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Battisti A, Della Monaca M, Di Giorgio D, Priore P, Terenzi V, Valentini V. Extranodal follicular dendritic cell sarcoma of the tonsil: An extremely rare clinical entity. Oral Oncol 2024; 149:106690. [PMID: 38224644 DOI: 10.1016/j.oraloncology.2024.106690] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 01/09/2024] [Indexed: 01/17/2024]
Abstract
Follicular dentritic cell sarcomatous neoplasms originate from dendritic cells contained within the lymph nodes. In extranodal location, these neoplasms, are rare clinical entities, and even more so, their location in the head-neck region is extremely rare. Only 17 cases of primary dendritic cell sarcoma of the tonsil are reported in the literature at present. Being such a rare entity, histopathological diagnosis can be complex and requires great expertise and proper immunohistochemical analysis [1]. We present a case of a 48-year-old young man diagnosed with follicular dendritic cell sarcoma of the tonsil who underwent, probably for the first time in the literature, transoral robotic surgical resection.
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Affiliation(s)
- Andrea Battisti
- Department of Odontostomatological and Maxillofacial Sciences, "La Sapienza University of Rome", Rome, Italy
| | - Marco Della Monaca
- Department of Odontostomatological and Maxillofacial Sciences, "La Sapienza University of Rome", Rome, Italy
| | - Danilo Di Giorgio
- Department of Odontostomatological and Maxillofacial Sciences, "La Sapienza University of Rome", Rome, Italy.
| | - Paolo Priore
- Department of Odontostomatological and Maxillofacial Sciences, "La Sapienza University of Rome", Rome, Italy
| | - Valentina Terenzi
- Department of Surgical Sciences, Tor Vergata University, Rome, Italy
| | - Valentino Valentini
- Department of Odontostomatological and Maxillofacial Sciences, "La Sapienza University of Rome", Rome, Italy
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Sangalli L, Yanez-Regonesi F, Fernandez-Vial D, Moreno-Hay I. Self-reported improvement in obstructive sleep apnea symptoms compared to treatment response with mandibular advancement device therapy: a retrospective study. Sleep Breath 2023; 27:1577-1588. [PMID: 36449217 DOI: 10.1007/s11325-022-02754-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Revised: 11/09/2022] [Accepted: 11/21/2022] [Indexed: 12/02/2022]
Abstract
PURPOSE Mandibular advancement device (MAD) is recognized as the treatment option for management of obstructive sleep apnea (OSA) in mild-moderate cases or those unable to tolerate positive airway pressure therapy. Post-treatment sleep study is recommended to establish MAD efficacy when maximal therapeutic benefit is achieved based on OSA symptom improvement or maximum anatomical protrusion. The aim of this study was to investigate the difference between responders and non-responders in OSA symptom improvement and predictors of treatment success. METHODS Medical charts of patients referred to the Orofacial Pain Clinic between 2016 and 2021 for management of OSA with MAD were retrospectively evaluated. Participants with post-treatment sleep study with MAD in situ were included. Participants were categorized as responders according to different criteria: 50% reduction in apnea-hypopnea index (AHI) compared to baseline; post-treatment AHI ≤ 10 with ≥ 50% reduction from baseline; AHI ≤ 5 with ≥ 50% reduction. OSA symptoms included snoring, apneas, sleep quality, tiredness upon awakening, daytime sleepiness, and subjective improvement. Differences in pre- and post-treatment variables within/between groups and predictors were analyzed with t test and logistic regression. RESULTS Among 53 participants (30 females), mean age was 64.2 ± 10.7 and pre-treatment was AHI 23.3 ± 17.2. Depending upon the criteria, responders ranged between 26 and 57%. At first follow-up after MAD delivery, non-responders reported less tiredness upon awakening (p = 0.003), better sleep quality (p = 0.005), and greater subjective improvement (p = 0.012) than responders. Among significant OSA symptoms, tiredness upon awakening, poorer sleep quality, and less subjective improvement were consistently found as predictors of treatment response. CONCLUSION Subjective improvement, sleep quality, and tiredness upon awakening significantly improved in non-responders at first follow-up compared to responders, according to the strictest definition of treatment response. Therefore, a post-treatment sleep study is crucial to confirm proper management of OSA with MAD.
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Affiliation(s)
- Linda Sangalli
- Department of Oral Health Science, College of Dentistry, Orofacial Pain Clinic, University of Kentucky, Lexington, KY, USA.
- College of Dental Medicine-Illinois (CDMI), Midwestern University, Downers Grove, IL, USA.
| | - Fernanda Yanez-Regonesi
- Department of Oral Health Science, College of Dentistry, Orofacial Pain Clinic, University of Kentucky, Lexington, KY, USA
| | - Diego Fernandez-Vial
- Department of Oral Health Science, College of Dentistry, Orofacial Pain Clinic, University of Kentucky, Lexington, KY, USA
| | - Isabel Moreno-Hay
- Department of Oral Health Science, College of Dentistry, Orofacial Pain Clinic, University of Kentucky, Lexington, KY, USA
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Fernández-Sanjuán P, Arrieta JJ, Sanabria J, Alcaraz M, Bosco G, Pérez-Martín N, Pérez A, Carrasco-Llatas M, Moreno-Hay I, Ríos-Lago M, Lugo R, O’Connor-Reina C, Baptista P, Plaza G. Optimizing Mandibular Advancement Maneuvers during Sleep Endoscopy with a Titratable Positioner: DISE-SAM Protocol. J Clin Med 2022; 11:jcm11030658. [PMID: 35160107 PMCID: PMC8836970 DOI: 10.3390/jcm11030658] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2021] [Revised: 01/20/2022] [Accepted: 01/24/2022] [Indexed: 12/21/2022] Open
Abstract
Mandibular advancement devices (MAD) are an effective alternative treatment to CPAP. Different maneuvers were performed during drug sleep-induced endoscopy (DISE) to mimic the effect of MAD. Using the Selector Avance Mandibular (SAM) device, we aimed to identify MAD candidates during DISE using a titratable, reproducible, and measurable maneuver. This DISE-SAM protocol may help to find the relationship between the severity of the respiratory disorder and the degree of response and determine the advancement required to improve the collapsibility of the upper airway. Explorations were performed in 161 patients (132 males; 29 females) with a mean age of 46.81 (SD = 11.42) years, BMI of 27.90 (SD = 4.19) kg/m2, and a mean AHI of 26.51 (SD = 21.23). The results showed no relationship between severity and MAD recommendation. Furthermore, there was a weak positive relationship between the advancement required to obtain a response and the disease severity. Using the DISE-SAM protocol, the response and the range of mandibular protrusion were assessed, avoiding the interexaminer bias of the jaw thrust maneuver. We suggest prescribing MAD as a single, alternative, or multiple treatment approaches following the SAM recommendations in a personalized design.
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Affiliation(s)
- Patricia Fernández-Sanjuán
- Department of Maxillofacial Surgery and Dentistry, Hospital Universitario San Francisco de Asís, Universidad Rey Juan Carlos, 28002 Madrid, Spain;
- Dental Sleep Medicine, Hospital Universitario Sanitas La Zarzuela, 28942 Madrid, Spain
| | - Juan José Arrieta
- Department of Stomatology, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
| | - Jaime Sanabria
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Fundación Jiménez Díaz, 28040 Madrid, Spain;
| | - Marta Alcaraz
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Sanitas La Zarzuela, 28942 Madrid, Spain; (M.A.); (G.B.); (N.P.-M.)
| | - Gabriela Bosco
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Sanitas La Zarzuela, 28942 Madrid, Spain; (M.A.); (G.B.); (N.P.-M.)
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28942 Madrid, Spain
| | - Nuria Pérez-Martín
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Sanitas La Zarzuela, 28942 Madrid, Spain; (M.A.); (G.B.); (N.P.-M.)
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28942 Madrid, Spain
| | - Adriana Pérez
- Department of Otolaryngology Head and Neck Surgery, Hospital La Milagrosa, 28010 Madrid, Spain;
| | - Marina Carrasco-Llatas
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Dr. Peset., 46017 Valencia, Spain;
| | - Isabel Moreno-Hay
- Division of Orofacial Pain, Department of Oral Health Science, College of Dentistry, University of Kentucky, Lexington, KY 40536, USA;
| | - Marcos Ríos-Lago
- Department of Basic Psychology II, Faculty of Psychology, UNED, 28040 Madrid, Spain;
| | - Rodolfo Lugo
- Department of Otolaryngology Head and Neck Surgery, Hospital San José, Monterrey 64718, Mexico;
| | - Carlos O’Connor-Reina
- Department of Otolaryngology Head and Neck Surgery, Hospital Quironsalud Marbella, 29603 Marbella, Spain;
- Department of Otolaryngology Head and Neck Surgery, Hospital Quironsalud Campo de Gibraltar, 11379 Palmones, Spain
| | - Peter Baptista
- Department of Otolaryngology Head and Neck Surgery, Clínica Universitaria de Navarra, 31008 Pamplona, Spain;
| | - Guillermo Plaza
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario Sanitas La Zarzuela, 28942 Madrid, Spain; (M.A.); (G.B.); (N.P.-M.)
- Department of Otolaryngology Head and Neck Surgery, Hospital Universitario de Fuenlabrada, Universidad Rey Juan Carlos, 28942 Madrid, Spain
- Correspondence:
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Napodano C, Callà C, Fiorita A, Marino M, Taddei E, Di Cesare T, Passali GC, Di Santo R, Stefanile A, Fantoni M, Urbani A, Paludetti G, Rapaccini GL, Ciasca G, Basile U. Salivary Biomarkers in COVID-19 Patients: Towards a Wide-Scale Test for Monitoring Disease Activity. J Pers Med 2021; 11:jpm11050385. [PMID: 34066701 PMCID: PMC8151878 DOI: 10.3390/jpm11050385] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/28/2021] [Accepted: 05/04/2021] [Indexed: 01/08/2023] Open
Abstract
The ongoing outbreak of coronavirus disease 2019 (COVID-19), which impairs the functionality of several organs, represents a major threat to human health. One of the hardest challenges in the fight against COVID-19 is the development of wide-scale, effective, and rapid laboratory tests to control disease severity, progression, and possible sudden worsening. Monitoring patients in real-time is highly demanded in this pandemic era when physicians need reliable and quantitative tools to prioritize patients’ access to intensive care departments. In this regard, salivary biomarkers are extremely promising, as they allow for the fast and non-invasive collection of specimens and can be repeated multiple times. Methods: We compare salivary levels of immunoglobulin A subclasses (IgA1 and IgA2) and free light chains (kFLC and λFLC) in a cohort of 29 SARS-CoV-2 patients and 21 healthy subjects. Results: We found that each biomarker differs significantly between the two groups, with p-values ranging from 10−8 to 10−4. A Receiving Operator Curve analysis shows that λFLC level is the best-suited candidate to discriminate the two groups (AUC = 0.96), with an accuracy of 0.94 (0.87–1.00 95% CI), a precision of 0.91 (0.81–1.00 95% CI), a sensitivity of 1.00 (0.96–1.00 95% CI), and a specificity of 0.86 (0.70–1.00 95% CI). Conclusion: These results suggest λFLC as an ideal indicator of patient conditions. This hypothesis is strengthened by the consideration that the λFLC half-life (approximately 6 h) is significantly shorter than the IgA one (21 days), thus confirming the potential of λFLC for effectively monitoring patients’ fluctuation in real-time.
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Affiliation(s)
- Cecilia Napodano
- Dipartimento di Scienze Mediche e Chirurgiche, UOC Gastroenterologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.N.); (G.L.R.)
| | - Cinzia Callà
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (A.S.); (A.U.)
| | - Antonella Fiorita
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa e del Collo, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.F.); (T.D.C.); (G.C.P.); (G.P.)
| | - Mariapaola Marino
- Dipartimento di Medicina e Chirurgia Traslazionale, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy;
| | - Eleonora Taddei
- Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.T.); (M.F.)
| | - Tiziana Di Cesare
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa e del Collo, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.F.); (T.D.C.); (G.C.P.); (G.P.)
| | - Giulio Cesare Passali
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa e del Collo, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.F.); (T.D.C.); (G.C.P.); (G.P.)
| | - Riccardo Di Santo
- Dipartimento di Neuroscienze, Sezione di Fisica, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.D.S.); (G.C.)
| | - Annunziata Stefanile
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (A.S.); (A.U.)
| | - Massimo Fantoni
- Dipartimento di Sicurezza e Bioetica, Sezione di Malattie Infettive, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (E.T.); (M.F.)
| | - Andrea Urbani
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (A.S.); (A.U.)
| | - Gaetano Paludetti
- Dipartimento di Scienze dell’Invecchiamento, Neurologiche, Ortopediche e della Testa e del Collo, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (A.F.); (T.D.C.); (G.C.P.); (G.P.)
| | - Gian Ludovico Rapaccini
- Dipartimento di Scienze Mediche e Chirurgiche, UOC Gastroenterologia, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.N.); (G.L.R.)
| | - Gabriele Ciasca
- Dipartimento di Neuroscienze, Sezione di Fisica, Fondazione Policlinico A. Gemelli IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (R.D.S.); (G.C.)
| | - Umberto Basile
- Dipartimento di Scienze di Laboratorio e Infettivologiche, Fondazione Policlinico Universitario “A. Gemelli” IRCCS, Università Cattolica del Sacro Cuore, 00168 Rome, Italy; (C.C.); (A.S.); (A.U.)
- Correspondence:
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