Laryngitis Research Articles

Association of Sinonasal Factors With Chronic Laryngitis in Korean Adults

Allergic laryngitis is underdiagnosed owing to overlapping clinical manifestations that arise from other causes of laryngitis. Sinonasal conditions associated with chronic laryngitis, including allergic laryngitis, have not been reported using population-based epidemiologic data. To estimate the association of the prevalence of chronic laryngitis with various sinonasal symptoms and endoscopic findings, and to identify which of the sinonasal factors are particularly associated with allergic cause of chronic laryngitis. This cross-sectional, population-based study of 11 283 participants 18 years and older who had undergone laryngoscopic and nasal endoscopic examination used data from 2010 through 2012 in the fifth edition of the Korea National Health and Nutrition Examination Survey, a nationwide survey of South Korea. Participants were extracted by stratified, multistage, clustered sampling to comprise a nationally representative sample. Data were analyzed in September 2017. Sociodemographic characteristics, smoking status, alcohol use, questionnaires for voice change and sinonasal symptoms, and nasal endoscopic examinations before and after shrinkage of the nasal mucosa. Chronic laryngitis diagnosed by laryngoscopic examination, and allergic cause of laryngitis determined by specific serum immunoglobulin E tests. Of the 11 283 participants included in the study, the mean (SD) age was 50.1 (16.6) years, and 6365 (56.4%) were women. In total, 343 participants (3.0%) were diagnosed with chronic laryngitis through results of laryngoscopic examination. Chronic laryngitis was associated with a higher rate of rhinitis symptoms (odds ratio [OR], 1.54; 95% CI, 1.21-1.96), anterior/posterior nasal drip (OR, 2.03; 95% CI, 1.38-2.98), nasal congestion (OR, 1.49; 95% CI, 0.99-2.25), endoscopic findings of pale mucosa (OR, 1.74; 95% CI, 1.33-2.28), mucous or puslike discharge (OR, 1.53; 95% CI, 1.08-2.18), and puslike discharge in the middle meatus (OR, 1.85; 95% CI, 1.19-2.88), especially in female participants and participants older than 50 years. Subgroup analysis revealed that all participants with allergic laryngitis showed sensitization to Dermatophagoides farinae, and the allergic laryngitis group (n = 9) had a higher presence of rhinitis symptoms (n = 5; 56%) than did the nonallergic laryngitis group (n = 1 of 12; 8%) among participants younger than 50 years (risk difference, 47%; 95% CI, 4%-78%). The association of various sinonasal factors with chronic laryngitis were prominent in female participants, as well as those 50 years and older. Nevertheless, the presence of rhinitis symptoms in patients with chronic laryngitis was associated with allergic cause of laryngitis solely in participants younger than 50 years. In young adults, presence of rhinitis symptoms might aid in considering allergic laryngitis.

Acute supraglottic laryngitis complicated by vocal fold immobility: prognosis and management.

Acute supraglottic laryngitis (ASL) is manifested by supraglottic inflammation that has the potential for rapid and fatal airway obstruction. Complete/incomplete vocal fold immobility (VFIm) in the setting of ASL may contribute to airway obstruction. The rate of VFIm complicating ASL is not known, and it is not clear whether its occurrence alters the course and the management of ASL, particularly the need to secure the airway (by endotracheal intubation/tracheostomy). This study seeks to describe the natural history of VFIm associated with ASL (ASLIm) and to determine the added effect of VFIm on ASL severity, management, and the need for intervention to secure the airway. This is a retrospective cohort study in a tertiary referral center. The medical records of all patients hospitalized due to ASL between January 2007 and December 2016 were reviewed. Of the 214 patients admitted due to ASL, VFIm was identified in 9 (4.2%). The VFIms resolved within 1-90days in all 8 patients with available follow-up of 1-3months. One patient required endotracheal intubation. The 9 ASLIm patients had significantly higher rates of hoarseness and a history of diabetes mellitus. There was no group difference in the need to secure the airway. VFIm is an apparently uncommon finding among patients with ASL. It appears to be usually transient, short-lasting, and full recovery can be expected. VFImdid not alter the ASL course, nor did it put our patients at increased risk for the need for intervention to secure the airway. 4.

Laryngeal sarcoidoisis – a case report

Introduction. Sarcoidosis is a multi-organ disease characterized by noncaseating granulomas. The lesions are usually localized within the lungs and hilar lymph nodes. The sarcoidosis of the upper respiratory tract (SURT) rate is estimated at 0.5-6%. The involvement of the larynx is extremely rare - it occurs in 1.2% of cases of SURT. Materials and methods. We present a case of a patient with laryngeal sarcoidosis. Results. A 48-year-old man had had a diagnosed of dysphonia for 5 years. A diagnosis of chronic hypertrophic laryngitis was made. Empirical course of methylprednisolone was attempted with a short-term improvement. Due to coexisting skin lesions, he was diagnosed with allergy. Chest CT showed moderately enlarged mediastinal and hilar lymph nodes as well as bilateral nodules around the hila. The bronchial biopsy showed no granulomas. Samples taken during microlaryngoscopy revealed sarcoid infiltrates. Conclusions and discussion. There is no unambiguous test confirming the diagnosis of sarcoidosis. It is a typical example of a diagnosis by exclusion. Laryngeal involvement is extremely rare and occurs in 1.2% of cases of SURT. The clinical course of the disease is often difficult to predict. In many patients, the lesion may undergo spontaneous regression. In patients poorly responding to steroid therapy or developing side effects, cytotoxic drugs may be considered.

Influence of TNF-α on the immunomodulatory property of laryngeal mucosa mesenchymal stromal cells'

Objective: To investigate the effect of tumor necrosis factor-alpha(TNF-α)on the immunoregulatory capacity of laryngeal mucosal mesenchymal stromal cells (LM-MSCs) and its potential molecular mechanism, and provide a theoretical basis for the study of chronic laryngitis. Methods: LM-MSCs were separated from epiglottal mucosa. The LM-MSCs cells were directly co-cultured with T cells in vitro to detect the immunomodulatory property of LM-MSCs. After long-term stimulation with inflammatory factors TNF-α in vitro, the differences were compared in the immunomodulatory ability of LM-MSCs between normal LM-MSCs and TNF-α stimulated LM-MSCs. The expression of general control non-repressed protein5(GCN5), FAS, FASL in normal LM-MSCs and TNF-α stimulated LM-MSCs was detected by Western blot and quantitative real-time RT-PCR(RT-qPCR). Results: After chronic stimulation of TNF-α, the RNA relative expression of GCN5 was 0.31±0.03 (3 days) and 0.53±0.06 (7 days) compared with control group, showing significant difference (F=13.45, P<0.05). The percentage of LM-MSC-induced T cell apoptosis was 6.27%±0.81% (3 days) and 4.99%±0.52% (7 days) in chronic stimulation group compared with control group 10.02%±1.02%. There is a significant difference among these groups (F=11.13, P<0.05). Moreover, the ability of LM-MSCs to induce T cell apoptosis is regulated by GCN5. Conclusion: With the chronic stimulation of TNF-α, the expression of GCN5 in LM-MSCs is decreased, thus impairing its immunoregulatory capacity.

Современный подход к диагностике хронического ларингита

The timely detection and treatment of chronic hypertrophic laryngitis is a task of particular importance, it is the main link in the prevention of malignant diseases of the larynx. The traditional diagnostic methods do not always provide proper assessment of the state of the larynx in chronic laryngitis and the dynamics of recovery processes during therapeutic activities. Therefore, the combined use of modern methods of examination of the larynx condition is getting more and more important. Based on examination of 15 men and 5 women aged from 24 to 72 years previously treated for chronic hypertrophic laryngitis, it has been shown that video stroboscopy, autofluorescence diagnostics, NBI endoscopy, and cytological examination of swabs from the affected vocal fold areas are methods of early diagnostics of chronic hyperplastic laryngitis, they can complement each other not only in the event of diagnostic difficulties, but in the assessment of efficacy of treatment and rehabilitation measures aimed at restoration of laryngeal functions and prevention of the development of tumors. The data obtained made it possible to clarify the nature of the hypertrophic changes in the mucous membrane of the vocal folds and thereby confidently interpret the clinical picture of the disease in the examined patients as a manifestation of chronic hyperplastic laryngitis with leukokeratosis and leukoplakia.

Acute and chronic laryngitis in the subjects engaged in the voice and speech professions

Laryngitis is one of the commonest causes of dysphonia in the subjects engaged in the voice and speech professions. This condition can be either associated with the professional activities or related to voice fatigue. It is a common practice to distinguish between acute and chronic forms of occupational laryngitis. The main factors responsible for development of both conditions include the non-observance of directions concerning the protection and hygiene of the speaking and singing voice. The present study included 478 (100%) subjects engaged in the voice and speech professions presenting with the diagnosis of acute or chronic occupational laryngitis who applied for medical assistance to our Phoniatric Care Department. The clinical state of their larynx was evaluated with the use of the videoendostroboscopic technique. Acute laryngitis was diagnosed in 103 (21.5%) of the examined subjects while the remaining 375 (78.5%) ones presented with chronic laryngitis. A characteristic feature of acute occupational laryngitis documented in 38 (36.9%) examined professional voice users with this condition (practically healthy in all other respects) was the development of this disorder as a result of overloading the speech organs. On the contrary, viral and/or bacterial laryngitis revealed in 65 (63.1%) of the patients was preceded by acute respiratory symptoms. A total of 62 (16.5%) patients suffered from chronic occupational laryngitis attributable to overloading of the organs of speech during protracted periods. The remaining 313 examined professional voice users were found to present with various forms of chronic laryngitis including catarrhal laryngitis in 175 (46.7%) of them, edematous-polypoid and atrophic forms in 32 (8.5%) and 19 (5.1%) subjects respectively. The main etiological factors underlying the development of all the tree forms of chronic laryngitis were smoking, chronic tonsillitis, gastroesophageal reflux disease, bronchial asthma, and diabetes mellitus.

Laryngeal manifestation due to smoking among the pediatric age group – Our experiences at an Indian teaching hospital

Background and Aim: Smoking among the pediatric age group is a public health concern. It has direct link to laryngeal manifestations. Due to increased exposure to smoking, it is affecting the children directly or indirectly through involving upper airway, particularly the larynx. In this study, we explored the effect of cigarette smoking in laryngeal manifestations among the pediatric age group. Materials and Methods: It is a retrospective study conducted at a tertiary care teaching hospital of eastern India between December 2017 and June 2019. There were 112 pediatric patients between the age of 5 and 16 years with complaints of hoarseness of voice. Out of 112, 32 (28.57%) had history of exposure to cigarette smoking. All the children of this study underwent a careful and detailed general and physical examinations and local examinations such as the ear, nose, and throat. All the children were also subjected to videolaryngoscopy for the assessment of the larynx. Results: The majority of the children with smoking habit were male (59.37%). The most common diagnosis among children with smoking habit was laryngopharyngeal reflux (LPR) (40.62%) followed by chronic laryngitis (25%), vocal fold keratosis (18.75%), Reinke's edema (12.50%), and malignancy (3.12%). All these laryngeal lesions were treated appropriately. LPR and chronic laryngitis were treated with conservative medications and speech therapy. Vocal fold keratosis and Reinke's edema were treated with microlaryngeal surgery and conservative treatment. Conclusion: Smoking has adverse effect on the larynx in the pediatric age group. It has an impact to alter the structural changes in the vocal folds. Speech therapy, vocal hygiene, and absolute cessation of the smoking are ideal treatment for pediatric dysphonia due to the effect of smoking.

Laryngeal assessment of patients with rheumatoid arthritis using laryngeal photodocumentation

Objective The aim was to assess the prevalence of dysphonia and laryngeal changes upon videolaryngoscopic examination of patients with rheumatoid arthritis (RA). Background RA effects on larynx vary from mild asymptomatic effect to life-threatening conditions. Many authors have emphasized the need of studies in different communities on its effect. In Egypt, the knowledge regarding its manifestations on the larynx, as well as its laryngeal alterations, is limited. Patients and methods A total of 79 patients diagnosed as having RA in Menoufia University Hospitals from March 2015 to March 2017 were assessed by taking history and asking about different laryngeal complaints followed by telescopic videolaryngeal examination. Results The estimated prevalence of laryngeal complaints in patients with RA was 57%. The most frequent complaints were globus pharyngeus in 53.2% of patients followed by phonasthenic symptoms in 32.9% of the patients. Dysphonia prevalence was 25.3%. Regarding videolaryngoscopic findings, the prevalence of changes was present in 86.15% of the patients. Most common finding has been posterior laryngitis, which was found in 78.5% of patients, followed by glottic gap in 34.2% and vocal folds rheumatoid nodules in 26.6% of them. Conclusion Laryngeal complaints and videolaryngoscopic morphological findings are prevalent among patients with RA, with a prevalence rate of 57 and 86.15%, respectively. The most frequent complaints were globus pharyngeus in 53.2% of patients followed by phonasthenic symptoms in 32.9% of the patients. Most common videolaryngoscopic findings have been posterior laryngitis, which was found in 78.5% of our patients, followed by glottic gaps in 34.2%.

Outliers Treatment to Improve the Recognition of Voice Pathologies

Abstract In some of the processes used in data analysis, such as the recognition of pathologies and pathological subjects, the presence of anomalous instances in the dataset is an unfavorable situation that can lead to misleading results. This article presents a function that implements the identification of anomalies in dataset using the boxplot and standard deviation methods. Also was used the filling technique to treat these anomalies, in which the anomalous point value were substituted by a limit value determined by the boxplot or standard deviation methods. To improve the outliers methods some normalization processes based on the z-score, logarithmic and squared root methodologies were experimented. These outliers treatment were applied to the dataset used in the recognition of vocal pathologies (dysphonia, chronic laryngitis and vocal cords paralysis vs control), performed by a MLP and LSTM neural networks. After the experiments, both the standard deviation and the boxplot methods with z-score normalization showed very useful for pre-processing the dataset for voice pathologies recognition. The accuracy was improved between 3 and 13 points in percentage.

Клинико-диагностический алгоритм работы врача-оториноларинголога с профессионалами голоса

Diagnosis and treatment of larynx diseases in voice professionals are an important task of otorhinolaryngology. 244 voice professionals have visited Phoniatric Department of Saint Petersburg Research Institute of Ear, Throat, Nose and Speech. The condition of larynx was assessed by videoendolaryngoscopic and videoendolaryngostroboscopy methods. Larynx pathology was found in 212 patients, 32 persons were healthy. The main causes of dysphonias were the continuous vocal stress, work in sick condition, the diseases of endocrine, gastroduodenal, respiratory, neural system. 77 patients with voice disorders were diagnosed with functional dysphonia, 61 patients – with acute or chronic laryngitis. The cause of hoarseness in 46 persons were the vocal fold nodules, and in 28 patients – the vocal fold polyps. The article describes the clinical manifestations of pathological changes of the larynx. Based on the studied voice disorder etiological factors and clinical picture of the larynx, the authors developed a clinical and diagnostic algorithm of otorhinolaryngologist’s work with voice professionals.

Эффективность гомеопатического лекарственного препарата в комплексном лечении острого обструктивного ларингита у детей

Эффективность гомеопатического лекарственного препарата в комплексном лечении острого обструктивного ларингита у детей

Importance of timely diagnosis of diseases of the larynx during initial examination performed by an otorhinolaryngologist

Diagnosis and treatment of diseases of the larynx in patients with dysphonia are an urgent task of modern otorhinolaryngology. The reason for this is the constant growth of professions with high requirements for voice quality. The modern methods of diagnosis in diseases of the larynx are based on endoscopic diagnostic techniques. The article provides detailed description of the clinical and endoscopic signs of functional and organic diseases of the larynx that are significantly more prevalent in voice professionals: hypotonic and hypo-hypertonic functional dysphonia, soft and hard vocal fold nodules, acute and chronic occupational laryngitis, and vascular pathology of vocal cords. The article presents the main approaches to the treatment of diseases of the larynx, including using the drug Homeovox. The article will be useful to the otorhinolaryngologists of the outpatient network to establish the diagnosis and assign а therapy to the voice and speech professionals.

Occupational diseases as resalt of overstrain of some bodies and systems.

In the article a scries of occupational diseases, which are according to the etiological classification, arise from overstrain of some bodies and systems are submitted. In the presented publication the author focuses on the series of occupational diseases resulted from the overstrain of separate bodies and systems which are insufficiently widely displayed in publications on a professional pathology due to their insufficient distribution until this time. Today a series of them get the increasing urgency, taking into account specificity of modern operating conditions. This became the basic purpose of the work performed. The important problem in modern conditions is significant psyhoemothional loading on the organism of workers, work with video-display terminals and pressure of the voice apparatus. Physical loading on separate bodies and systems in conditions of modern automation has a smaller value, but also takes place in modern conditions. In the article selective data concerning several groups or separate diseases presented in etiological classification of occupational diseases are resulted. The rest of them are presented in previous publications of the author, listed in reference list. Specification concerning professional neuroses, shortsightedness, phonasthenia, chronic laryngitis, nodular and contact ulcers on the voice folds, emphysema of lungs, metroptosis uterine prolapse and coloptosis are submitted. The basic concepts concerning the reasons of occurrence, clinical picture, diagnostics, differential diagnostics, preventive maintenance and working capacity examination in these diseases are considered. The data concerning the forecast, establishment of the link of the disease with occupation are resulted also.

ОСОБЕННОСТИ ТЕЧЕНИЯ РЕСПИРАТОРНОЙ МИКСТ-ВИРУСНОЙ ИНФЕКЦИИ У ЖЕНЩИН ВО ВТОРОМ ТРИМЕСТРЕ БЕРЕМЕННОСТИ ПРИ ВНУТРИУТРОБНОМ ИНФИЦИРОВАНИИ ИХ НОВОРОЖДЕННЫХ С ЦЕРЕБРАЛЬНОЙ ИШЕМИЕЙ

Clinical and serological features of the gestational process in 85 women with pregnancy, uncomplicated and complicated with parainfluenza-influenza infection in the second trimester of gestation, were studied. All examined women were divided into three groups. The first group (control) included 32 women with physiological course of pregnancy and their healthy full-term newborns. The second group included 32 patients with respiratory mixed-virus infection in the second trimester of gestation, and in their newborns there was diagnosed moderate cerebral ischemia and no signs of intrauterine infection. The third group included 21 women with respiratory mixed virus infection in the second trimester of pregnancy, which was the cause of antenatal infection in their full-term infants with cerebral ischemia of moderate severity. It was shown that the women of the third group compared with the second and first groups often complained of headache, photophobia, sweating and weakness, increase in body temperature to 37.6-38ºC, hoarseness of the voice, sore throat, as well as a prolonged course of acute nasopharyngitis and acute laryngitis. The above clinical features of acute respiratory viral infection in women in the second trimester of gestation may contribute to antenatal infection and may disrupt optimal conditions for intrauterine brain development in their babies.

ARE THE PERSISTENT SYMPTOMS TO PROTON PUMP INHIBITOR THERAPY DUE TO REFRACTORY GASTROESOPHAGEAL REFLUX DISEASE OR TO OTHER DISORDERS?

Gastroesophageal reflux disease (GERD) is a clinical condition that develops when the reflux of stomach contents causes troublesome symptoms and/or complications. Transient lower esophageal sphincter relaxation is the main pathophysiological mechanism of GERD. Symptoms and complications can be related to the reflux of gastric contents into the esophagus, oral cavity, larynx and/or the lung. Symptoms and other possible manifestations of GERD are heartburn, regurgitation, dysphagia, non-cardiac chest pain, chronic cough, chronic laryngitis, asthma and dental erosions. The proton pump inhibitor (PPI) is the first-choice drug and the most commonly medication used for the treatment of GERD. The most widespread definition of Refractory GERD is the clinical condition that presents symptoms with partial or absent response to twice-daily PPI therapy. Persistence of symptoms occurs in 25% to 42% of patients who use PPI once-daily and in 10% to 20% who use PPI twice-daily. The objective is to describe a review of the current literature, highlighting the causes, diagnostic aspects and therapeutic approach of the cases with suspected reflux symptoms and unresponsive to PPI. Initially, the management of PPI refractoriness consists in correcting low adherence to PPI therapy, adjusting the PPI dosage and emphasizing the recommendations on lifestyle modification change, avoiding food and activities that trigger symptoms. PPI decreases the number of episodes of acid reflux; however, the number of "non-acid" reflux increases and the patient continues to have reflux despite PPI. In this way, it is possible to greatly reduce greatly the occurrence of symptoms, especially those dependent on the acidity of the refluxed material. Response to PPI therapy can be evaluated through clinical, endoscopic, and reflux monitoring parameters. In the persistence of the symptoms and/or complications, other causes of Refractory GERD should be suspected. Then, diagnostic investigation must be initiated, which is supported by clinical parameters and complementary exams such as upper digestive endoscopy, esophageal manometry and ambulatory reflux monitoring (esophageal pH monitoring or esophageal impedance-pH monitoring). Causes of refractoriness to PPI therapy may be due to the true Refractory GERD, or even to other non-reflux diseases, which can generate symptoms similar to GERD. There are several causes contributing to PPI refractoriness, such as inappropriate use of the drug (lack of patient adherence to PPI therapy, inadequate dosage of PPI), residual acid reflux due to inadequate acid suppression, nocturnal acid escape, "non-acid" reflux, rapid metabolism of PPI, slow gastric emptying, and misdiagnosis of GERD. This is a common cause of failure of the clinical treatment and, in this case, the problem is not the treatment but the diagnosis. Causes of misdiagnosis of GERD are functional heartburn, achalasia, megaesophagus, eosinophilic esophagitis, other types of esophagitis, and other causes. The diagnosis and treatment are specific to each of these causes of refractoriness to clinical therapy with PPI.

SEX &amp; AGE-WISE DISTRIBUTION AND CAUSES OF DYSPHONIA IN CHILDREN

Background: Dysphonia is common in children due to which they suffer adversely both at home and at school. The objectives of this study were to determine the sex &amp; age-wise distribution and causes of dysphonia in children. Materials &amp; Methods: This descriptive cross-sectional study was conducted at the Department of ENT and Head &amp; Neck surgery, Hayatabad Medical Complex, Peshawar, Pakistan from January 1, 2017 to December 31, 2018. Sample size consisted of 72 patients presenting with chronic dysphonia, selected using the non-probability consecutive sampling technique Inclusion criteria were children presenting with dysphonia for more than 4 weeks. Exclusion criteria were children with stammering, puberphonia, acute respiratory distress, deaf mutism, speech articulation and increased or decreased nasal twang in voice. The demographic variables were sex and age groups and research variables were causes of dysphonia. All variables except age being categorical were analyzed by frequency and percentages carried out using SPSS 16.0 for windows. Results: Mean age of the sample of patients was 8.78+3.6 with range of 12 years (3-15). Out of 72 patients, 44(61.11%) were boys and 28(38.89%) girls with boy to girl ratio of 1.57:1. Chronic nonspecific laryngitis was the commonest etiology followed by reflux laryngitis. Functional dysphonia was noted only in girls and vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were noted only in boys. Conclusion: Chronic nonspecific laryngitis and reflux laryngitis were the commonest causes especially in males less than 9 years of age. Vocal nodules, vocal hematoma and post traumatic laryngeal stenosis were found only in boys and functional dysphonia was noted only in adolescent girls.

Molecular features of head and neck squamous cell carcinoma

Relevance.To identify new markers of early diagnosis and prognosis of head and neck squamous cell carcinoma (HNSCC) it is necessary to study the molecular features of this disease.Purpose.The aim of the study was to analyze blood serum protein spectrum in patients with HNSCC and in healthy volunteers using the methods of mass spectrometry and to evaluate the selected serum protein markers as candidates for early detection of HNSCC.Materials and Methods: The blood serum of HNSCC patients before therapy with metastases, without metastases and healthy volunteers was studied by proteomic methods. Validation of the results of proteomic analysis was carried out by ELISA in serum of 52 patients with HNSCC (T1-4N0-3M0), 10 patients with chronic hyperplastic laryngitis, dysplasia DII-DIII and 10 healthy volunteers. The statistical analysis was carried out using Statistica 6.0. Software package.Results.Blood serum proteome of HNSCC patients with metastases, without metastases and healthy volunteers are different and contain proteins of different classes. Adenylyl cyclase-associated protein 1 (CAP1) and protein phosphatase 1B (PPM1B) were selected to validate the obtained results. It was shown that the serum level of CAP1 and PPM1B differed in control and dysplasia groups and dysplasia and cancer groups (p ≤ 0,05). In patients with HNSCC (T1N0M0) the serum CAP1 and PPM1B levels were higher than in patients with dysplasia and healthy individuals (p ≤ 0,05). It was noted the positive correlation of the CAP1 level in the serum with the presence of metastases and the PPM1B level.Conclusion.Candidates for serum markers of HNSCC prognosis were identified. The difference in serum levels of CAP1 and PPM1B depending on the prevalence of primary tumors and the difference in serum level of CAP1 depending on the presence of regional metastases was shown. Determination of CAP1 level in the serum can be useful for early diagnosis and prognosis of HNSCC.

Misdiagnosis experience of laryngeal carcinoma with acute laryngitis as the first symptom

Misdiagnosis experience of laryngeal carcinoma with acute laryngitis as the first symptom

Use of a national identification database to determine the lifetime prognosis in cattle with necrotic laryngitis and the predictive value of venous pCO2.

BackgroundNecrotic laryngitis, caused by Fusobacterium necrophorum, frequently requires surgical intervention (laryngostomy) in the chronic stage.Hypothesis/ObjectivesTo determine survival until slaughter of cattle surgically treated for necrotic laryngitis and to identify predictors of mortality.AnimalsA total of 221 cattle diagnosed with necrotic laryngitis by laryngoscopy and surgically treatedMethodsRetrospective cohort study. Clinical records were matched with the national cattle identification, registration, and movement database. Information on possible predictors including clinical examination, biochemistry, and surgery was collected. A multivariable Cox proportional hazard model was used to identify predictors of mortality.ResultsThe overall survival rate was 65.2% and 58.6% of the animals with a completed life cycle could be slaughtered. Animals <6 months old experienced significantly higher mortality risk (hazard ratio [HR], 2.0; 95% confidence interval [CI], 1.1‐3.5). The venous partial pressure of carbon dioxide (pCO2; HR, 2.4; 95% CI, 1.4‐4.2) at a 64.5 mm Hg cut‐off was most significantly associated with mortality. Sensitivity and specificity of the final model consisting of age and pCO2 were 49.1 and 86.4%, respectively. Instead of pCO2, total carbon dioxide (TCO2) could also be used, with similar diagnostic accuracy.Conclusions and Clinical RelevanceThe lifetime prognosis for chronic necrotic laryngitis in cattle with surgical intervention appears fair. Age, venous pCO2 and TCO2 are easily accessible predictors of survival to support owners and veterinarians in their decision process of whether or not to operate and to identify high risk animals that require more intensive follow‐up.

Coarse particles and hospital admissions due to respiratory diseases in children. An ecological time series study.

Exposure to particulate matter (PM) is associated with hospitalizations due to respiratory diseases among children. An ecological time series study was carried out to identify the role of coarse fractions of particulate matter (PM10-2.5) in hospitalizations among children up to 10 years of age, in Piracicaba (SP) in the year 2015. A generalized additive model of Poisson regression was used to estimate the risk of hospitalization due to acute laryngitis and tracheitis, pneumonia, bronchitis, bronchiolitis and asthma. Lags of 0 to 7 days were considered, and the model was adjusted for the temperature and relative humidity of the air and controlled for short and long-term exposure. Proportional attributable ratios, population-attributable fractions and hospital costs were calculated with increasing concentrations of these pollutants. 638 hospitalizations were evaluated during this period, with a mean of 1.75 cases per day (standard deviation, SD = 1.86). The daily averages were 22.45 µg/m3 (SD = 13.25) for the coarse fraction (PM10-2.5) and 13.32 µg/m3 (SD = 6.38) for the fine fraction. Significant risks of PM10-2.5 exposure were only observed at lag 0, with relative risk (RR) = 1.012, and at lag 6, with RR = 1.011. An increase of 5 µg/m3 in the coarse fraction concentration implied an increase in the relative risk of hospitalizations of up to 4.8%, with an excess of 72 hospitalizations and excess expenditure of US$ 17,000 per year. This study showed the impact of coarse-fraction exposure on hospital admissions among children due to respiratory diseases.