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International Journal of Pediatric... Jun 2024Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis. The goal of this study is to...
BACKGROUND
Increasing evidence suggests that autoimmune disorders and their immunomodulating medications may increase the risk of rhinosinusitis. The goal of this study is to determine if autoimmune and autoinflammatory diseases are associated with increased risk of chronic rhinosinusitis (CRS) in children.
METHODS
A retrospective case-control study of pediatric patients (age 2-18 years) seen in the West Virginia University Hospitals System in the past 10 years was performed. Cases were children with autoimmune or autoinflammatory diseases. Controls were children without any autoimmune or autoinflammatory disorders. Query of our electronic medical record (Epic) was performed using ICD-10 codes. Univariate (unadjusted) and multivariate (adjusted) logistic regression were used to calculate the strength of association of autoimmune or autoinflammatory disorders with CRS and the other airway disorders while adjusting for age, sex, and race.
RESULTS
420582 pediatric patients were queried with mean age of 10.8 years (SD of 4.8, range of 2-18 years), and 47.9% being female. 1956 (0.5%) had autoimmune disorders and 293 (0.07%) had autoinflammatory disorders. Both autoimmune and autoinflammatory disorders increase the odds of having CRS in the unadjusted [OR = 3.36, p < 0.001 and 5.69, p < 0.001 for the respectively] and the adjusted [OR = 2.90, p < 0.001 and OR = 5.07, p < 0.001 respectively after adjusting for age, sex, and race] models.
CONCLUSION
Autoimmune and autoinflammatory disorders increase the risk of CRS and chronic rhinitis in children.
Topics: Humans; Sinusitis; Child; Female; Male; Rhinitis; Adolescent; Chronic Disease; Retrospective Studies; Autoimmune Diseases; Child, Preschool; Case-Control Studies; West Virginia; Risk Factors; Rhinosinusitis
PubMed: 38795462
DOI: 10.1016/j.ijporl.2024.111988 -
Turkish Archives of Otorhinolaryngology Dec 2023Quality of life (QoL) assessments are increasingly important for evaluating the well-being of children with Obstructive Sleep Apnea Syndrome (OSAS). This study's...
OBJECTIVE
Quality of life (QoL) assessments are increasingly important for evaluating the well-being of children with Obstructive Sleep Apnea Syndrome (OSAS). This study's objective is to culturally adapt and validate the Turkish version of the OSA-18 questionnaire, a commonly used tool for assessing QoL in children with OSAS.
METHODS
The OSA-18 questionnaire was translated and culturally adapted for use in the Turkish-speaking population. The study was conducted with 180 participants, 100 boys and 80 girls, with a mean age of 6.16±2.14 years. The participants were divided into two groups. The patient group comprised individuals with symptoms of OSAS based on clinical evaluation, including anamnesis, physical examination, and video recording of apnea and snoring. The patient group underwent adenotonsillectomy and their caregivers completed the Turkish version of the OSA-18 scale postoperatively. The control group comprised 90 children who were similar to the patient group in terms of gender and age. These children had no major complaints such as snoring, apnea, fatigue during the day, irritability, or distraction. In the physical examination of this group, no major tonsillar or adenoid hypertrophy, which causes significant stenosis in the upper airway, was observed. Internal consistency, reliability, validity, responsiveness, and factor analysis were assessed.
RESULTS
The Turkish version of the OSA-18 questionnaire demonstrated excellent reliability, with a Cronbach's alpha of 0.929. The test-retest results were not statistically different. Validity was confirmed through a positive correlation between the OSA-18 score and external parameters, such as the Mallampati score, and tonsil and adenoid size. We found a statistically significant reduction in OSA-18 scores postoperatively, signifying a robust responsiveness to the intervention.
CONCLUSION
Our study confirms the suitability of the Turkish OSA-18 questionnaire for assessing the QoL in children with OSAS. This quick and easy-to-use tool will be valuable for future research on Turkish-speaking children with OSAS, aiding in the evaluation of pediatric OSAS and QoL.
PubMed: 38784954
DOI: 10.4274/tao.2023.2023-10-1 -
Oxford Medical Case Reports May 2024Adenoid cystic/Basal-cell carcinoma (ACC/BCC) of the prostate is a rare histological type exhibiting various morphological characteristics and an optimal treatment has...
Adenoid cystic/Basal-cell carcinoma (ACC/BCC) of the prostate is a rare histological type exhibiting various morphological characteristics and an optimal treatment has not yet been established. We report the case of a 63-year-old patient who complained of incomplete bladder emptying and recurrent urinary infection six months after transurethral resection of a high-grade urothelial bladder tumor. The clinical features, digital rectal examination, serum PSA levels, and multiparametric MRI did not refer to any suspicious prostatic lesions and cystoscopy revealed bladder neck hypertrophy, and yellowish zones in the prostatic urethra. Transurethral resection was performed due to these findings and histopathological analysis showed poorly differentiated ACC/BCC of the prostate. Even though there is no proven mutual correlation between ACC/BCC and urothelial bladder cancer, the appearance of obstructive urinary symptoms, bladder-neck hypertrophy, and macroscopic changes in prostatic urethra should be reconsidered for transurethral resection biopsy considering the possibility of ACC/BCC.
PubMed: 38784775
DOI: 10.1093/omcr/omae050 -
Technology in Cancer Research &... 2024Head and neck adenoid cystic carcinoma (HNACC) is a radioresistant tumor. Particle therapy, primarily proton beam therapy and carbon-ion radiation, is a potential... (Meta-Analysis)
Meta-Analysis
Head and neck adenoid cystic carcinoma (HNACC) is a radioresistant tumor. Particle therapy, primarily proton beam therapy and carbon-ion radiation, is a potential radiotherapy treatment for radioresistant malignancies. This study aims to conduct a meta-analysis to evaluate the impact of charged particle radiation therapy on HNACC. A comprehensive search was conducted in Pubmed, Cochrane Library, Web of Science, Embase, and Medline until December 31, 2022. The primary endpoints were overall survival (OS), local control (LC), and progression-free survival (PFS), while secondary outcomes included treatment-related toxicity. Version 17.0 of STATA was used for all analyses. A total of 14 studies, involving 1297 patients, were included in the analysis. The pooled 5-year OS and PFS rates for primary HNACC were 78% (95% confidence interval [CI] = 66-91%) and 62% (95% CI = 47-77%), respectively. For all patients included, the pooled 2-year and 5-year OS, LC, and PFS rates were as follows: 86.1% (95% CI = 95-100%) and 77% (95% CI = 73-82%), 92% (95% CI = 84-100%) and 73% (95% CI = 61-85%), and 76% (95% CI = 68-84%) and 55% (95% CI = 48-62%), respectively. The rates of grade 3 and above acute toxicity were 22% (95% CI = 13-32%), while late toxicity rates were 8% (95% CI = 3-13%). Particle therapy has the potential to improve treatment outcomes and raise the quality of life for HNACC patients. However, further research and optimization are needed due to the limited availability and cost considerations associated with this treatment modality.
Topics: Humans; Carcinoma, Adenoid Cystic; Head and Neck Neoplasms; Proton Therapy; Heavy Ion Radiotherapy; Treatment Outcome
PubMed: 38773763
DOI: 10.1177/15330338241246653 -
Cureus Apr 2024Klippel-Feil syndrome (KFS) is a triad comprising cervical spine fusion, a low posterior hairline, and constrained neck movement. This triad is not universally present....
Klippel-Feil syndrome (KFS) is a triad comprising cervical spine fusion, a low posterior hairline, and constrained neck movement. This triad is not universally present. The most frequent accompaniment is Sprengel's scapula deformity. According to the Feil classification, Class 1 (C1) is an immense fusion of many cervical vertebrae, Class 2 (C2) is a fusion of one or two vertebrae only, and Class 3 (C3) is coupled with thoracic and lumbar spinal vertebral fusion in addition to the fusion of the cervical vertebrae. Clarke's categorization of KFS includes other associated anomalies. The different classification systems for KFS have been made by the different specialists to whom patients may present, which include orthopedic surgeons, neurosurgeons, orthodontists, faciomaxillary surgeons, cardiologists, and pediatricians. This anomaly being rare and the lack of universally accepted classification may lead to confusion regarding the identification of the syndrome, especially the Clarke Type 3 with isolated facial dysmorphism may go undiagnosed. We report a case with KFS-Clarke Type 3 with isolated facial dysmorphism and Feil Type 2 with the fusion of C2-C3 cervical vertebrae, detected as an incidental radiologic finding, and initial impression of adenoid facies. Hence, this case also highlights the contrasting features between the facial dysmorphism of Clarke Type 3 KFS and adenoid facies.
PubMed: 38765366
DOI: 10.7759/cureus.58466 -
Veterinary Journal (London, England :... Jun 2024The pharyngeal tonsil, located in the nasopharynx, can effectively defend against pathogens invading the body from the upper respiratory tract and play a crucial role in...
The pharyngeal tonsil, located in the nasopharynx, can effectively defend against pathogens invading the body from the upper respiratory tract and play a crucial role in mucosal immunity of the respiratory tract. Immunoglobulin A (IgA) and Immunoglobulin G (IgG) serve as key effector molecules in mucosal immunity, exhibiting multiple immune functions. This study aimed to investigate the distribution patterns and age-related alterations of IgA and IgG antibody-secreting cells (ASCs) in the pharyngeal tonsils of Bactrian camels. Twelve Alashan Bactrian camels were categorized into four age groups: young (1-2 years, n=3), pubertal (3-5 years, n=3), middle-aged (6-16 years, n=3) and old (17-20 years, n=3). The distribution patterns of IgA and IgG ASCs in the pharyngeal tonsils of Bactrian camels of different ages were meticulously observed, analyzed and compared using immunohistochemical and statistical methods. The results revealed that IgA ASCs in the pharyngeal tonsils of all age groups were primarily clustered or diffusely distributed in the reticular epithelium and its subepithelial regions (region A) and around the glands (region C), scattered in the subepithelial regions of non-reticular epithelium (region B), and sporadically distributed in the interfollicular regions (region D). Interestingly, the distribution pattern of IgG ASCs in the pharyngeal tonsils closely mirrored that of IgA ASCs. The distribution densities of IgA and IgG ASCs in these four regions were significantly decreased in turn (P<0.05). However, IgA ASCs exhibited significantly higher densities than IgG ASCs in the same region (P<0.05). Age-related alterations indicated that the distribution densities of IgA and IgG ASCs in each region of the pharyngeal tonsils exhibited a trend of initially increasing and subsequently decreasing from young to old camels, reaching a peak in the pubertal group. As camels age, there was a significant decrease in the densities of IgA and IgG ASCs in all regions of the pharyngeal tonsils (P<0.05). The results demonstrate that the reticular epithelium and its subepithelial regions in the pharyngeal tonsils of Bactrian camels are the primary regions where IgA and IgG ASCs colonize and exert their immune functions. These regions play a pivotal role in inducing immune responses and defending against pathogen invasions in the pharyngeal tonsils. IgA ASCs may be the principal effector cells of the mucosal immune response in the pharyngeal tonsils of Bactrian camels. Aging significantly reduces the densities of IgA and IgG ASCs, while leaving their distribution patterns unaffected. These findings will provide valuable insights for further investigations into the immunomorphology, immunosenescence, and response mechanisms of the pharyngeal tonsils in Bactrian camels.
Topics: Animals; Camelus; Immunoglobulin G; Immunoglobulin A; Antibody-Producing Cells; Aging; Age Factors; Male; Immunity, Mucosal; Adenoids; Female; Palatine Tonsil
PubMed: 38763403
DOI: 10.1016/j.tvjl.2024.106131 -
Journal of Investigative Medicine High... 2024Breast cancers of either ductal or lobular pathology make up the vast majority of breast malignancies. Other cancers occur rarely in the breast. Benign pathology can at... (Review)
Review
Breast cancers of either ductal or lobular pathology make up the vast majority of breast malignancies. Other cancers occur rarely in the breast. Benign pathology can at times mimic breast cancers on imaging and initial needle biopsies. We report a rare breast pathology of cylindroma. Cylindromas are usually benign, rare dermatologic lesions most commonly associated with head or neck locations. They more commonly occur as sporadic and solitary masses. Less commonly is an autosomal-dominant multi-centric form of this disease. Malignant cylindromas are very rare. We present a patient with findings of a cylindroma of the breast after excision. This was initially felt to be concerning for breast cancer on imaging and core biopsy. Treatment of cylindromas of the breast is excision. Sentinel lymph node dissection is not indicated, nor are adjuvant therapies when identified in the breast. This lesion needs to be included in the differential diagnosis for breast cancer. If cylindromas can be accurately diagnosed preoperatively, this would negate the need for consideration of axillary nodal surgery and adjuvant therapies.
Topics: Humans; Female; Breast Neoplasms; Carcinoma, Adenoid Cystic; Diagnosis, Differential; Biopsy, Large-Core Needle; Breast; Middle Aged; Mammography
PubMed: 38761035
DOI: 10.1177/23247096241246627 -
Asian Journal of Surgery May 2024
PubMed: 38760204
DOI: 10.1016/j.asjsur.2024.04.185 -
International Journal of Particle... Mar 2024Adenoid cystic carcinoma (ACC) is a rare malignancy accounting for 1% of all head and neck cancers. Treatment for ACC has its challenges and risks, yet few outcomes...
PURPOSE
Adenoid cystic carcinoma (ACC) is a rare malignancy accounting for 1% of all head and neck cancers. Treatment for ACC has its challenges and risks, yet few outcomes studies exist. We present long-term outcomes of patients with ACC of the head and neck treated with proton therapy (PT).
MATERIALS AND METHODS
Under an institutional review board-approved, single-institutional prospective outcomes registry, we reviewed the records of 56 patients with de novo, nonmetastatic ACC of the head and neck treated with PT with definitive ( = 9) or adjuvant PT ( = 47) from June 2007 to December 2021. The median dose to the primary site was 72.6 gray relative biological equivalent (range, 64-74.4) delivered as either once ( = 19) or twice ( = 37) daily treatments. Thirty patients received concurrent chemotherapy. Thirty-one patients received nodal radiation, 30 electively and 1 for nodal involvement.
RESULTS
With a median follow-up of 6.2 years (range, 0.9-14.7), the 5-year local-regional control (LRC), disease-free survival, cause-specific survival, and overall survival rates were 88%, 85%, 89%, and 89%, respectively. Intracranial extension ( = .003) and gross residual tumor ( = .0388) were factors associated with LRC rates. While the LRC rate for those with a gross total resection was 96%, those with subtotal resection or biopsy alone were 81% and 76%, respectively. The 5-year cumulative incidence of clinically significant grade ≥3 toxicity was 15%, and the crude incidence at the most recent follow-up was 23% ( = 13).
CONCLUSION
This is the largest sample size with the longest median follow-up to date of patients with ACC treated with PT. PT can provide excellent disease control for ACC of the head and neck with acceptable toxicity. T4 disease, intracranial involvement, and gross residual disease at the time of PT following either biopsy or subtotal resection were significant prognostic features for worse outcomes.
PubMed: 38757074
DOI: 10.1016/j.ijpt.2024.100008 -
Otolaryngology--head and Neck Surgery :... May 2024The purpose of this study was to define an improved staging system for adenoid cystic carcinoma (ACC) in the external auditory canal (EAC) based on biological behaviors,...
OBJECTIVE
The purpose of this study was to define an improved staging system for adenoid cystic carcinoma (ACC) in the external auditory canal (EAC) based on biological behaviors, image findings, and the prognosis of patients with ACC in the EAC.
STUDY DESIGN
A retrospective study.
SETTING
A single center data.
METHODS
We performed a single-institution retrospective review of 154 patients with ACC in the EAC between January 2004 and September 2021. Risk factors associated with disease-free survival (DFS) and cancer-specific survival (CSS) of ACC in the EAC were identified using univariate and multivariate cox regression analysis. Then an improved staging system was proposed and compared with the Pittsburgh-modified tumor, node, and metastasis (TNM) staging system for statistical differences in DFS and CSS.
RESULTS
An improved staging system of ACC in the EAC was defined, in which stage T4 were subclassified into T4a and T4b and were statistically different from the Pittsburgh-modified TNM staging system in DFS and CSS. We also found that the dura mater, facial nerve, sigmoid sinus, deep lobe of parotid gland, and parapharyngeal space involvement were significantly associated with poor prognosis of ACC in the EAC.
CONCLUSION
The improved staging system is more accurate in predicting survival prognosis than Pittsburgh-modified TNM staging system for patients with ACC in the EAC, and may provide more efficient guidance of treatment strategy.
SUMMARY
The improved staging system of ACC in the EAC is more accurately to predict survival prognosis, and provide guidance of treatment plan than Pittsburgh-modified TNM staging system.
PubMed: 38751096
DOI: 10.1002/ohn.828