da função do sistema otolítico e das vias vestíbulo-espinhal e vestíbulo-ocular. Objetivo: Avaliar a importância do potencial evocado miogênico vestibular na determinação do prognóstico dos pacientes com surdez súbita. Método: Uma busca de trabalhos publicados até dezembro de 2018 foi realizada nos bancos de dados PubMed, Cochrane, BVS e Lilacs com descritores cadastrados no MeSH. Foram incluídos artigos retrospectivos e prospectivos que contivessem o potencial evocado miogênico vestibular cervical ou ocular em pacientes com surdez súbita e informações sobre vertigem e/ou tontura associados. Resultados: Dezesseis de 62 artigos selecionados inicialmente preencheram os critérios de inclusão e foram analisados. Quanto à metodologia dos trabalhos avaliados, 8 estudos foram prospectivos, seis retrospectivos, um continha parte dos dados oriunda de uma análise retrospectiva e outra parte de uma análise prospectiva e um estudo foi transversal. Foram avaliados 872 pacientes (50,22% do gênero masculino e 49,77% feminino) com média de 51,26 anos. Do total de pacientes, 426 (50,35%) apresentavam vertigem e/ou tontura associada à surdez súbita. O potencial evocado miogênico vestibular cervical foi realizado em todos os estudos, porém o potencial evocado miogênico vestibular ocular em apenas sete. O potencial evocado miogênico vestibular cervical apresentou alteração em 38,65% de 846 orelhas avaliadas, enquanto o potencial evocado miogênico vestibular ocular estava alterado em 47,88% das 368 orelhas avaliadas. A taxa de recuperação auditiva foi analisada por 8 artigos, 63,4% de 410 orelhas avaliadas apresentavam recuperação auditiva. Conclusões: Os estudos demonstram que a avaliação do sistema vestibular com o uso do potencial evocado miogênico vestibular parece ter importância no prognóstico da surdez súbita. Para melhor acompanhamento do paciente com surdez súbita a ênfase não deve se restringir à cóclea, mas também no diagnóstico e tratamento de alterações vestibulares, independentemente da presença de vertigem. Keywords: Vestibular evoked myogenic potentials, Prognosis, Sudden hearing loss, Palavras-chave: Potencial evocado miogênico vestibular, Prognóstico, Surdez súbita

John H. Grose, Emily Buss, Hollis Elmore

The purpose of this study was to determine whether cochlear synaptopathy can be shown to be a viable basis for age-related hearing difficulties in humans and whether it manifests as deficient suprathreshold processing of temporal and spectral modulation. Three experiments were undertaken evaluating the effects of age on (a) the auditory brainstem response as a function of level, (b) temporal modulation detection as a function of level and background noise, and (c) spectral modulation as a function of level. Across the three experiments, a total of 21 older listeners with near-normal audiograms and 29 young listeners with audiometrically normal hearing participated. The auditory brainstem response experiment demonstrated reduced Wave I amplitudes and concomitant reductions in the amplitude ratios of Wave I to Wave V in the older listener group. These findings were interpreted as consistent with an electrophysiological profile of cochlear synaptopathy. The temporal and spectral modulation detection experiments, however, provided no support for the hypothesis of compromised suprathreshold processing in these domains. This pattern of results suggests that even if cochlear synaptopathy can be shown to be a viable basis for age-related hearing difficulties, then temporal and spectral modulation detection paradigms are not sensitive to its presence.

Yang LF, Cai LM, Li M et al.

Li-Fen Yang,1,* Liang-Ming Cai,1,* Ming Li,2,* Jin-Tao Liu,3 Zhao-Ni Wang,1 Wei-Hao Wang,4 Qin-tai Yang,4 Zhuang-Gui Chen1,5 1Department of Pediatrics Intensive Care Unit and Respiratory Medicine, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People&rsquo;s Republic of China; 2Department of Pulmonary Diseases, The First Affiliated Hospital of Sun Yat-Sen University, Guangzhou, People&rsquo;s Republic of China; 3Department of Population and Quantitative Health Science, Case Western Reserve University, Cleveland, OH, USA; 4Department of Otorhinolaryngology-Head and Neck Surgery, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, People&rsquo;s Republic of China; 5Institution of Respiratory Diseases of Sun Yat-sen University, Guangzhou, People&rsquo;s Republic of China *These authors contributed equally to this work Objective: To investigate the alterative spectrum and trends of aeroallergens sensitization in children with allergic rhinitis (AR) in Guangzhou, China in the past 10 years.Participants and methods: In this retrospective study, 4,111 children with complaints of nasal hyper-reactivity who visited the Pediatric Department and/or Otolaryngology Department from January 2007 to November 2016 were enrolled. Serum specific immunoglobulin E was measured and positive detection was made in 3,328 patients, who were, therefore, diagnosed with AR. Positive rates and trends of different aeroallergens sensitization were assessed. The tendency of positive rates changing over the years, and the difference and trends in positive rate of aeroallergen sensitization that occurred in subgroups of gender, age, and season were determined and analyzed with logistic regression.Results: The percentage of detected common aeroallergens in AR children was (from high to low) 81.07%, 34.44%, 14.72%, 11.81%, 6.04%, and 3.70% for house dust mites (HDMs), cat&ndash;dog dander, cockroach, mold mixture, tree pollen mixture, and herb pollen mixture, respectively. An ascending trend of aeroallergens sensitization or AR (odds ratio [OR] =1.116, 95% CI: 1.086&ndash;1.146) was found. Interestingly, an increasing trend of cat&ndash;dog dander and mold sensitization was found in AR children (OR =1.164, 95% CI: 1.133&ndash;1.196; OR =1.169, 95% CI: 1.120&ndash;1.223) in this retrospective study, while HDMs sensitization held a steady trend (OR =0.983, 95% CI: 0.961&ndash;1.007).Conclusion: In the increasing trend of aeroallergens sensitization or AR, HDMs sensitization still held the majority. But emphasis should be made on pet allergy for young children with AR in the context of ascending trend of sensitization to cat&ndash;dog dander. Keywords: allergic rhinitis, aeroallergen, children, sIgE

Christina J. Yang

Karla Anacleto de Vasconcelos, Maria Dolores Gonçalves Amâncio Pereira

OBJETIVO: verificar se o nível de educação formal dos responsáveis pelas crianças atendidas no serviço de Saúde Auditiva de um Hospital Universitário, assim como a suas rendas familiares e o grau das perdas auditivas das crianças, influencia na adesão ao uso de próteses auditivas. MÉTODOS: foi realizado um estudo retrospectivo por meio de um levantamento de dados secundários contidos em fichas técnicas no Laboratório de Exames Complementares do referido Hospital. Foram verificados os dados sobre o tipo e o grau das perdas auditivas, tipo de adaptação, renda familiar e escolaridade dos pais ou responsáveis. A adesão ao uso de próteses auditivas foi verificado por meio da presença em consulta anual após alta. RESULTADO: foram verificados dados de 105 pacientes. Em 35 (10,47%) casos, os entrevistados relataram até um salário mínimo como única renda familiar, 54 (51,4%) entre um e três salários mínimos, 4 (3,8%) entre três e 10 salários mínimos e em 12 (11,4%) casos esse dado não foi informado na entrevista. Em relação à escolaridade dos responsáveis pelas crianças, 51 (48,5%) responsáveis relataram ter no máximo, ensino fundamental I, 39 (37,1%) iniciaram ou completaram o ensino médio, 5 (4,7%) iniciaram ou completaram um curso superior e em 10 (9,7%) entrevistas não constava essa informação. Em 94 casos foi encontrada adesão e em 11, não adesão. Não houve significância estatística entre a renda familiar ou escolaridade dos responsáveis com o sucesso na adesão de crianças atendidas no Hospital Universitário. CONCLUSÃO: a renda familiar ou a escolaridade dos responsáveis não influencia na adesão em crianças de até 12 anos atendidas no Hospital Universitário.

João Ferreira de Mello Júnior, Olavo de Godoy Mion, Nilvano Alves de Andrade et al.

Opresente documento tem por objetivo esclarecer àqueles que tratam das doenças nasossinusais, tanto especialistas quanto generalistas, sobre as terapêuticas tópicas nasais. Por meio de uma revisão das evidências científicas, a Academia Brasileira de Rinologia vem proporcionar sua visão prática e atualizada sobre as medicações tópicas nasais mais utilizadas, excetuando-se as medicações que possuam antibióticos tópicos na sua formulação.<br>This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.

Katarina Paunovic

Many reviews have documented the adverse effects of noise on children′s health, but the international scientific community was previously unfamiliar with noise research in Central and Eastern Europe (CEE), South-East Europe (SEE), and Newly Independent States (NIS). The aim of this review was to present studies on the effects of noise on children′s health, conducted in aforementioned countries in the second half of the 20 th century, interpret their findings, and criticize their methodology and results wherever possible. This review focused on 30 papers published in national journals in the period from 1965 to 2000. By design, 22 studies were observational and cross-sectional, and eight studies were experimental. The outcomes under the study included auditory changes, stress reactions, sleep disturbances, school performance, upright posture, and vegetative functions. Researchers from CEE, SEE, and NIS were the pioneers in the assessment of noise-induced changes of vegetative functions and blood pressure of children in urban areas, as well as of infants exposed to noise in incubators. Future research should focus on intervention studies and follow-up of children′s health in relation to noise exposure.