1,721,020 research outputs found
Evidence of unexpected oxidative stress in airways of adolescents born very preterm.
No full textPrematurity and its main respiratory complication, bronchopulmonary dysplasia (BPD), are potentially associated with lifelong respiratory morbidities and/or lung function abnormalities. The mechanisms behind these long-term respiratory problems are still unclear.
We assessed airway oxidative stress in adolescents born very preterm (≤ 32 gestational weeks) by measuring 8-isoprostane concentration in the exhaled breath condensate (EBC). In addition, the study protocol included spirometry and measuring nitric oxide in the exhaled air (FeNO).
The study groups included 34 ex-preterm adolescents with BPD, 18 ex-preterm adolescents without BPD, and 34 healthy controls born at term.
Regardless of a history of BPD, the ex-premature adolescents had higher EBC 8-isoprostane levels [BPD: 9.5(7.3–12.2); preterm non-BPD: 10(8.1–16) pg·mL−1)] than the controls [3.2(1.9–6.5) pg·mL−1] (p<0.001). FEV1 was lower in the BPD group [Z-score:−2.1(1.58)] than in the preterm non-BPD individuals [−1.13(1.15)], who showed in turn significantly lower values than the controls [0.18(0.83); p<0.001]. FeNO was similar in the 3 groups (p=0.55).
Our data show that, after premature birth, evidence of oxidative stress in the airways may be detected into adolescence, suggesting that long-term respiratory abnormalities after preterm birth may be associated with an ongoing airway disease and not just a stabilized structural lung damage
CD105- and CD31-assessed microvessel density in laryngeal carcinoma biopsies as a predictor of recurrence after exclusive primary surgery
No full textPurpose: Surgery is currently indicated as a unimodal therapeutic approach with curative intent in selected laryngeal squamous cell carcinomas (LSCCs) ranging from stage I to III. The main aim of this study was to evaluate the prognostic role of CD105- and CD31-assessed microvessel density (MVD) in biopsy and in surgical specimens from a cohort of consecutive stage I-III LSCCs who had undergone exclusive primary surgery, according to current guidelines. Materials and methods: CD105- and CD31-assessed MVD were analyzed in paired biopsies and surgical specimens of 24 consecutive cases of LSCC who underwent exclusive surgery. Results: On biopsy specimens, CD105- and CD31-assessed MVD were positively associated with recurrence risk (hazard ratio [HR] 1.266, p = 0.0034 and HR 1.265, p = 0.0081, respectively). In surgical specimens, CD105- and CD31-assessed MVD were significantly associated with disease-free survival (DFS) (HR 1.213, p = 0.0016 and HR 1.237, p = 0.0023 respectively). Considering a stratification based on median value, recurrence risk was higher in patients with a CD105-assessed MVD>0 in both biopsies and surgical specimens (HR 11.005, p = 0.0326 and HR 34.483, p = 0.0311). No significant differences in terms of recurrence risk were found for CD31-assessed on biopsies or on surgical specimens. Conclusions: This study supports the role of biopsy CD105-MVD as a predictor of recurrence after exclusive surgery for LSCCs. Further prospective studies are mandatory to better characterize the prognostic role of CD105-MVD evaluated on biopsies to develop novel criteria to identify patients at higher risk of recurrence for more aggressive approaches or adjuvant treatment
Prevalence of drug and polydrug abuse in drunk drivers. Possible implications in the driving license regranting system
No full textUnderlying substance abuse in drunk drivers. Lack of a uniform toxicological protocol in assessing fitness to drive.
No full textBlood eosinophilic and basophilic trends in recurring and non-recurring eosinophilic rhinosinusitis with nasal polyps
No full textBackground: Very few studies have compared blood eosinophil and basophil levels before and after surgery in patients with
eosinophilic CRSwNP (eCRSwNP). No investigations seem to have repeatedly measured them pre- and postoperatively in
eCRSwNP patients with recurring versus non-recurring disease to examine how their levels evolved.
Objective: Hence this study to analyze blood eosinophil and basophil levels in patients with eCRSwNP immediately before
surgery and afterwards, at 4months, 1 year, and then yearly up to 5 years.
Methods: Fifty-one eCRSwNP patients were enrolled, who all had preoperative laboratory data and the results of at least 4
of the 6 scheduled postoperative follow-up tests.
Results: Seventeen patients had recurrent disease. Blood eosinophil counts (p1⁄40.005) and percentages (p1⁄40.002) were
both higher in these patients than in those whose eCRSwNPs did not recur after surgery. Blood basophil counts (p1⁄40.04)
and percentages (p<0.05) were also significantly higher in patients whose eCRSwNPs relapsed. The time by relapse
interaction was not significant for either counts or percentages, though an effect of time was detected for basophil
counts (p1⁄40.01).
Conclusions: In eCRSwNP, the statistical analysis of repeated quantitative laboratory data can shed light on the evolution of
a patient’s systemic inflammatory picture in response to previous treatments, and above all to long-term therapies. Longterm
monitoring of blood eosinophil and basophil levels could be of significant value when monoclonal antibodies that inhibit
IL signaling will widely enter in clinical practice for eCRSwNP treatment to follow the effectiveness of therapy over time
Angiogenesis, programmed death ligand 1 (PD-L1) and immune microenvironment association in laryngeal carcinoma.
No full textIn the specific field of laryngeal carcinoma (LSCC), evidence
about the interaction between angiogenetic
pathway and immune microenvironment has not yet been
explored. Given the potential relevance of such an interaction
for prognostic and therapeutic purposes, the main
aim of this exploratory study was to investigate the existence
of a correlation between angiogenesis (quantified
through CD31 expression), programmed cell death ligand
1 (PD-L1) expression, and immune microenvironment. A
secondary aim was to verify whether considering a combination
of angiogenesis and immune microenvironment
variables might improve prognostic accuracy compared to
the traditional clinical-pathological prognostic tools.
CD31-assessed micro-vessel density (MVD), PD-L1 in
terms of combined positive score (CPS), and tumour
infiltrating lymphocytes (TILs) were assessed on 45
consecutive cases of LSCC.
Cox proportional hazards model revealed increasing
CD31-assessed MVD values, PD-L1 CPS <1, and TILs
count rate <30%, as predictive of reduced disease free
survival (DFS). Multivariate analysis found that MVD
(p<0.0001) and TILs (p=0.0420) retained their significant
independent prognostic value. Spearman’s correlation
model disclosed a significant negative correlation between
CD31-assessed MVD values and PD-L1 CPS (p=0.0040).
PD-L1 CPS and TILs count rate were positively correlated
(p<0.0001). DFS was significantly lower in the CD31-
assessed MVD >7, PD-L1 CPS <1, TILs <30% group
than in the MVD 7, PD-L1 CPS 1, TILs 30% group
(p=0.0001).
These data preliminarily support an integrated interpretation
of the prognostic role or angiogenesis and immune
microenvironment markers in LSCC. This is of potential
clinical relevance suggesting a synergistic effect of the
combination of anti-angiogenic drugs with programmed
death-1/PD-L1 checkpoint inhibitors in advanced LSCC
Facial nerve sacrifice in lateral approaches to the skull base: Simultaneous reconstruction by graft interposition.
No full textPurpose: To evaluate the outcome of facial nerve (FN) cable graft interposition in lateral skull base surgery.
Materials and methods: A group of 16 patients who underwent FN graft interposition procedure was retrospectively considered. Postoperative FN function was evaluated using the House-Brackmann (HB) grading
system, the Sunnybrook Facial Grading System (SFGS), the Facial Disability Index (FDI) and the Oral Functioning Scale (OFS) questionnaires.
Results: 56.2% of patients had a good postoperative FN outcome (HB grade II-III). Postoperative electromyography (EMG) showed re-innervation potentials in 60% of patients; median age of these patients was significantly lower compared to who did not manifest re-innervation (p = 0.039).
Conclusion: FN primary reconstruction remains the advisable rehabilitative option when the nerve is interrupted during lateral skull base surgeries, allowing to satisfactory postoperative results in more than half of patients. EMG confirmed the restoring of nerve conduction and it was more frequent in younger patients. The
SFGS, the FDI and the OFS are important tools especially in the setting of a rehabilitation program
Sulfurous-arsenical-ferruginous thermal water nasal inhalation and irrigation in children with recurrent upper respiratory tract infections: clinical outcomes and predictive factors
No full textPurpose: Recurrent upper respiratory disorders (RURD) are among the most common problems diagnosed
in pediatric otolaryngology practice. Although several preliminary studies have demonstrated beneficial
effects of thermal water inhalations for RURD, inhalation of thermal water has not been included among
validated management protocols. The effects of sulfurous-arsenical-ferruginous thermal water nasal irrigations
have been confirmed also in prospective, randomized studies. The main aim of this explorative, retrospective,
observational study has been to compare the clinical outcome in pediatric patients with RURD
treated with sulfurous-arsenical-ferruginous thermal water inhalation versus combined inhalation and
nasal irrigation.
Methods: Two hundred and fifty-three pediatric patients with RURD were considered; 231 underwent
thermal water inhalations (inhalation of hot humid air and aerosol) only, while 22 underwent nasal irrigations
combined with inhalations. Subjective overall efficacy perception and treatment tolerability
were scored as categorical variables (from 0 = no efficacy/worst tolerability to 3 = maximal efficacy/
best tolerability).
Results: Nasal obstruction, sneezing, serous, mucous, and purulent rhinorrhea, cough, and snoring improved respectively
in 80.2%, 72.9%, 79.0%, 93.8%, 92.3%, 64.8%, and 60.4% of patients referring these symptoms at
presentation, respectively. No statistically significant differences between inhalations alone and combined inhalations
and irrigations emerged. The median overall efficacy perception score was 2 while the median treatment
tolerability score was 3.
Conclusions: This investigation found that sulfurous-arsenical-ferruginous water treatment was a welltolerated
therapeutic option for selected pediatric patients with RURD. These promising preliminary results
should be confirmed in prospective, randomized, double-blind settings, also using minimally invasive
but objective and quantitative evaluation methods
acute surgical removal of low-grade (Spetzler-Martin I-II) bleeding arteriovenous malformations
No full textTumor-Stroma Ratio and Programmed Cell Death Ligand 1 expression in preoperative biopsy and matched laryngeal carcinoma surgical specimen.
Full text linkProgrammed cell death ligand 1 (PD-L1) seems to rely on close relations between neoplastic and immune cells in the tumor microenvironment. Tumor to stroma ratio (TSR) has been associated with prognosis in different malignancies. The aims of this exploratory investigation were to analyze for the first time the: (i) association between TSR, PD-L1 expression and other clinical–pathological features in laryngeal squamous cell carcinoma (LSCC) biopsies and paired surgical specimens; (ii) prognostic and predictive role of TSR and PD-L1. TSR, PD-L1 expression (in terms of combined positive score [CPS]), and other clinical–pathological features were analyzed in biopsies and surgical specimens of 43 consecutive LSCC cases. A CPS < 1 evaluated on surgical specimens was associated with a low TSR (stroma rich) on both biopsies and surgical specimens (p = 0.0143 and p = 0.0063). Low TSR showed a significant negative prognostic value when evaluated on both biopsies and surgical specimens (HR = 8.808, p = 0.0003 and HR = 11.207, p = 0.0002). CPS ≥ 1 appeared to be a favorable prognostic factor (HR = 0.100, p = 0.0265). The association between bioptic and surgical specimen TSR and PD-L1 expression should be further investigated for a potential impact on targeted treatments, also with regard to immunotherapeutic protocols
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