1,720,977 research outputs found
Myositis ossificans of the head and neck.
No full textA case of traumatic myositis ossificans circumscripta involving the left sternocleidomastoid muscle occurring in a 52-year-old male patient is reported. This seems to be the first observation to be reported. A review of all cases of myositis ossificans circumscripta in the head and neck areas is made. Problems connected with pathology and clinico-therapeutic approach are dealt with. The pathogenesis of the lesion is also discussed. © 1983 Springer-Verlag
Nasal polyposis pathophysiology: Endotype and phenotype open issues.
No full textPURPOSE:
Endotyping chronic rhinosinusitis with nasal polyps (CRSwNP) poses a challenge for rhinologists nowadays. Phenotyping CRSwNP proved inappropriate as an approach to their classification because of their common clinical features. Endotyping, being based on the pathogenic mechanism, provides a precise picture more appropriate for use in clinical practice. Patients' treatment and follow-up can thus be tailored to cope with the degree of aggressiveness of a specific CRSwNP endotype. The aim of this study was to analyze the available information about the main currently accepted endotypes of CRSwNP; furthermore, we reported and commented evidence regarding some clinical conditions associated with nasal polyposis which could be related with new endotypes.
MATERIALS AND METHODS:
Pubmed and Scopus electronic database were searched. The main available studies about CRSwNP endotyping published predominantly in the last 5 years were critically analyzed.
RESULTS:
The pathophysiological features of some asthma-related CRSwNP (allergic fungal rhinosinusitis, aspirin-exacerbated respiratory disease) are quite well understood, including them among known endotypes of CRSwNP. On the other hand, because of their known pathophysiological mechanisms, some well-known diseases associated with aggressive forms of CRSwNP, such as eosinophilic granulomatosis with polyangiitis, primary ciliary dyskinesia and cystic fibrosis, should be investigated as potentially related with CRSwNP endotypes.
CONCLUSIONS:
CRSwNP comprises several inflammatory endotypes defined by different pathogenic mechanisms. These endotypes correlate with the disease's clinical manifestations and behavior. A thorough understanding of CRSwNP endotypes will enable targeted medical therapies and tailored follow-up protocols
Pre- and postoperative blood neutrophil- and eosinophil-to-lymphocyte ratios in patients with sinonasal polyps. A preliminary investigation.
No full textBackground. Identifying specific endotypes within the broad picture of chronic rhinosinusitis with nasal polyps (CRSwNP), using biomarkers for instance, remains a challenge. The prognostic role of the neutrophil-to-lymphocyte ratio (NLR) and eosinophil-to-lymphocyte ratio (ELR) as potential markers of inflammation has already been discussed.
Objective. The aim of the present study was to compare NLR and ELR before and after endoscopic sinus surgery (ESS) and nasal mometasone furoate for CRSwNP, stratifying patients by their clinical and histological features.
Methods. The study concerned 115 consecutive patients with CRSwNP treated with ESS and nasal mometasone furoate with a postoperative follow-up beyond 12 months. Eosinophilic-type CRSwNP was histopathologically defined after hematoxylin-eosin tissue staining.
Results. In the sub-cohort of patients with histological diagnosis of eosinophilic-type CRSwNP, the mean ELR significantly decreased postoperatively (0.22±0.16 vs 0.18±0.12; p=0.04), while among patients with histological diagnosis of non-eosinophilic-type CRSwNP, the mean NLR significantly decreased after surgery (1.98±0.98 vs 1.90±0.90, p=0.04).
Conclusion. Different CRSwNP endotypes are characterized by different biohumoral patterns. It is reasonable to assume that surgery enables clearance of the polyps and polypoid mucosa reducing the load of antigens triggering the inflammation. Consistently with the above-mentioned biological mechanism, ESS could correspond to a reduction in blood ELR and eosinophil count in eosinophilic-type CRSwNP. The data did not demonstrate an added value of measuring pre- vs post-operative ELR compared to measuring blood eosinophil count. When used after ESS, topical corticosteroids also have more significant anti-inflammatory effects. As for the sub-cohort of patients with non-eosinophilic CRSwNP, the fact that the mean NLR dropped significantly after surgery is definitely an original finding: unlike eosinophilic inflammation, the inflammatory patterns seen in non-eosinophilic CRSwNP are still poorly understood
Blood Eosinophil and Basophil Values Before and After Surgery for Eosinophilic-type Sinonasal Polyps.
No full textBackground Blood eosinophil and basophil levels have recently been considered for the purpose of endotyping chronic rhinosinusitis with nasal polyps (CRSwNP). Histologically, eosinophilic-type CRSwNPs have been associated with high recurrence rates after treatment. Objective The present study was the first to compare blood eosinophil and basophil counts in eosinophilic-type CRSwNP patients before and after endoscopic sinus surgery. Methods The study concerned 79 consecutive patients with histologically confirmed eosinophilic-type CRSwNP treated with endoscopic sinus surgery. Results A significant drop in mean blood eosinophil counts and percentages occurred from before to after endoscopic sinus surgery in the cohort as a whole. Mean blood eosinophil counts and percentages were also reduced after surgery in the subcohorts of CRSwNP patients with (i) asthma, (ii) aspirin-exacerbated respiratory disease (AERD), and (iii) no allergy. Although blood eosinophil and basophil counts correlated directly before and after surgery, a statistical reduction in blood basophil counts and percentages after surgery emerged only in the subcohort of nonallergic CRSwNP patients. Conclusion Endoscopic sinus surgery can clear polyps, remove inflammatory tissue, and reduce inflammatory cytokine levels. Consistently with the biological mechanism described, endoscopic sinus surgery could coincide with a reduction in blood eosinophils in eosinophilic-type CRSwNP
Non-eosinophilic chronic rhinosinusitis with nasal polyps: blood eosinophil, basophil, and neutrophil counts before and after surgery.
No full textObjectives: Research selectively investigating non-eosinophilic chronic rhinosinusitis with nasal polyps (CRSwNP) is lacking. The inflammatory patterns seen in non-eosinophilic CRSwNP are still poorly understood. The present study is the first to compare blood eosinophil, basophil, and neutrophil counts before/after surgery in patients with non-eosinophilic CRSwNP stratified by their clinical features.
Methods: The study concerned 107 consecutive patients with histologically confirmed non-eosinophilic CRSwNP who
underwent endoscopic sinus surgery (ESS).
Results: Statistical analysis ruled out any significant change in mean blood eosinophil, basophil, and neutrophil counts after ESS. A significant positive correlation emerged between blood eosinophil and basophil counts in both pre- and post- ESS laboratory tests. In the subcohort of allergic patients, a significant negative correlation was found after ESS between eosinophil and neutrophil levels and between basophil and neutrophil levels.
Conclusions: In eosinophilic CRSwNP, ESS can clear polyps, remove inflammatory tissue, and reduce the inflammatory cytokines it generates, with a consequent reduction in blood eosinophil levels. The different results in non-eosinophilic CRSwNP support the conviction that the 2 types of CRSwNP are entities with distinct inflammatory response patterns
Cortactin expression in nasal polyps of Aspirin-Exacerbated Respiratory Disease (AERD) patients.
No full textPURPOSE:
The term aspirin-exacerbated respiratory disease (AERD) refers to a combination of asthma, chronic rhinosinusitis with nasal polyposis (CRSwNP), and acute respiratory tract reactions to nonsteroidal anti-inflammatory drugs. AERD has now been included among the CRSwNP endotypes, and is considered one of the most aggressive in terms of disease recurrence. Cortactin is a multi-domain protein with a part in several cellular mechanisms involving actin assembly and cytoskeleton arrangement. Cortactin seems to have a role in inflammatory responses and to be implicated in human airway secretion and contraction mechanisms. The novel aim of the present study was to examine cortactin expression in nasal polyps of a consecutive cohort of AERD patients and in nasal mucosa of a control group of patients.
MATERIALS AND METHODS:
Cortactin expression was assessed immunohistochemically in nasal polyps from 18 consecutive AERD patients who underwent endoscopic sinus surgery and in nasal mucosa of 19 patients without chronic rhinosinusitis.
RESULTS:
Concomitant allergy was found in 11 AERD patients, most of them male (8 cases; p = 0.02). Cortactin expression in nasal polyps was definitely high (+3) in 17 out of 18 cases, in both epithelial cells (cytoplasmic and membranous immunoreactivity) and activated fibroblasts. A higher cortactin expression was seen in female than in male AERD patients (p = 0.05).
CONCLUSIONS:
Given this preliminary evidence of cortactin upregulation in the polyps of AERD patients, prospective studies could further investigate the role of cortactin in the biology of AERD, and the potential role of cortactin-targeted approaches in integrated AERD treatments
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