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Clinical Oral Investigations May 2022To determine the relation between the severity of periodontitis and osteonecrosis of the jaw (ONJ) occurrence among different cancer locations and estimate the effect of...
OBJECTIVES
To determine the relation between the severity of periodontitis and osteonecrosis of the jaw (ONJ) occurrence among different cancer locations and estimate the effect of dental care on ONJ prevention in cancer patients.
MATERIALS AND METHODS
This population-based cross-sectional study was conducted through the Longitudinal Health Insurance Database, Taiwan. Patients with malignancies were collected and subdivided into groups according to their different cancer locations, the severity of periodontitis, and dental care. Multivariable logistic regression analysis was performed to assess the associations between ONJ and ONJ-related factors.
RESULTS
A total of 8,234 ONJ patients and 32,912 control patients were investigated. Lip, oral cavity, and pharynx malignancies had the highest ONJ risk among all cancer locations (OR from 3.07 to 9.56, P < 0.01). There is a linear relationship between different severities of periodontitis and ONJ. Patients with radiotherapy and severe periodontitis had the highest ONJ risk (adjusted OR, 9.56; 95% CI, 5.34-17.1). Patients with good dental care had a lower ONJ risk.
CONCLUSIONS
The periodontal condition and cancer location showed a significant impact on the risk of developing ONJ after adjusting for bisphosphonate use. Good dental care could decrease the risk of ONJ in cancer patients. The severity of periodontitis might be a target to predict the potency of ONJ.
CLINICAL RELEVANCE
Dentists must be vigilant about the increased risk of ONJ in cancer patients with periodontitis, especially in the head and neck cancer population. Good dental care is advised for cancer patients with severe periodontitis.
Topics: Bisphosphonate-Associated Osteonecrosis of the Jaw; Bone Density Conservation Agents; Cross-Sectional Studies; Diphosphonates; Head and Neck Neoplasms; Humans; Osteonecrosis; Periodontitis; Risk Factors
PubMed: 35482084
DOI: 10.1007/s00784-021-04175-1 -
Pediatric Pulmonology Sep 2018A bi-directional relationship exists between asthma and obstructive sleep apnea (OSA) in which presence of one is associated with increased prevalence and severity of...
OBJECTIVES
A bi-directional relationship exists between asthma and obstructive sleep apnea (OSA) in which presence of one is associated with increased prevalence and severity of the other. Our objective was to determine whether OSA accounted for differences in airway and systemic inflammation in asthmatic children and whether inflammation was associated with asthma control. We hypothesized that greater severity of SDB would correlate with increased upper airway and systemic inflammation and result in reduced asthma control.
METHODS
Non-obese children aged 4-12 years with persistent asthma, with or without OSA were recruited. Asthma control was measured with the Childhood Asthma Control Test. Children underwent polysomnography and blood sampling, and children with OSA underwent clinically indicated adenotonsillectomy. Tonsils and sera were analyzed for 11 cytokines.
RESULTS
Twenty-seven children (20 with OSA, seven without OSA) participated, mean age 7.9 years, 55.6% female, 92.6% African American. Levels did not differ for any cytokine between children with and without OSA. Lower nadir oxygen saturation was associated with higher levels of tonsil TNF-α (P < 0.001) and IL-10 (P < 0.05). Higher REM-related apnea-hypopnea index was associated with higher levels of tonsil TNF-α (P < 0.05). Children with uncontrolled asthma had significantly higher levels of serum IL-10, IL-13, and TNF-α, and tonsil TNF-α (all P < 0.05) than well-controlled asthmatic children. There was no association between OSA, or any polysomnography variable, and asthma control.
CONCLUSIONS
Despite the presence of OSA-associated airway inflammation, and asthma control-associated airway and systemic inflammation, OSA was not related to level of asthma control in this non-obese, largely minority, low income sample.
Topics: Adenoidectomy; Asthma; Child; Child, Preschool; Comorbidity; Female; Humans; Inflammation; Interleukin-10; Interleukin-13; Male; Minority Groups; Palatine Tonsil; Pilot Projects; Polysomnography; Poverty; Prevalence; Severity of Illness Index; Sleep Apnea, Obstructive; Surveys and Questionnaires; Tonsillectomy; Tumor Necrosis Factor-alpha; United States
PubMed: 29862666
DOI: 10.1002/ppul.24074 -
AAPS PharmSciTech Jul 2022Diseases caused by upper respiratory tract (URT) and pulmonary infections have been a serious threat to human health for millennia and lack of targeted effective...
Diseases caused by upper respiratory tract (URT) and pulmonary infections have been a serious threat to human health for millennia and lack of targeted effective therapeutic techniques. In this study, two kinds of cyclodextrin particles with typical particle shapes of nanocubes and microbars were synthesized through a facile process. Subsequently, the particles were used as carriers for loading and stabilizing iodine and characterizations were performed to demonstrate the loading mechanism. Next-generation impactor (NGI) experiments showed that iodine-loaded microbars (I@microbars) had a deposition rate of 79.75% in URT, while iodine-loaded nanocubes (I@nanocubes) were delivered to the deep lungs with a fine particle fraction (FPF) of 46.30%. Minimal inhibitory concentration (MIC) and minimal bactericidal concentration (MBC) indicated that the iodine-loaded nanocubes and microbars had similar bactericidal effect to povidone iodine solution. Cell viability studies and extracellular pro-inflammatory factor (TNF-α, IL-1β, IL-6) evaluations demonstrate noncytotoxic effects of the blank carriers and anti-inflammatory effects of iodine-loaded samples. The irritation of the rat pharynx by I@microbars was evaluated for the behavioral observations, body weight changes, histopathological studies, and TNF-α, IL-1β, and IL-6 levels in pharyngeal tissues. The results showed that I@microbars had no irritation to rat pharyngeal tissues at therapeutic doses. In conclusion, the present study provides novel treatment of URT infections via supramolecular cyclodextrin carriers for URT local therapy with iodine loading by a solvent-free method, which enhances the stability and reduces the inherent irritation without inhibiting their antimicrobial effects. Two kinds of cyclodextrin particles with typical shapes of microbars and nanocubes were synthesized by a facile process. Subsequently, iodine was successfully loaded into the particles by gas-solid interaction. The iodine-loaded microbars showed air dynamics characteristics for inhalation delivery to the upper respiratory tract with little alveolar deposition in the lungs.
Topics: Administration, Inhalation; Animals; Cyclodextrins; Interleukin-6; Iodine; Particle Size; Pneumonia; Rats; Tumor Necrosis Factor-alpha
PubMed: 35804252
DOI: 10.1208/s12249-022-02277-x -
Facial Plastic Surgery & Aesthetic... 2020The facial artery musculomucosal (FAMM) flap is a well vascularized axial flap which has been described for mucosal reconstructions throughout the oral cavity. There...
The facial artery musculomucosal (FAMM) flap is a well vascularized axial flap which has been described for mucosal reconstructions throughout the oral cavity. There are limited data regarding its efficacy in secondary repair of nasopharyngeal stenosis and velopharyngeal insufficiency due previous surgery and scar tissue formation. This study seeks to demonstrate the efficacy of FAMM flap procedure in patients with nasopharyngeal stenosis and velopharyngeal insufficiency. A retrospective case series included patients treated for nasopharyngeal stenosis or velopharyngeal insufficiency with a FAMM flap at an academic medical center from January 1, 2012 to November 1, 2017. Patients included in the study were those who underwent a FAMM flap procedure by the senior author during the specified time period. Functional outcomes included nasopharyngeal airway patency, nasal regurgitation, and speech quality. Any postoperative complications were recorded, including flap necrosis, infection, flap failure, dehiscence, trismus and need for revision surgery. A total of 6 FAMM flap procedures were performed by the senior author over the study period for the indications of this case series. Three patients had nasopharyngeal stenosis and three had velopharyngeal insufficiency. All had successful, sustained nasopharyngeal airway patency or restored velopharyngeal function. The only postoperative complication noted was trismus at the cheek donor site. There were no patients who suffered flap failure or need for revision surgery of the FAMM flap. The FAMM flap is useful for secondary reconstruction of nasopharyngeal stenosis and velopharyngeal insufficiency due to previous surgery and scarring. This study demonstrates the efficacy and reliability of FAMM flaps for repair of complete/near complete nasopharyngeal stenosis and cases of velopharyngeal insufficiency due to scarring of the pharynx.
Topics: Adolescent; Adult; Aged; Facial Muscles; Female; Humans; Male; Nasal Obstruction; Plastic Surgery Procedures; Reoperation; Retrospective Studies; Surgical Flaps; Velopharyngeal Insufficiency; Voice Quality
PubMed: 32397756
DOI: 10.1089/fpsam.2019.0001 -
Romanian Journal of Morphology and... 2015Squamous cell tonsil carcinoma is the most frequent form of oropharyngeal cancer, representing 70-80% of the total of head and neck malignant tumors. Poor clinical...
Squamous cell tonsil carcinoma is the most frequent form of oropharyngeal cancer, representing 70-80% of the total of head and neck malignant tumors. Poor clinical symptoms make that 60-80% of patients with squamous cell tonsil carcinoma have a late diagnosis, in the third and fourth stages, when the tumor exceeds the organ limits, invading the pharyngeal wall or the tongue base, being associated with metastases in the laterocervical lymphatic ganglions. The tumor necrosis factor alpha (TNF-α) represents an important inflammation mediator associated to carcinogenesis and even to tumor progression. We evaluated the seric values of TNF-α in a group of patients with tonsil cancer in comparison to a group of patients with chronic tonsillitis, as well as the reaction of mastocytes and macrophages in the two types of tonsil lesions. Seric levels of TNF-α in squamous cell tonsil carcinoma were quite high, varying from 1000 to 2000 pg÷mL, and in four patients, with poorly differentiated tonsil carcinoma in the fourth stage, the TNF-α values varied from 2000 to 4000 pg÷mL. In the patients undergoing radiotherapy, the TNF-α seric levels were within normal limits. In chronic tonsillitis, the TNF-α seric level varied from 10 to 200 pg÷mL. There were not observed any significant differences between the two types of tonsil lesions, regarding the macrophages and mast cells density on the surface unit.
Topics: Adult; Aged; Carcinoma, Squamous Cell; Female; Gene Expression Regulation, Neoplastic; Humans; Inflammation; Macrophages; Male; Mast Cells; Middle Aged; Pharynx; Tonsillar Neoplasms; Tonsillitis; Tumor Necrosis Factor-alpha
PubMed: 25826493
DOI: No ID Found -
Journal of the College of Physicians... Feb 2019To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre.
OBJECTIVE
To review the experience of single-stage reconstruction following pharygolaryngectomy and cervical esophageal defect with pedicle flaps in a tertiary care centre.
STUDY DESIGN
Retrospective study.
PLACE AND DURATION OF STUDY
Jinnah Burn and Reconstructive Surgery Centre, Lahore, from June 2007 to June 2017.
METHODOLOGY
All patients who underwent oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicled flaps were included.
RESULTS
Thirty-two reconstructions were done, of which 16 (50.0%) were supraclavicular flaps, 12 (37.5%) were pectoralis major myocutaneous flaps (PMMF) and 4 (12.5%) platysma myocutaneous flaps (PMF). Among these, 24 (75%) were males and 8 (25%) females. The mean hospital stay was 18.75 +5.45 days. Complications were noted in 12 (37.5%), salivary fistula being the most frequent found in 6 (18.75%). Wound dehiscence was noted in 4 (12.5%), partial flap necrosis and wound infection present in 1 (3.1%) each.
CONCLUSION
Oropharyngeal, hypopharyngeal and cervical esophageal reconstruction with pedicle flaps is still very useful and safe to perform, associated with minimal flap and donor site complications.
Topics: Adult; Databases, Factual; Esophageal Neoplasms; Female; Graft Survival; Humans; Hypopharynx; Laryngeal Neoplasms; Male; Middle Aged; Pakistan; Quality of Life; Plastic Surgery Procedures; Retrospective Studies; Risk Assessment; Surgical Flaps; Wound Healing
PubMed: 30700358
DOI: 10.29271/jcpsp.2019.02.168 -
Emerging Microbes & Infections Dec 2023Cytokine dynamics in patients with coronavirus disease 2019 (COVID-19) have been studied in blood but seldomly in respiratory specimens. We studied different cell...
Correlations of Myeloperoxidase (MPO), Adenosine deaminase (ADA), C-C motif chemokine 22 (CCL22), Tumour necrosis factor alpha (TNFα) and Interleukin-6 (IL-6) mRNA expression in the nasopharyngeal specimens with the diagnosis and severity of SARS-CoV-2 infections.
Cytokine dynamics in patients with coronavirus disease 2019 (COVID-19) have been studied in blood but seldomly in respiratory specimens. We studied different cell markers and cytokines in fresh nasopharyngeal swab specimens for the diagnosis and for stratifying the severity of COVID-19. This was a retrospective case-control study comparing Myeloperoxidase (MPO), Adenosine deaminase (ADA), C-C motif chemokine ligand 22 (CCL22), Tumour necrosis factor alpha (TNFα) and Interleukin-6 (IL-6) mRNA expression in 490 (327 patients and 163 control) nasopharyngeal specimens from 317 (154 COVID-19 and 163 control) hospitalized patients. Of the 154 COVID-19 cases, 46 died. Both total and normalized MPO, ADA, CCL22, TNFα, and IL-6 mRNA expression levels were significantly higher in the nasopharyngeal specimens of infected patients when compared with controls, with ADA showing better performance (OR 5.703, 95% CI 3.424-9.500, < 0.001). Receiver operating characteristics (ROC) curve showed that the cut-off value of normalized ADA mRNA level at 2.37 × 10 had a sensitivity of 81.8% and specificity of 83.4%. While patients with severe COVID-19 had more respiratory symptoms, and elevated lactate dehydrogenase, multivariate analysis showed that severe COVID-19 patients had lower CCL22 mRNA (OR 0.211, 95% CI 0.060-0.746, = 0.016) in nasopharyngeal specimens, while lymphocyte count, C-reactive protein, and viral load in nasopharyngeal specimens did not correlate with disease severity. In summary, ADA appears to be a better biomarker to differentiate between infected and uninfected patients, while CCL22 has the potential in stratifying the severity of COVID-19.
Topics: Humans; COVID-19; Interleukin-6; Tumor Necrosis Factor-alpha; Retrospective Studies; Adenosine Deaminase; Case-Control Studies; Peroxidase; Ligands; SARS-CoV-2; Cytokines; Chemokines; Nasopharynx; Chemokine CCL22
PubMed: 36482706
DOI: 10.1080/22221751.2022.2157338 -
Journal of Cranio-maxillo-facial... Jul 2015Numerous factors have been associated with the development of osteoradionecrosis (ORN) of the jaws. The purpose of this study was to investigate the factors that are...
BACKGROUND
Numerous factors have been associated with the development of osteoradionecrosis (ORN) of the jaws. The purpose of this study was to investigate the factors that are linked to the severity of mandibular ORN.
METHODS
A retrospective study was conducted which included all ORN cases treated in the Department of Oral and Maxillofacial Surgery in Munich (LMU) between 2003 and 2012. The cases were categorized according to the necrosis stage and several variables were evaluated in order to identify possible correlation between them and the severity of the necrosis.
RESULTS
A total of 115 patients with 153 osteonecrosis lesions were included in the study. Twenty-three cases were of stage I, 31 were of stage II and 99 were of stage III. The initial tumors were predominantly located in the floor of the mouth, the tongue or the pharynx. Diabetes mellitus (OR: 4.955, 95% Cl: 1.965-12.495), active smoking (OR: 13.542, 95% Cl: 2.085-87.947), excessive alcohol consumption (OR: 5.428, 95% Cl: 1.622-18.171) and dental treatment and/or local pathological conditions (OR: 0.237, 95% Cl: 0.086-0.655) were significant predictors for stage III necrosis.
CONCLUSIONS
The aforementioned factors are predictive of ORN severity and can guide its prophylaxis and management.
Topics: Aged; Alcohol Drinking; Chemotherapy, Adjuvant; Dental Care; Diabetes Complications; Female; Forecasting; Humans; Male; Mandibular Diseases; Middle Aged; Mouth Neoplasms; Neoplasm Staging; Osteoradionecrosis; Periodontal Diseases; Pharyngeal Neoplasms; Radiotherapy Dosage; Radiotherapy, Adjuvant; Retrospective Studies; Risk Factors; Smoking; Tongue Neoplasms
PubMed: 25939311
DOI: 10.1016/j.jcms.2015.03.024 -
Sleep & Breathing = Schlaf & Atmung Jun 2021Raftlin is a large, major lipid raft protein of cell membranes. Raftlin levels have not been previously examined in patients with obstructive sleep apnea (OSA). Our...
BACKGROUND
Raftlin is a large, major lipid raft protein of cell membranes. Raftlin levels have not been previously examined in patients with obstructive sleep apnea (OSA). Our study aimed to evaluate the changes in raftlin, interleukin-6 (IL-6), interleukin-8 (IL-8), and tumor necrosis factor alpha (TNFα) values from the preoperative state to the third month postoperatively in patients undergoing expansion sphincter pharyngoplasty for OSA.
METHODS
Of 60 patients, 10 patients had mild OSA (AHI 5-14), 10 moderate (AHI 15-29), 10 severe (AHI ≥ 30), and 30 with AHI < 5 formed a control group. Preoperatively and at 3 months post-operatively, IL-6, IL-8, TNFα, and raftlin values were measured.
RESULTS
Preoperatively, mean raftlin levels were 914.4 ± 62.7 pg/mL for controls, 910.0 ± 42.5 pg/mL in mild, 1000.5 ± 63.3 pg/mL in moderate, and 1386.3 ± 101.4 pg/mL in severe groups, with moderate and severe groups significantly elevated compared to controls (p < 0.001). Preoperatively to 3 months post-operatively, raftlin levels decreased significantly in each OSA group (p < 0.05). Levels of IL-6, IL-8 and TNFα followed similar patterns at baseline and after surgical intervention.
CONCLUSIONS
Raftlin levels at the third postoperative month decreased significantly compared with preoperative levels in parallel with other markers of inflammation.
Topics: Adult; Female; Humans; Interleukin-6; Interleukin-8; Male; Membrane Proteins; Middle Aged; Patient Acuity; Pharynx; Postoperative Period; Preoperative Period; Sleep Apnea, Obstructive; Treatment Outcome; Tumor Necrosis Factor-alpha
PubMed: 32776303
DOI: 10.1007/s11325-020-02161-7 -
PloS One 2022A subset of individuals with COVID-19 can suffer from a severe form of the disease requiring breathing support for respiratory failure and even death due to disease...
INTRODUCTION
A subset of individuals with COVID-19 can suffer from a severe form of the disease requiring breathing support for respiratory failure and even death due to disease complications. COVID-19 disease severity can be attributed to numerous factors, where several studies have associated changes in the expression of serum pro-inflammatory cytokines with disease severity. However, very few studies have associated the changes in expression of pro-inflammatory changes in the nasopharyngeal milieu with disease severity. Therefore, in the current study, we performed differential gene expression analysis of various pro-inflammatory cytokines in the nasopharyngeal milieu of mild & severe COVID-19 cases.
MATERIAL AND METHOD
For this retrospective, cross-sectional study, a total of 118 nasopharyngeal swab samples, previously collected from mild and severe (based on the WHO criteria) COVID-19 patients were used. A real-time qPCR was performed to determine the viral loads and also evaluate the mRNA expression of eight cytokines (IL-1, IL-2, IL-4, IL-6, IL-10, IFN-γ, TGF-β1, and TNF-α). Subsequently, an unpaired T-test was applied to compare the statistical difference in mean expression of viral loads and each cytokine between the mild and severe groups, while the Pearson correlation test was applied to establish a correlation between disease severity, viral load, and cytokines expression. Similarly, a multivariable logistic regression analysis was performed to assess the relationship between different variables from the data and disease severity.
RESULTS
Out of 118 samples, 71 were mild, while 47 were severe. The mean viral load between the mild and severe groups was comparable (mild group: 27.07± 5.22; severe group: 26.37 ±7.89). The mRNA expression of cytokines IL-2, IL-6, IFN- γ, and TNF-α was significantly different in the two groups (p<0.05), where the Log2 normalized expression of IL-2, IL-6, IFN- γ, and TNF-α was found to be 2.2-, 16-, 2.3-, and 1.73-fold less in the severe group as compared to the mild group. Furthermore, we also observed a significant positive correlation between all the cytokines in the severe group. The multivariate analysis showed a significant relationship between age, IL-6, and disease severity.
CONCLUSION
This decreased expression of certain cytokines (IL-2, IL-6, TNF-α, and IFN-γ) in the nasopharyngeal milieu may be considered early biomarkers for disease severity in COVID-19 patients.
Topics: Humans; Cytokines; Tumor Necrosis Factor-alpha; Interleukin-6; Interleukin-2; Retrospective Studies; Cross-Sectional Studies; COVID-19; Gene Expression; Nasopharynx; RNA, Messenger
PubMed: 36584119
DOI: 10.1371/journal.pone.0279270