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Przeglad Epidemiologiczny Jun 2024Respiratory tract infections in children are an interdisciplinary problem that pediatricians, allergists, laryngologists and immunologists encounter on a daily basis. In...
INTRODUCTION
Respiratory tract infections in children are an interdisciplinary problem that pediatricians, allergists, laryngologists and immunologists encounter on a daily basis. In the youngest children, these diseases are caused by the structure of the respiratory tract, which is shorter and narrower than in an adult, as well as the immaturity of the immune system. Among all children under 5 years of age hospitalized due to respiratory diseases, 20% of cases are acute respiratory infections.
OBJECTIVE
The aim of the study is to discuss selected respiratory diseases in children aged 0-18 years hospitalized at the Pediatric Hospital in Bielsko-Biała.
MATERIAL AND METHODS
In June 2023, statistical data from the Pediatric Hospital was received regarding the number of hospitalized children aged 0-18 in 2015-2022. This article covers the following respiratory diseases: acute laryngitis, acute pharyngitis, pneumonia, bronchitis and bronchiolitis, bronchial asthma, adenoid hypertrophy and palatine tonsil hypertrophy coexisting with adenoid hypertrophy. Then, a table was prepared illustrating the trends of individual disease entities in the discussed time period.
RESULTS
A total of 5,573 hospitalizations were analyzed for the period from 2015-2022. The largest group of children (1,583) were hospitalized due to acute bronchitis and bronchiolitis (28.41%), due to hypertrophy of the adenoid (1,093) and palatine tonsils (1,039), which is 19.6% and 18.64% respectively. The smallest number of children and adolescents were hospitalized due to acute laryngotracheitis (474) and pharyngitis (361), which is 8.51% and 6.47%, respectively, and due to asthma (54), which is 0.97%. It has been observed that from 2017 to 2022 the number of hospitalized patients is constantly increasing due to acute pharyngitis and pneumonia, and from 2018 to 2022 due to acute laryngotracheitis.
CONCLUSIONS
In the analyzed Pediatric Hospital in Bielsko-Biała, the number of hospitalized children (from 0 to 18 years of age) due to pharyngitis, laryngotracheitis and pneumonia increased during the COVID-19 pandemic (2020-2022). The number of hospitalized patients due to pneumonia increased by as many as 70 from 2021 (197) to 2022 (267). In the case of hospitalizations for pharyngitis during the COVID-19 period, the number ranged from 46 in 2019 to 69 in 2022. Also in the case of acute laryngotracheitis in the period 2019-2022, the number of hospitalized young patients increases and ranges from 61 to 76. Respiratory tract infections are an important and common health problem for children. The vast majority of respiratory infections are caused by viruses.
Topics: Humans; Child; Child, Preschool; Infant; Adolescent; Poland; Infant, Newborn; Respiratory Tract Diseases; Hospitalization; Male; Female; Hospitals, Pediatric; Respiratory Tract Infections; Pneumonia; Asthma
PubMed: 38904312
DOI: 10.32394/pe.77.49 -
Przeglad Epidemiologiczny Jun 2024Actinomycosis is a very rare, infectious disease, which is especially difficult to diagnose due to non-specific symptoms and the ability to emulate neoplasms or...
Actinomycosis is a very rare, infectious disease, which is especially difficult to diagnose due to non-specific symptoms and the ability to emulate neoplasms or inflammatory changes. Due to those facts, it is often misdiagnosed or diagnosed too late to be successfully treated. This article presents the case of 31-year-old Caucasian female with recurrent upper respiratory tract infections and tonsillitis as the potential risk factors of actinomycosis. Upon examination of material collected through the course of tonsillectomy, the patient was diagnosed with actinomycosis of the left palatine tonsil. Despite the introduction of antibiotic therapy, initial progression was noted with the appearance of numerous, hypodense changes in the liver and the spleen, which regressed during further antibiotic treatment. According to our team's knowledge, this is the first described case of a patient with actinomycosis occurring simultaneously in the cervico-facial and abdominal area. The unusual localization and potential dissemination of actinomycosis should be considered in clinical practice.
Topics: Humans; Female; Adult; Actinomycosis; Tonsillitis; Anti-Bacterial Agents; Actinomycosis, Cervicofacial; Abdomen
PubMed: 38904308
DOI: 10.32394/pe.77.50 -
Journal of Otolaryngology - Head & Neck... 2024Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life...
A Descriptive Study of Quality of Life Following Neoadjuvant Chemotherapy and Transoral Robotic Surgery for Human Papillomavirus-Associated Oropharyngeal Squamous Cell Carcinoma.
BACKGROUND
Patients with oropharyngeal squamous cell carcinoma (OPSCC) treated with radiation-based therapy suffer from short- and long-term toxicities that affect quality of life (QOL). Transoral robotic surgery (TORS) has an established role in the management of early OPSCC but adjuvant treatment is often indicated postoperatively due to the high incidence of nodal metastasis associated with advanced human papillomavirus (HPV)-related OPSCC. To overcome the need for adjuvant radiation therapy (RT), neoadjuvant chemotherapy followed by TORS and neck dissection (ND) is proposed. This study aimed to assess if QOL in HPV-associated OPSCC receiving neoadjuvant chemotherapy followed by TORS and ND returns to baseline within 12 months of completing treatment.
METHODS
A 12 month longitudinal study was carried out at McGill University Health Centre in Montreal, Canada, among a convenience sample of patients with American Joint Committee on Cancer Seventh Edition stage III and IVa HPV-related OPSCC who were treated with neoadjuvant chemotherapy followed by TORS and ND. QOL data were obtained pretreatment and at 1, 3, 6, and 12 months following treatment completion using the European Organisation for Research and Treatment of Cancer Core and Head and Neck extension modules. Paired tests and mixed models for repeated measures analysis were used to assess changes in QOL from baseline to 12 months postoperatively and over time, respectively.
RESULTS
Nineteen of 23 patients (median age 58 years) who received the study treatment fulfilled the eligibility criteria. OPSCC subsites were palatine tonsil (n = 12) and base of tongue (n = 7). All 19 patients were treated per protocol and none required adjuvant RT as per pathology review and protocol requirements at a postoperative multidisciplinary team tumor board discussion. No significant differences were found when comparing 12 month QOL follow-up scores to pretreatment scores in measures that would likely be affected by RT [eg, swallowing ( = .7), social eating ( = .8), xerostomia ( = .9)].
CONCLUSION
In HPV-related OPSCC, neoadjuvant chemotherapy followed by TORS and ND as definitive treatment is associated with excellent QOL outcomes. Postoperative QOL scores returned to baseline by 3 months and were maintained for all measures, indicating a return to normal function.
Topics: Humans; Quality of Life; Robotic Surgical Procedures; Male; Middle Aged; Female; Oropharyngeal Neoplasms; Neoadjuvant Therapy; Papillomavirus Infections; Aged; Carcinoma, Squamous Cell; Longitudinal Studies; Neck Dissection; Chemotherapy, Adjuvant; Adult; Human Papillomavirus Viruses
PubMed: 38888957
DOI: 10.1177/19160216241248670 -
Cureus May 2024Nasopharyngeal dermoid tumors, or hairy polyps, are rare benign congenital malformations of bigerminal origin with both ectodermal and mesodermal elements. It is often...
Nasopharyngeal dermoid tumors, or hairy polyps, are rare benign congenital malformations of bigerminal origin with both ectodermal and mesodermal elements. It is often seen in the neonatal period and can lead to respiratory distress and/or feeding disorders. Tonsillectomy is defined as a surgical procedure that completely removes the tonsil, including its capsule, by dissecting the peritonsillar space between the tonsil capsule and muscular wall. This case demonstrates a female who was born at Albany Medical Center with no gestational complications. She presented with respiratory distress and increased work of breathing. When examined, she was noted to have a mass that extruded from her oral cavity. The mass was identified as a rare nasopharyngeal dermoid tumor that was peduculated to the left palatine tonsil. Transoral surgery was performed successfully and resulted in the excision of the dermoid tumor and left palatine tonsil, relieving the patient of respiratory distress with no complications. This case documents the rare concurrence of a nasopharyngeal dermoid tumor attached to the left tonsil, indicating the youngest tonsillectomy to date at day three of age. This case subsequently highlights the importance of including dermoid tumors in the differential of neonates experiencing respiratory distress.
PubMed: 38883080
DOI: 10.7759/cureus.60349 -
Cell Communication and Signaling : CCS Jun 2024Mesenchymal stem cells (MSCs) are widely used in the development of therapeutic tools in regenerative medicine. However, their quality decreases during in vitro...
BACKGROUND
Mesenchymal stem cells (MSCs) are widely used in the development of therapeutic tools in regenerative medicine. However, their quality decreases during in vitro expansion because of heterogeneity and acquired cellular senescence. We investigated the potential role of podoplanin (PDPN) in minimizing cellular senescence and maintaining the stemness of tonsil-derived MSCs (TMSCs).
METHODS
TMSCs were isolated from human tonsil tissues using an enzymatic method, expanded, and divided into two groups: early-passaged TMSCs, which were cultured for 3-7 passages, and late-passaged TMSCs, which were passaged more than 15 times. The TMSCs were evaluated for cellular senescence and MSC characteristics, and PDPN-positive and -negative cells were identified by fluorescence-activated cell sorting. In addition, MSC features were assessed in siRNA-mediated PDPN-depleted TMSCs.
RESULTS
TMSCs, when passaged more than 15 times and becoming senescent, exhibited reduced proliferative rates, telomere length, pluripotency marker (NANOG, OCT4, and SOX2) expression, and tri-lineage differentiation potential (adipogenesis, chondrogenesis, or osteogenesis) compared to cells passaged less than five times. Furthermore, PDPN protein levels significantly decreased in a passage-dependent manner. PDPN-positive cells maintained their stemness characteristics, such as MSC-specific surface antigen (CD14, CD34, CD45, CD73, CD90, and CD105) and pluripotency marker expression, and exhibited higher tri-lineage differentiation potential than PDPN-negative cells. SiRNA-mediated silencing of PDPN led to decreased cell-cycle progression, proliferation, and migration, indicating the significance of PDPN as a preliminary senescence-related factor. These reductions directly contributed to the induction of cellular senescence via p16/Rb pathway activation.
CONCLUSION
PDPN may serve as a novel biomarker to mitigate cellular senescence in the clinical application of MSCs.
Topics: Mesenchymal Stem Cells; Humans; Cellular Senescence; Membrane Glycoproteins; Cyclin-Dependent Kinase Inhibitor p16; Palatine Tonsil; Cell Differentiation; Cell Proliferation; Signal Transduction; Cells, Cultured
PubMed: 38867259
DOI: 10.1186/s12964-024-01705-8 -
JMIR Research Protocols Jun 2024Testing for SARS-CoV-2 is essential to provide early COVID-19 treatment for people at high risk of severe illness and to limit the spread of infection in society. Proper... (Randomized Controlled Trial)
Randomized Controlled Trial
Molecular Detection of SARS-CoV-2 From Throat Swabs Performed With or Without Specimen Collection From the Tonsils: Protocol for a Multicenter Randomized Controlled Trial.
BACKGROUND
Testing for SARS-CoV-2 is essential to provide early COVID-19 treatment for people at high risk of severe illness and to limit the spread of infection in society. Proper upper respiratory specimen collection is the most critical step in the diagnosis of the SARS-CoV-2 virus in public settings, and throat swabs were the preferred specimens used for mass testing in many countries during the COVID-19 pandemic. However, there is still a discussion about whether throat swabs have a high enough sensitivity for SARS-CoV-2 diagnostic testing, as previous studies have reported a large variability in the sensitivity from 52% to 100%. Many previous studies exploring the diagnostic accuracy of throat swabs lack a detailed description of the sampling technique, which makes it difficult to compare the different diagnostic accuracy results. Some studies perform a throat swab by only collecting specimens from the posterior oropharyngeal wall, while others also include a swab of the palatine tonsils for SARS-CoV-2 testing. However, studies suggest that the palatine tonsils could have a tissue tropism for SARS-CoV-2 that may improve the SARS-CoV-2 detection during sampling. This may explain the variation of sensitivity reported, but no clinical studies have yet explored the differences in sensitivity and patient discomfort whether the palatine tonsils are included during the throat swab or not.
OBJECTIVE
The objective of this study is to examine the sensitivity and patient discomfort of a throat swab including the palatine tonsils compared to only swabbing the posterior oropharyngeal wall in molecular testing for SARS-CoV-2.
METHODS
We will conduct a randomized controlled study to compare the molecular detection rate of SARS-CoV-2 by a throat swab performed from the posterior oropharyngeal wall and the palatine tonsils (intervention group) or the posterior oropharyngeal wall only (control group). Participants will be randomized in a 1:1 ratio. All participants fill out a baseline questionnaire upon enrollment in the trial, examining their reason for being tested, symptoms, and previous tonsillectomy. A follow-up questionnaire will be sent to participants to explore the development of symptoms after testing.
RESULTS
A total of 2315 participants were enrolled in this study between November 10, 2022, and December 22, 2022. The results from the follow-up questionnaire are expected to be completed at the beginning of 2024.
CONCLUSIONS
This randomized clinical trial will provide us with information about whether throat swabs including specimens from the palatine tonsils will improve the diagnostic sensitivity for SARS-CoV-2 molecular detection. These results can, therefore, be used to improve future testing recommendations and provide additional information about tissue tropism for SARS-CoV-2.
TRIAL REGISTRATION
ClinicalTrials.gov NCT05611203; https://clinicaltrials.gov/study/NCT05611203.
INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)
DERR1-10.2196/47446.
Topics: Humans; Specimen Handling; Pharynx; SARS-CoV-2; COVID-19; Palatine Tonsil; COVID-19 Nucleic Acid Testing; Adult; Male; Sensitivity and Specificity; Female; Randomized Controlled Trials as Topic; Middle Aged; COVID-19 Testing
PubMed: 38865190
DOI: 10.2196/47446 -
Ultrasound in Medicine & Biology Aug 2024Needle biopsy is a common technique used to obtain cell and tissue samples for diagnostics. Currently, two biopsy methods are widely used: (i) fine-needle aspiration...
OBJECTIVE
Needle biopsy is a common technique used to obtain cell and tissue samples for diagnostics. Currently, two biopsy methods are widely used: (i) fine-needle aspiration biopsy (FNAB) and (ii) core needle biopsy (CNB). However, these methods have limitations. Recently, we developed ultrasound-enhanced fine-needle aspiration biopsy (USeFNAB), which employs a needle that flexurally oscillates at an ultrasonic frequency of ∼32 kHz. The needle motion contributes to increased tissue collection while preserving cells and tissue constructs for pathological assessment. Previously, USeFNAB has been investigated only in ex vivo animal tissue. The present study was aimed at determining the feasibility of using USeFNAB in human epithelial and lymphoid tissue.
METHODS
Needle biopsy samples were acquired using FNAB, CNB and USeFNAB on ex vivo human tonsils (N = 10). The tissue yield and quality were quantified by weight measurement and blinded pathologists' assessments. The biopsy methods were then compared.
RESULTS
The results revealed sample mass increases of, on average, 2.3- and 5.4-fold with USeFNAB compared with the state-of-the-art FNAB and CNB, respectively. The quality of tissue fragments collected by USeFNAB was equivalent to that collected by the state-of-the-art methods in terms of morphology and immunohistochemical stainings made from cell blocks as judged by pathologists.
CONCLUSION
Our study indicates that USeFNAB is a promising method that could improve tissue yield to ensure sufficient material for ancillary histochemical and molecular studies for diagnostic pathology, thereby potentially increasing diagnostic accuracy.
Topics: Humans; Palatine Tonsil; Lymphoid Tissue; Biopsy, Fine-Needle; Feasibility Studies; Ultrasonography, Interventional; Image-Guided Biopsy; Epithelium
PubMed: 38834492
DOI: 10.1016/j.ultrasmedbio.2024.04.015 -
Primary Tuberculosis of Tonsils: Interesting Case Detected During the Histopathological Examination.Cureus May 2024Despite being a preventable and curable disease, tuberculosis, which mainly affects the lungs, is still a major cause of illness and death worldwide, with more than one...
Despite being a preventable and curable disease, tuberculosis, which mainly affects the lungs, is still a major cause of illness and death worldwide, with more than one million people dying from it each year. The affliction of the tonsils is uncommon, and isolated tonsillar tuberculosis in the absence of active pulmonary disease is an extremely rare condition that requires early and accurate diagnosis to provide proper management. Microscopic examination is one of the gold-standard tools for diagnosing tuberculosis. However, routine histopathological investigation for tonsillectomy specimens is not justified except in cases of unusual clinical or postoperative presentations. A 20-year-old female patient who experienced recurrent episodes of infections with enlarged tonsils and adenoids and showed a slightly unusual presentation was sent for a histopathology examination. Upon microscopic examination, a caseating granulomatous reaction was found, and staining for acid-fast bacilli tested positive. The patient was treated for tuberculosis of the tonsils, and their condition improved.
PubMed: 38832186
DOI: 10.7759/cureus.59616 -
Turkish Journal of Medical Sciences 2024Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of risk factors for the development of OSA is essential for early...
BACKGROUND/AIM
Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder in children. Determination of risk factors for the development of OSA is essential for early diagnosis and treatment of the disease and decreases the risk of negative consequences. This study aimed to investigate the predictive values of Mallampati score, tonsillar size, and BMI z-score in the presence and severity of OSA in children.
MATERIALS AND METHODS
This prospective cross-sectional study included 114 children with OSA symptoms. All children were assessed by BMI z-score, Mallampati score, and tonsillar size and underwent overnight polysomnography. They were consecutively selected and assigned to 4 groups as follows: Group 1 included normal-weight with a low Mallampati score; Group 2 involved normal-weight with a high Mallampati score; Group 3 included obese with a low Mallampati score; and Group 4 involved obese with a high Mallampati score.
RESULTS
Of the 114 included children, 58 were female and 56 were male, with a mean age of 13.1 ± 2.9 years. OSA frequency and apnea-hypopnea index were significantly higher in group 4 compared with other groups (p = 0.003 and p < 0.0001, respectively), whereas average and minimum spO were significantly lower (for both, p = 0.001). Mallampati score and BMI z-score were found to be significant for predicting OSA (odds ratio = 4.147, 95% CI: 1.440-11.944; p = 0.008 and odds ratio = 1.760, 95% CI: 1.039-2.980; p = 0.035, respectively). Among OSA patients, the Mallampati score, tonsillar size, and BMI z-score were found to be significant for predicting OSA severity (odds ratio = 4.520, 95% CI: 1.332-15.335, p = 0.015, odds ratio = 9.177, 95% CI: 2.513-33.514, p = 0.001, and odds ratio = 2.820, 95% CI: 1.444-5.508; p = 0.002, respectively).
CONCLUSION
The coexistence of the Mallampati score and BMI z-score significantly increases the presence of OSA in children. Mallampati score, tonsillar size, and BMI z-score are promising parameters for predicting OSA severity.
Topics: Humans; Sleep Apnea, Obstructive; Male; Female; Palatine Tonsil; Cross-Sectional Studies; Body Mass Index; Prospective Studies; Child; Adolescent; Severity of Illness Index; Polysomnography; Predictive Value of Tests; Risk Factors
PubMed: 38812649
DOI: 10.55730/1300-0144.5791 -
Frontiers in Immunology 2024Sex-based differences in immune cell composition and function can contribute to distinct adaptive immune responses. Prior work has quantified these differences in...
Sex-based differences in immune cell composition and function can contribute to distinct adaptive immune responses. Prior work has quantified these differences in peripheral blood, but little is known about sex differences within human lymphoid tissues. Here, we characterized the composition and phenotypes of adaptive immune cells from male and female ex vivo tonsils and evaluated their responses to influenza antigens using an immune organoid approach. In a pediatric cohort, female tonsils had more memory B cells compared to male tonsils direct ex vivo and after stimulation with live-attenuated but not inactivated vaccine, produced higher influenza-specific antibody responses. Sex biases were also observed in adult tonsils but were different from those measured in children. Analysis of peripheral blood immune cells from vaccinated adults also showed higher frequencies of tissue homing CD4 T cells in female participants. Together, our data demonstrate that distinct memory B and T cell profiles are present in male vs. female lymphoid tissues and peripheral blood respectively and suggest that these differences may in part explain sex biases in response to vaccines and viruses.
Topics: Humans; Female; Male; Child; Palatine Tonsil; Adult; Influenza Vaccines; Influenza, Human; Sex Characteristics; Child, Preschool; Adolescent; Antibodies, Viral; Memory B Cells; Organ Specificity; Young Adult; Sex Factors; CD4-Positive T-Lymphocytes; B-Lymphocytes; Immunologic Memory
PubMed: 38812520
DOI: 10.3389/fimmu.2024.1373537