Nasopharyngeal Region Research Articles

Spatial distribution and risk assessment of toxic metals in agricultural soils from endemic nasopharyngeal carcinoma region in South China

Abstract Sihui city (South China) is much affected by nasopharyngeal carcinoma (NPC). To investigate the relationships between the toxic metals in soil and NPC incidence in Sihui, 119 surface soil samples were collected from agricultural fields and analyzed. The soil As–Cr contents in Longjiang (high-incidence area) are significantly lower than those in Weizheng and Jianglin (low-incidence areas), whereas the soil Pb content in Longjiang is significantly higher than that in Weizheng. The Nemerow pollution indices (PIN) of soils decrease in the order of Jianglin > Weizheng > Longjiang. The enrichment factor (EF) of Cd indicates that the Cd enrichment is contributed by human activities. Potential toxic metal-related ecological risk values decrease in the order of Jianglin > Weizheng > Longjiang. The mean hazard index (HI) value of Longjiang was lower than those of Weizheng and Jianglin. There are no adverse noncarcinogenic health effects of soil toxic metals to adults in the study areas. Carcinogenic risks of As and Cr via ingestion and dermal contact and total carcinogenic risk are within the warning range, from 10−6 to 10−4. Hence, we suggest that toxic metals in the soil may not be major geochemical carcinogenic factors of high NPC incidence in Sihui.

JA:2021-20. Source Attribution of MRSA Exposure and Carriage among Dairy Workers

ABSTRACT Purpose: Dairy farmers experience a heavy burden of bioaerosol-related respiratory ailments. Bioaerosols are known to contain inflammagens (specifically endotoxin), and a diverse bacterial community that is associated with upper respiratory inflammation and pulmonary decrement among workers. However, identifying casual agents (beyond endotoxin) is still an area that warrants further research. Industrialization and modernization of the dairy industry has led to dramatic changes in production, work organization, and tasks. Consequently, exposure patterns have been altered. Recently, we demonstrated that the mass of dairy bioaerosols is predominantly present in particle size ranges that span 10–100 μm in aerodynamic diameter; these are known to deposit in the upper respiratory system (i.e., the nasopharyngeal region). The nose contains complex bacterial communities, and this microbiome may play a role in the inflammatory response to bioaerosols. Recently, the nasal microbiome in dairy farmers was shown to contain over two times the bacterial diversity (and abundance) as compared to non-farmers. It is believed that this diversity is protective against the colonization of methicillin-resistant Staphylococcus aureus (MRSA). In contrast, persistent nasal carriage of MRSA, specifically livestock-associated strain, has been demonstrated in swine production workers. Recent evidence shows an increase in soft tissue infections caused by livestock associated (LA)-MRSA among at risk populations. The objective of this research was to characterize the presence and carriage of Staphylococcus spp. with a focus on LA-MRSA in the nose of dairy workers. Methods: We collected nasal lavage samples before and after each shift across 5 consecutive days. The presence of MRSA in each sample was evaluated using culture-based methods, specifically tryptic soy agar, mannitol salt agar, Chromagar Staph Aureus, and Chromagar MRSA II. Antibiotic sensitivity was conducted using Kirby Disc Diffusion method using tetracycline, vancomycin, and cefoxitin. Further genetic MRSA confirmation is to be accomplished using PCR and MALDI-TOF. Results/Findings: To date, up to 4% of participants were identified to be carriers of MRSA, and up to 16% of participants were identified to be carriers of Staphylococcus aureus. Based on the results from selective media, the MRSA is attributed to mixed sources, including livestock. Confirmation of these isolates will be conducted using matrix-assisted laser desorption/ionization time-of-flight and polymerase chain reaction methods. Practical application: Based on previous pilot studies and initial results, further investigation into LA-MRSA prevalence among dairy workers is needed to help inform control strategies.

JA:2021-6. Effectiveness of a Low-cost Intervention: Changes to Cytokines and Microbiome among Bioaerosol Exposed Dairy Workers

ABSTRACT Purpose: Livestock workers experience an increased burden of bioaerosol-induced respiratory disease. We have previously demonstrated that dairy operations generate bioaerosols spanning the inhalable size fraction. These aerosols contained complex bacterial communities and inflammagens. Because those particles with an aerodynamic diameter between 10 and 100 μm are known to deposit in the nasopharyngeal region, we believe that exposure health outcomes in the upper respiratory tract are important and need consideration, especially in the context of the nasal microbiome (i.e., collection of bacterial communities suggested to play a key role in health and disease). Methods: We evaluated the effectiveness of a hypertonic saline nasal lavage in reducing inflammatory responses in dairy workers from a high-volume dairy operation. We collected inhalable personal breathing zone (PBZ) samples and pre-/post-shift nasal lavage samples from each participant over five consecutive days. The treatment group (n = 5) received hypertonic saline, while the control group (n = 5) received normotonic saline. PBZ samples were analyzed for particulate concentrations and endotoxin using gravimetric and enzymatic methods, respectively. Pro- and anti-inflammatory cytokines (i.e., IL-8, IL-10, and TNF-α) were measured from nasal lavage samples using a multiplex assay. To measure the air and nasal microbiomes, lavage and dust samples were analyzed using 16S rRNA sequencing. Results/Findings: Inhalable dust concentrations ranged from 0.15 to 1.9 mg/m3. Significant differences in pro-inflammatory cytokines were observed between treatment and control groups for IL-6. Contrary to the hypothesis, IL-6 concentrations were higher in the treatment group than the control group. However, the treatment group had significantly higher IL-10 (anti-inflammatory) concentrations than the control group. Distinct bacterial communities were observed in pre- and post-shift lavage samples, with post-shift communities more closely resembling those found in dust samples. Practical Implications: Based on pilot results, the intervention was successful in upregulating anti-inflammatory cytokines and promoting changes in the nasal microbiome. Therefore, more research is warranted to determine if a hypertonic nasal rinse is an effective intervention that does not cause adverse perturbations to the microbiome.

Determining a sampling regime for PCR detection of respiratory tract viral infection at coronial post-mortem examinations

Death due to respiratory infection is commonly encountered at autopsy. With only one opportunity to obtain samples for identification of a causative agent, it is important to ensure that sampling regimes are optimized to provide the greatest detection, without the expense and redundancy that can arise from over-sampling. This study was performed retrospectively using data from Coronial autopsies over the period 2012–2019 from which swabs from the nasopharyngeal region, trachea and lung parenchyma, in addition to samples of lung tissue, had been submitted for multiplex PCR detection of respiratory pathogens. From 97 cases with all four samples, there were 24 with at least one positive result for viral infection. Some cases had multiple positive results and a total of 27 respiratory tract viruses were identified, of which rhinovirus, influenza A virus and respiratory syncytial virus were the most common. Seventeen of the 27 viral infections (63%) were identified in all four samples. However, in nearly all cases (96%) the nasopharyngeal swab detected the infective agent when the multiplex PCR panel had detected infection in any of the four sample types. A nasopharyngeal swab is considered to be an optimal sample for detection of respiratory tract viral infection. As the samples analyzed were acquired before the appearance of the COVID-19 virus, the applicability of this finding for COVID-19 screening is not established.

CORRELATION OF KI67 LEVEL TO METASTATIC EVENTS IN NASOPHARYNGEAL CARCINOMA

Introduction
 Nasopharyngeal carcinoma (KNF) is a malignant squamous cell tumor occurring in the nasopharyngeal epithelial region where the cuboid epithelium is transformed into squamous cells. One of the typical signs of malignancy is uncontrolled cell proliferation. K67 is an immunohistochemical (IHC) test to assess cell proliferation activity. Increased Ki67 expression is associated with increased mitotic activity in cell proliferation.
 Objective
 To determine the correlation of ki67 expression to regional and distant metastases events of nasopharyngeal carcinoma at KNF in Dr. Mohammad Hoesin Palembang.
 Methods
 This cross-sectional study was conducted on 31 subjects of KNF patients who had been diagnosed in Oncology Division of Department of Ear Nose and Throat Head Neck Surgery, then performed immunohistochemistry inspection of KI67 in Department of Anatomical Pathology of Dr. Mohammad Hoesin Palembang. The subjects were collected consecutive sampling from October to December 2017 and performed other tests for staging such as computer tomography, chest x ray and abdominal ultrasound.
 Results
 In the Ki67 level correlation analysis of the incidence of metastasis in nasopharyngeal carcinoma, the correlation coefficient was 0.98 with very strong correlation strength and the positive correlation was not statistically significant (p=0.599). However, in Ki67 level correlation analysis of histopathology result of nasopharyngeal carcinoma was found correlation coefficient of 0.385 and positive correlation which was statistically significant (p=0.032).
 Conclusion
 Ki67 levels of metastatic occurrence in nasopharyngeal carcinoma have no statistically significant correlation. However, Ki67 level on histopathological results of nasopharyngeal carcinoma and Ki67 immunoreactivity with primary tumor has a statistically significant correlation.

Pharyngeal metastasis following living-donor liver transplantation for hepatocellular carcinoma: a case report and literature review

BackgroundThe most common sites of recurrence after liver transplantation for hepatocellular carcinoma (HCC) have been reported to be the liver, lung, bone, and adrenal glands, but there have also been many reports of cases of multiple recurrence. The prognosis after recurrence is poor, with reported median survival after recurrence of HCC ranging from 9 to 19 months. Here, we report a case of long-term survival after recurrence of pharyngeal metastasis following living-donor liver transplantation (LDLT) for HCC within the Milan criteria, by resection of the metastatic region and cervical lymph node dissection.Case presentationA 47-year-old man with a Model End-stage Liver Disease (MELD) score of 11 underwent LDLT for HCC within the Milan criteria for liver cirrhosis associated with hepatitis B virus infection, with his 48-year-old elder brother as the living donor. One year and 10 months after liver transplantation, he visited a nearby hospital with a chief complaint of discomfort on swallowing. A pedunculated polyp was found in the hypopharynx, and biopsy revealed HCC metastasis. We performed pharyngeal polypectomy. Two years later, cervical lymph node metastasis appeared, and neck lymph node dissection was performed. Although recurrence subsequently occurred three times in the grafted liver, the patient is still alive 12 years and 10 months after recurrence of pharyngeal metastasis. He is now a tumor-free outpatient taking sorafenib.ConclusionIt is necessary to recognize that the nasopharyngeal region is a potential site of HCC metastasis. Prognostic improvement can be expected with close follow-up, early detection, and multidisciplinary treatment, including radical resection.

Source apportionment of size-segregated atmospheric particles and the influence of particles deposition in the human respiratory tract in rural and urban locations of north-east India

Aerosol samples were collected using eight stage non-viable Andersen cascade impactor at three urban and two rural sites in north-east India during 2018 covering three seasons i.e., winter, summer and monsoon. The size-segregated samples collected in the selected locations were carefully analysed in terms of deposition in human respiratory tract using inhalation and deposition curves. Seasonal variation of fractional deposition of particulate matter (PM) in human respiratory tract was observed. For example, during winter, in one of the urban sites i.e., S3 (0.61) the maximum deposition was in Pulmonary (P) region, while in the case of other sites, the maximum deposition was in Nasopharyngeal (NOPL) region. Regional deposition in P was high in S1 and S3 when compared with other sites. Vehicular emissions was dominant in both S1 and S3 in P, while biomass burning being dominant in S3 which could be the reason for maximum deposition in P. Positive matrix factorization (PMF) revealed five to eight factors at each individual site in NOPL, tracheobronchial (TB) and P regions: biomass burning (accounting for 7–32% of PM), coal combustion (14–27%), construction dust (9–25%), dust emissions (17–28%), industrial emissions (12–26%), oil refinery (18%), secondary aerosols (17–33%) and vehicular emissions (12–39%). Dominant sources in urban and rural areas were vehicular emissions and dust emissions, respectively. Therefore, the present study highlights the importance of analyzing source apportionment of PM at ultrafine scale and forms a basis upon which the future air quality studies and mitigation strategies can be formulated in this region.

Perspectives in HPV Secondary Screening and Personalized Therapy Basing on Our Understanding of HPV-Related Carcinogenesis Pathways.

As cervical cancer is one of the most common malignancies in women worldwide even with present screening methods, the incidence in most developed countries is not decreasing for the last 15-20 years. A shift has been observed in the age of diagnosis in favour of younger women, and treatment of already developed cervical cancer is a challenge for surgeons. It is imperative to find new diagnostic methods for accurately pointing out patients at high risk of developing malignant disease and developing personalized treatment. Since cervical cancer is almost exclusively associated with HPV infection, understanding changes happening in an infected cell may prove invaluable for search of such methods, but it may also prove helpful in the diagnosis and treatment of other anogenital and nasopharyngeal region cancers. This review follows HPV-related changes in infected cell biology to point what potential markers and targets for therapy are in option when dealing with HPV-related diseases.

Development, validation and application of a 3D printed model depicting adenoid hypertrophy in comparison to a Nasoendoscopy

BackgroundThe exploration of tridimensional (3D) technology of computational tomography and the development of valid 3D printed models may improve the assessment of adenoid obstruction. The identification of an enlarged adenoid in childhood would streamline the referral of appropriately selected cases to an otolaryngologist, leading to early treatment of affected children when indicated. The objective of this study is to validate the use of a 3D printed model depicting adenoid hypertrophy based on the pediatric otolaryngologist, head and neck surgeon (OHNS) participants assessment.MethodsA cross-sectional study was performed to develop and validate 3D depictions, including print-outs, of the nasopharynx including different degrees of Adenoidal Hypertrophy (AH). The print-outs were obtained from 14 Cone-beam computed tomography (CBCT) scans of 14 children (12 boys, 2 girls; mean age of 10.61 years) representing grades 1, 2, 3, and 4 nasopharyngeal adenoidal obstructions, according to a previously Nasoendoscopy-graded (NE) classification by a licensed OHNS. The prevalence of AH in this study was 36%. Two OHNS were recruited to assess the print-outs representing two different representations of the nasopharyngeal airway, the lumen (LU) and adenoid mass (AD). LU and AD were visualized in 2D - pictures- and in 3D – printed prototypes. Intraclass correlation was used to assess intra- and inter-reliability. The validity of our depictions was analyzed through comparison (accuracy and correlation) to the reference standard (NE). The data were clustered to calculate the sensitivity (Se), specificity (Sp), positive predictive value (PPV), and negative predictive value (NPV). Cross-tab and Pearson’s T-test were performed.ResultsOverall, the 3D depiction tools showed different diagnostic capabilities. AD representations showed strong (AD 2D, 75%) to almost perfect (AD 3D, 88%) accuracy compared to NE. Excellent sensitivity and specificity were observed for the AD 3D (100, 70%), as well as adequate PPV and NPV (66 and 97% respectively), with only 5% of false-negative cases.ConclusionThe use of Dolphin software for the acquisition of a 3D printed prototype of the nasopharyngeal adenoidal region seems promising. These prototypes may be a practical and readily available alternative for the assessment of the nasopharyngeal obstructed area. CBCT in children must be taken under strong solid indications. Early referral to an OHNS for a full assessment remains the main objective in children with unclear symptoms.

Virom/SARS-CoV2 interakcija - upražnjeno mesto za prirodne komponente

One of the most striking marks of infection caused by the SARS-CoV-2 is the distinguishing heterogeneity of the clinical presentations in a population that varies from asymptomatic to severe forms. Pandemic proportion brings into the foreground the number of people with severe forms of the disease, putting aside the fact that a large portion of the population is an asymptomatic, making them silent carriers of the virus. Additional confusion is made by inconsistent data about the presence of the virus in the nasopharyngeal region and the manifestation of the disease symptoms. Different tissue distribution of virus in the body starting from guts, liver, muscles, kidney etc. without any signs of tissue destruction, opens up the possibility that individuals with negative results of PCR test in the nasopharyngeal swab may also be latent carriers of the infection. Overall clinical presentation of the disease is influenced by the initial protection gained through the accumulated "experience" collected from previous encountering of corona family and noncorona viruses, resulting in overlapping of the humoral and cellular immunity. Apart from this, unjustifiably neglected but very significant form of host defense against infection is disease tolerance based on cohabitation with pathogen. It is important to note that consequences of the disease tolerance in terms of pathological and epidemiological aspects are quite different then classical antiviral immune response. This work will elaborate the impact of virome on the course of infection at all stages taking into account both immune resistance, as an ability of the host immune system to eliminate pathogen, and disease tolerance, as a form of host defense with neutral to positive impact to pathogen load. Also, in accordance with the above mentioned, the potential of naturally occurring compounds to profile the course of infection and to support currently available protocols for COVID-19 treatment was discussed.

Nanoparticles in toner material

Printer toner is a material in everyday life. It is a cheap material which is distributed by many companies. Each printer and copier require specific toner material. Therefore, differences in the consistence occur concerning the size and chemical composition of the toner particles. They are known as microscaled objects which are made up of nanoparticles. The first goal of this investigation was to determine the material composition as well as the size, the shape and the possible crystallinity of the particles from three different toner materials (distributed by Hewlett-Packard, Lyreco and Epson) to turn one’s attention whether these nanoparticles can be taken for scientific investigations instead of carrying out sophisticated preparation procedures. It was found that cheap toner material can be used to obtain crystalline $$\hbox {SiO}_2$$ nanoparticles with a size of about 10–20 nm using the investigated toner material from HP and Lyreco. With benzene as solvent, they are agglomerated to particles of about 200–400 nm. Using n-hexane one gets single nanoparticles without agglomeration. Additionally, amorphous carbon nanoparticles can be gained with a size of approximately 80 nm using the toner powder from Epson. A further goal was directed to give more information concerning possible health hazards due to the use of printers and copiers which emit particle dust coming from the toner. Due to that particulate pollution inspiration can result in inflammatory processes in the lung up to lung cancer. Additionally, nanoparticles can have a toxic effect within cells and be mutagenic. For all three toner materials, the particles without dissolving show a diameter of about $$10~\upmu \hbox {m}$$ . Therefore, most of these particles should remain in the nasopharyngeal region without reaching the alveolar region.

SUN-288 Severe Growth Hormone Deficiency in a 13-Year-Old Girl with Congenital Eye Anomalies, Secondary to Transsphenoidal Encephalocele

Background: Transphenoidal encephaloceles are very rare with estimated incidence of 1 in 700,000 live births. They can be associated with pituitary hormonal deficiencies, facial midline defects or eye anomalies. Lack of feeding problems, respiratory difficulties and/or characteristic facies can lead to delayed diagnosis to adolescence or adulthood. Clinical Case: a 13 year old female was referred for evaluation of short stature. She had history of left microophthalmia, congenital coloboma, persistent hyperplastic primary vitreous (PHPV), and subsequent enucleation. She had no other congenital anomalies. She described some discomfort of left eye prosthesis. No headache or nasal symptoms. She maintained height around 2%tile (Z= -2.09) until the age of 6 yrs with subsequent slowing to less than 1%tile (Z= -2.49). She slowed down further (Z= -2.66) over the last year despite showing pubertal changes including breast and pubic hair development. Weight was around 27% tile (Z= - 0.61) until the age of 10 yrs with subsequent acceleration up to 54%tile (Z= 0.10) at time of presentation, despite healthy diet and scheduled physical activities. On physical exam, she was overweight (BMI 91%tile, Z= 1.25), positive left eye prosthesis, no other congenital anomalies, and Tanner stage III breasts/pubic hair. Bone age was normal at 13 years 6 months. IGF-1 level was low for pubertal stage at 183 ng/ml with normal IGFBP-3 of 4.61 mg/l. Other pituitary hormonal studies were completely normal. Peak growth hormone level was only 1.3 ng/ml on Arginine-Glucagon tolerance test. Brain MRI showed considerable deformity of sella turcica with encephalocele extending through the inferior and anterior aspects into the nasopharyngeal region. Pituitary gland was flattened and deformed by the encephalocele. Pituitary stalk was partially visualized, with inferior coursing of optic chiasm and optic nerves. Conclusions: Pituitary hormonal deficiencies including growth hormone have been described rarely in association with transphenoidal encephaloceles and congenital eye anomalies, typically “morning glory” anomaly of optic disc. Transphenoidal encephalocele and subsequent pituitary dysfunction should be considered early when a child with any eye congenital anomaly presents with short stature/growth failure, even without other midline/facial abnormalities or symptoms.

Bioaerosols Play a Major Role in the Nasopharyngeal Microbiota Content in Agricultural Environment.

Background: Bioaerosols are a major concern for public health and sampling for exposure assessment purposes is challenging. The nasopharyngeal region could be a potent carrier of long-term bioaerosol exposure agents. This study aimed to evaluate the correlation between nasopharyngeal bacterial flora of swine workers and the swine barns bioaerosol biodiversity. Methods: Air samples from eight swine barns as well as nasopharyngeal swabs from pig workers (n = 25) and from a non-exposed control group (n = 29) were sequenced using 16S rRNA gene high-throughput sequencing. Wastewater treatment plants were used as the industrial, low-dust, non-agricultural environment control to validate the microbial link between the bioaerosol content (air) and the nasopharynxes of workers. Results: A multivariate analysis showed air samples and nasopharyngeal flora of pig workers cluster together, compared to the non-exposed control group. The significance was confirmed with the PERMANOVA statistical test (p-value of 0.0001). Unlike the farm environment, nasopharynx samples from wastewater workers did not cluster with air samples from wastewater treatment plants. The difference in the microbial community of nasopharynx of swine workers and a control group suggest that swine workers are carriers of germs found in bioaerosols. Conclusion: Nasopharynx sampling and microbiota could be used as a proxy of air sampling for exposure assessment studies or for the determination of exposure markers in highly contaminated agricultural environments.

Antibacterial Effect of Zinc Oxide Nanoparticles on Group A β-Hemolytic Streptococci with Macrolide Resistance Isolated from University Student Carriers in North of Iran

Background: The increase in the resistance of group A β-hemolytic streptococci (GABHS) to antibiotics is considered as a serious threat to human health. Objectives: The current study aimed at determining the antimicrobial effect of zinc oxide nanoparticles (ZnONPs) on the growth of erythromycin-resistant GABHS harboring mef gene isolated from university student carriers. Methods: The study was conducted on 100 healthy students from Islamic Azad University, Gorgan Branch. Specimens were collected from the nasopharyngeal region using sterile swab. After biochemical tests to identify GABHS, resistance to various antibiotics was determined using agar disk diffusion test (the Kirby-Bauer method). The minimum inhibitory concentration (MIC) of erythromycin was also determined by broth micro-dilution test. The macrolide resistance gene (mefA) was identified by polymerase chain reaction (PCR) using specific primers, and the antibacterial properties of ZnONPs were evaluated by agar-well diffusion method. The data were analyzed by chi-square and ANOVA tests (P < 0.001). Results: In the current study, the frequency of GABHS carriers was reported 11%. The highest amount of bacterial resistance was correlated with erythromycin with the frequency of 45.4%. Also, 91% of the isolated streptococci were susceptible to cefazolin, followed by cefalexin (82%), penicillin (73%), and amoxicillin (46%). Besides, 43% of the erythromycin-resistant isolates had the MIC of ≥ 1 µg/mL. From the five isolates resistant to erythromycin, 60% harbored the mefA gene. The results of agar-well diffusion test showed that 40% of the strains, which were resistant to erythromycin and harbored mefA gene, were inactivated in the concentration of 50 mg/mL of ZnONPs, and the rest were also inactivated in the concentration of 100 mg/mL. Conclusions: The ZnONPs used in the current study had a high antimicrobial activity against all GABHS isolates that were resistant to erythromycin. It was revealed that the bactericidal property increased upon increasing the concentration of the nanoparticles.

FDG-PET/CT for diagnosis and follow-up of necrotizing (malignant) external otitis.

Imaging is important for the diagnosis and follow-up of necrotizing external otitis (NEO). The best imaging modality is controversy. To suggest 2-deoxy-2-[fluorine-18] fluoro-D-glucose-positron emission tomography/computed tomography (18F-FDG-PET/CT) as an alternative to technetium-99m and gallium-67 scans for diagnosis and assessment of response to treatment for patients with NEO. Case series. Tertiary referral center. From 2013 through 2017, 12 patients were diagnosed with NEO based on clinical features and positive FDG uptake within the temporal bone on PET/CT. Mean age was 74 ± 11.5; 83% of the patients were male; and 83% had diabetes. PET/CT scans were reviewed independently by two nuclear medicine specialists. Imaging located osteomyelitis in external ear canal, mastoid, temporomandibular joint, and nasopharyngeal region (100%, 50%, 16%, 8%, respectively). Mean follow-up was 16 months. Eight patients (67%) underwent a second PET/CT scan after active otitis resolved and after at least 6 weeks of antibiotic treatment. The scan demonstrated no or substantially reduced FDG uptake and treatment was stopped. The patients had no NEO symptoms at the end of follow-up. One patient had significant uptake, and antibiotic treatment was continued until a third scan demonstrated no FDG uptake. Two patients died before the second PET/CT, and two were lost to follow-up. 18F-FDG-PET/CT is a reliable imaging modality for diagnosis, disease localization, and decision making regarding treatment cessation. 18F-FDG-PET/CT should be considered as the imaging modality of choice for initial diagnosis and follow-up in NEO patients. Larger, controlled studies are warranted. 4 Laryngoscope, 129:961-966, 2019.

Environmental and Life-Style Related Risk Factors for Sinonasal and Nasopharyngeal Malignancies among a Prospective Cohort in Jos, Nigeria.

Background Worldwide evidence indicates that environmental and life-style related factors are associated with increased risk for cancers in the head and neck region. We aim to study the association between these risk factors and cancers in the sinonasal and nasopharyngeal regions in our environment. Methods Longitudinal prospective cohort study at the Jos University Teaching Hospital, Jos, Nigeria. Risk exposures were classified based on the International Agency for the Research on Cancer (IARC) classification of suspected carcinogens. Associations between variables were analyzed using logistic regression. Results We studied 44 patients with malignancies in nasopharynx (n= 24; 54.5%) and sinonasal regions (n= 20; 45.5%). Male to female ratio is 1.9:1 and mean age is 45.2 years. Alcohol was the commonest risk factor in males (n= 19; 43.2%) while cooking wood fumes were the commonest in females (n= 14; 31.8%) which was associated with increased risk for malignancies for all sites, showing ten times risk in nasal cancers (OR= 9.67; 95% CI 1.87- 9.88; p= 0.01). Tobacco was associated with elevated risk of malignancies in the nasomaxillary and nasal regions. Other risks were herbicides, pesticides, and chemical fertilizers in farmers. Conclusion The significant risk exposures in females were cooking wood fumes and alcohol, tobacco, and exposure to agricultural chemicals in males. Life-style modification and environmental changes to ensure clean air in Nigeria are essential to reduce risks.

Assessment of otological and audiological status in patients of allergic rhinitis

&lt;p class="abstract"&gt;&lt;strong&gt;Background:&lt;/strong&gt; Allergic rhinitis (AR) is a type-I hypersensitivity reaction of the nasal mucosa to the airborne allergens, primarily mediated by immunoglobulin E (IgE) characterized by nasal obstruction, watery rhinorrhea, sneezing and itching at the nose, palate and nasopharyngeal region. Various studies have been done to study the relationship between middle ear afflictions and allergic rhinitis and majority of them incriminate nasal allergies as a probable factor to the development of otitis media.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Methods:&lt;/strong&gt; A total of 70 patients, affected by allergic rhinitis, were recruited for the study after fulfilling the inclusion and exclusion criteria. Complete audiological work up including tympanometry studies was performed. Patients’ data was then compiled and analyzed using statistical analyses. &lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Results:&lt;/strong&gt; It was observed that disease is more common in age group of 21 to 30 years. 63% patient had perennial allergic rhinitis and rest 37% had seasonal allergic rhinitis. Otoscopic examination of the participants revealed that abnormal tympanic membrane findings such as retracted, congested, bulged and dull TM is more common in PAR than SAR. Hearing impairment is more common in PAR than SAR. Tympanometry study showed that in PAR ‘B’ type of tympanogram was found in 20% cases and ‘C’ type curve was found in 19% cases while in SAR these value were 4% and 8% respectively.&lt;/p&gt;&lt;p class="abstract"&gt;&lt;strong&gt;Conclusions:&lt;/strong&gt; Allergic rhinitis whether seasonal or perennial adversely affect the eustachian tube functions which in turn may lead to increased incidence of middle ear effusion and otitis media. Diagnosis and proper management of allergic rhinitis is the key to avoid these middle ear diseases.&lt;/p&gt;

Infection and pathological lesions of lymph nodes induced by Linguatula serrata nymphs in one-humped camels in Iran

Linguatula serrata (Pentastomida: Linguatulidae) known tong-worm is a cosmopolitan, zoonotic, and obligate endoparasite. The parasite lives in the nasopharyngeal region of the final hosts, which primarily include dogs and other carnivores. Various herbivores, including, camels serve as the best intermediate hosts for nymph stages. In present study the mesenteric lymph nodes of 101camels were examined for infection to L. serrata macroscopically and histopathologically. The infected and normal lymph nodes were processed for histopathology. The results indicated that out of 101 sampled 33 (32.67%) were infected. Macroscopic examination revealed that the infected lymph nodes are swollen and dark, with rubbery consistency, some with subcapsular hemorrhage on cutting. Extensive hemorrhage occurred in various parts of infected lymph nodes. A section of L. serrata parasite was observed near one of the hemorrhage centers. Neutrophil count was very high in these centers and giant cells were present around the parasite, indicating granulomatous reaction. Our findings confirmed that different regions of Iran is an endemic for L. serrata infections. Because L. serrata is a zoonotic parasite, preventive measures should be adopted to disrupt the parasite’s life cycle and minimize the risk of infection in both humans and other animals.

Composition and variation of respiratory microbiota in healthy military personnel.

Certain occupational and geographical exposures have been associated with an increased risk of lung disease. As a baseline for future studies, we sought to characterize the upper respiratory microbiomes of healthy military personnel in a garrison environment. Nasal, oropharyngeal, and nasopharyngeal swabs were collected from 50 healthy active duty volunteers eight times over the course of one year (1107 swabs, completion rate = 92.25%) and subjected to pyrosequencing of the V1–V3 region of 16S rDNA. Respiratory bacterial taxa were characterized at the genus level, using QIIME 1.8 and the Ribosomal Database Project classifier. High levels of Staphylococcus, Corynebacterium, and Propionibacterium were observed among both nasal and nasopharyngeal microbiota, comprising more than 75% of all operational taxonomical units (OTUs). In contrast, Streptococcus was the sole dominant bacterial genus (approximately 50% of all OTUs) in the oropharynx. The average bacterial diversity was greater in the oropharynx than in the nasal or nasopharyngeal region at all time points. Diversity analysis indicated a significant overlap between nasal and nasopharyngeal samples, whereas oropharyngeal samples formed a cluster distinct from these two regions. The study produced a large set of pyrosequencing data on the V1–V3 region of bacterial 16S rDNA for the respiratory microbiomes of healthy active duty Service Members. Pre-processing of sequencing reads showed good data quality. The derived microbiome profiles were consistent both internally and with previous reports, suggesting their utility for further analyses and association studies based on sequence and demographic data.

Nasopharyngeal glial heterotopia with delayed postoperative meningitis

A male infant, who underwent radical resection of a large glial heterotopia at the nasopharynx at 8 days, developed delayed postoperative bacterial meningitis at 9 months. Neuroradiological examination clearly demonstrated...