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Passos IM, Tamashiro E, Fantucci MZ, Murashima AAB, Silva LECM, Garcia DM, Faria FM, Martins RB, Arruda E, Anselmo-Lima WT, Valera FCP. The influence of inhibitors of apoptosis proteins (IAPs) on chronic rhinosinusitis with nasal polyps. Rhinology 2024; 62:101-110. [PMID: 37864409 DOI: 10.4193/rhin23.160] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2023]
Abstract
BACKGROUND Inhibitors of apoptosis proteins (IAPs) modulate the inflammatory process, and may facilitate the formation of chronic rhinosinusitis with nasal polyps (CRSwNP). This study aimed to observe if IAPs were differently expressed between patients with CRSwNP and controls, and to correlate the expression of IAPs with some inflammatory markers, as with the response to nasal corticosteroids in patients with CRSwNP. METHODOLOGY We obtained nasal biopsies from patients with CRSwNP (n=27) and controls (n=16). qRT-PCR measured the expression of IAPs and caspases, while Luminex assay measured the concentration of cytokines. Unpaired parametric tests and Principal Component Analysis (PCA) were used for statistical analysis. RESULTS We observed lower expression of IAP genes (XIAP, BIRC2/IAP1, and BIRC3/IAP2) in CRSwNP patients compared to controls, and we identified that patients with bad response to corticosteroids presented lower levels of BIRC2/IAP1, XIAP, BCL2, CASP9, and IL-17, and higher levels of CASP7 and TGF-B. CONCLUSIONS IAPs expression was downregulated in CRSwNP, and was associated with poorer response to nasal corticosteroids. The present findings suggest the importance of IAPs as a link between environment and the host inflammatory responses, and this pathway could be explored as a potential new target therapy for patients with CRSwNP.
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Affiliation(s)
- I M Passos
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - E Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - M Z Fantucci
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - A A B Murashima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - L E C M Silva
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - D M Garcia
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - F M Faria
- Department of Pathology, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - R B Martins
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - E Arruda
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - W T Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
| | - F C P Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Brazil
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Sedaghat AR, Fokkens WJ, Lund VJ, Hellings PW, Kern RC, Reitsma S, Toppila-Salmi S, Bernal-Sprekelsen M, Mullol J, Gevaert P, Teeling T, Alobid I, Anselmo-Lima WT, Baroody FM, Cervin A, Cohen NA, Constantinidis J, De Gabory L, Desrosiers M, Harvey RJ, Kalogjera L, Knill A, Landis BN, Meco C, Philpott CM, Ryan D, Schlosser RJ, Senior BA, Smith TL, Tomazic PV, Zhang L, Hopkins C. Consensus criteria for chronic rhinosinusitis disease control: an international Delphi Study. Rhinology 2023; 61:519-530. [PMID: 37804121 DOI: 10.4193/rhin23.335] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/08/2023]
Abstract
BACKGROUND Chronic rhinosinusitis (CRS) disease control is a global metric of disease status for CRS. While there is broad acceptance that it is an important treatment goal, there has been inconsistency in the criteria used to define CRS control. The objective of this study was to identify and develop consensus around essential criteria for assessment of CRS disease control. METHODS Modified Delphi methodology consisting of three rounds to review a list of 24 possible CRS control criteria developed by a 12-person steering committee. The core authorship of the multidisciplinary EPOS 2020 guidelines was invited to participate. RESULTS Thirty-two individuals accepted the invitation to participate and there was no dropout of participants throughout the entire study (3 rounds). Consensus essential criteria for assessment of CRS control were: overall symptom severity, need for CRS-related systemic corticosteroids in the prior 6 months, severity of nasal obstruction, and patient-reported CRS control. Near-consensus items were: nasal endoscopy findings, severity of smell loss, overall quality of life, impairment of normal activities and severity of nasal discharge. Participants’ comments provided insights into caveats of, and disagreements related to, near-consensus items. CONCLUSIONS Overall symptom severity, use of CRS-related systemic corticosteroids, severity of nasal obstruction, and patient-reported CRS control are widely agreed upon essential criteria for assessment of CRS disease control. Consideration of near-consensus items to assess CRS control should be implemented with their intrinsic caveats in mind. These identified consensus CRS control criteria, together with evidence-based support, will provide a foundation upon which CRS control criteria with wide-spread acceptance can be developed.
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Affiliation(s)
- A R Sedaghat
- Department of Otolaryngology-Head and Neck Surgery, University of Cincinnati College of Medicine, Cincinnati, OH, USA
| | - W J Fokkens
- Department of Otorhinolaryngology and Head and Neck Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - V J Lund
- Royal National ENT Hospital, University College London Hospital NHS Foundation Trust, London, UK
| | - P W Hellings
- Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, KU Leuven, Belgium
| | - R C Kern
- Department of Otorhinolaryngology, Head and Neck Surgery, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA
| | - S Reitsma
- Department of Otorhinolaryngology and Head and Neck Surgery, Amsterdam University Medical Centres, location AMC, Amsterdam, The Netherlands
| | - S Toppila-Salmi
- Department of Otorhinolaryngology, Kuopio University Hospital and University of Eastern Finland, Finland and Department of Allergy, Inflammation Center, Helsinki University Hospital and University of Helsinki, Finland
| | | | - J Mullol
- Rhinology Unit and Smell Clinic, ENT Department, Hospital Clinic, FRCB-IDIBAPS, Universitat de Barcelona, CIBERES, Barcelona, Catalonia, Spain
| | - P Gevaert
- Department of Otorhinolaryngology, Ghent University, Ghent, Belgium
| | - T Teeling
- Patient representative, Task Force Healthcare, WTC Den Haag, The Netherlands
| | - I Alobid
- Rhinology and Skull Base Unit, ENT Department, Hospital Clinic, Universitat de Barcelona, August Pi i Sunyer Biomedical Research Institute, CIBERES, Barcelona, Spain
| | - W T Anselmo-Lima
- Division of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, Head and Neck Surgery, Ribeirao Preto Medical School-University of Sao Paulo, Sao Paulo, Brazil
| | - F M Baroody
- Department of Otorhinolaryngology-Head and Neck Surgery, The University of Chicago Medicine and the Comer Children’s Hospital, Chicago, IL, USA
| | - A Cervin
- Department of Otorhinolaryngology, Head and Neck Surgery, Royal Brisbane and Women's Hospital; Faculty of Medicine, University of Queensland, Brisbane, Australia and Department of Clinical Sciences, Lund University, Lund, Sweden
| | - N A Cohen
- Department of Otorhinolaryngology - Head and Neck Surgery, Perelman School of Medicine at The University of Pennsylvania, Philadelphia, PA, USA
| | - J Constantinidis
- 1st Department of ORL, Head and Neck Surgery, Aristotle University, AHEPA Hospital, Thessaloniki, Greece
| | - L De Gabory
- Rhinology and Plastic Surgery Unit, Otorhinolaryngology, Head and Neck Surgery and Pediatric ENT Department, CHU ux, Hospital Pellegrin, Centre F-X Michelet, Bordeaux, France
| | - M Desrosiers
- Department of ORL-HNS, Universitat de Montreal, Montreal, Canada
| | - R J Harvey
- Rhinology and Skull Base Department, Applied Medical Research Centre, UNSW (Conjoint) and Macquarie University (Clinical), Sydney, Australia
| | - L Kalogjera
- Department of Otorhinolaryngology/Head and Neck Surgery, Zagreb School of Medicine; University Hospital Center, Sestre milosrdnice,Zagreb, Croatia
| | - A Knill
- Patient representative, Sinus UK, London, UK
| | - B N Landis
- Rhinology-Olfactology Unit, Otorhinolaryngology Department, University Hospital of Geneva, Geneva, Switzerland
| | - C Meco
- Department of Otorhinolaryngology, Head and Neck Surgery, Ankara University, Ankara, Turkey and Department of Otorhinolaryngology, Head and Neck Surgery, Salzburg Paracelsus Medical University, Salzburg, Austria
| | - C M Philpott
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, UK and Norfolk and Waveney ENT Service, James Paget University Hospital, Great Yarmouth and Norfolk and Norwich University Hospital, Norwich, UK
| | - D Ryan
- Allergy and Respiratory Research Group, Usher Institute of Population Health Sciences and Informatics, University of Edinburgh, Edinburgh, Scotland, UK and International Primary Care Respiratory Group, Edinburgh, Scotland, UK
| | - R J Schlosser
- Department of Otolaryngology - Head and Neck Surgery, Medical University of South Carolina, Charleston, SC, USA
| | - B A Senior
- Department of Otolaryngology - Head and Neck Surgery, University of North Carolina, Chapel Hill, NC, USA
| | - T L Smith
- Division of Rhinology and Sinus Surgery, Oregon Sinus Center, Oregon Health
| | - P V Tomazic
- Department of Otorhinolaryngology, Medical University of Graz, Graz, Austria
| | - L Zhang
- Department of Allergy, Beijing TongRen Hospital, Capital Medical University, Beijing, China and Department of Otolaryngology, Head and Neck Surgery, Beijing TongRen Hospital, Capital Medical University, Beijing, China and Beijing Institute of Otolaryngology, Beijing Laboratory of Allergic Diseases, Beijing Key Laboratory of Nasal Diseases, Key Laboratory of Otolaryngology Head and Neck Surgery, Ministry of Education, Capital Medical University, Beijing, China and Research Unit of Diagnosis and T
| | - C Hopkins
- Department of Otolaryngology and Head Neck Surgery, Guys and St Thomas’ Hospital, London, UK
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de Lima TM, Martins RB, Miura CS, Souza MVO, Cassiano MHA, Rodrigues TS, Veras FP, Sousa JDF, Gomes R, de Almeida GM, Melo SR, da Silva GC, Dias M, Capato CF, Silva ML, Luiz VEDDB, Carenzi LR, Zamboni DS, Jorge DMDM, Cunha FDQ, Tamashiro E, Anselmo-Lima WT, Valera FCP, Arruda E. Tonsils are major sites of persistence of SARS-CoV-2 in children. Microbiol Spectr 2023; 11:e0134723. [PMID: 37737615 PMCID: PMC10581087 DOI: 10.1128/spectrum.01347-23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 08/01/2023] [Indexed: 09/23/2023] Open
Abstract
In the present study, we show that SARS-CoV-2 can infect palatine tonsils, adenoids, and secretions in children without symptoms of COVID-19, with no history of recent upper airway infection. We studied 48 children undergoing tonsillectomy due to snoring/OSA or recurrent tonsillitis between October 2020 and September 2021. Nasal cytobrushes, nasal washes, and tonsillar tissue fragments obtained at surgery were tested by RT-qPCR, immunohistochemistry (IHC), flow cytometry, and neutralization assay. We detected the presence of SARS-CoV-2 in at least one specimen tested in 27% of patients. IHC revealed the presence of the viral nucleoprotein in epithelial surface and in lymphoid cells in both extrafollicular and follicular regions, in adenoids and palatine tonsils. Also, IHC for the SARS-CoV-2 non-structural protein NSP-16 indicated the presence of viral replication in 53.8% of the SARS-CoV-2-infected tissues. Flow cytometry showed that CD20+ B lymphocytes were the most infected phenotypes, followed by CD4+ lymphocytes and CD123 dendritic cells, CD8+ T lymphocytes, and CD14+ macrophages. Additionally, IF indicated that infected tonsillar tissues had increased expression of ACE2 and TMPRSS2. NGS sequencing demonstrated the presence of different SARS-CoV-2 variants in tonsils from different tissues. SARS-CoV-2 antigen detection was not restricted to tonsils but was also detected in nasal cells from the olfactory region. Palatine tonsils and adenoids are sites of prolonged RNA presence by SARS-CoV-2 in children, even without COVID-19 symptoms. IMPORTANCE This study shows that SRS-CoV-2 of different lineages can infect tonsils and adenoids in one quarter of children undergoing tonsillectomy. These findings bring advancement to the area of SARS-CoV-2 pathogenesis, by showing that tonsils may be sites of prolonged infection, even without evidence of recent COVID-19 symptoms. SARS-CoV-2 infection of B and T lymphocytes, macrophages, and dendritic cells may interfere with the mounting of immune responses in these secondary lymphoid organs. Moreover, the shedding of SARS-CoV-2 RNA in respiratory secretions from silently infected children raises concern about possible diagnostic confusion in the presence of symptoms of acute respiratory infections caused by other etiologies.
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Affiliation(s)
- Thais Melquiades de Lima
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Ronaldo Bragança Martins
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Clinical, Toxicological and Bromatological Analysis, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Carolina Sponchiado Miura
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Vitória Oliveira Souza
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Murilo Henrique Anzolini Cassiano
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Tamara Silva Rodrigues
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Flávio Protásio Veras
- Department of BioMolecular Sciences, University of São Paulo School of Pharmaceutical Sciences, Ribeirão Preto, São Paulo, Brazil
| | - Josane de Freitas Sousa
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Rogério Gomes
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Glaucia Maria de Almeida
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Stella Rezende Melo
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Gabriela Condé da Silva
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Matheus Dias
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Carlos Fabiano Capato
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Maria Lúcia Silva
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Veridiana Ester Dias de Barros Luiz
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Lucas Rodrigues Carenzi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Dario Simões Zamboni
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
- Department of Biochemistry and Immunology, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Daniel Macedo de Melo Jorge
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fernando de Queiroz Cunha
- Department of Pharmacology, University of Sao Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Department of Cellular and Molecular Biology and Pathogenic Bioagents, University of São Paulo School of Medicine, Ribeirão Preto, São Paulo, Brazil
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Oliveira HFD, Bollela VR, Anselmo-Lima WT, Pianto DM, Oliveira CACPD, Nakanishi M. Acquisition of endoscopic nasal surgery skills with a lamb's head model. Braz J Otorhinolaryngol 2022; 88 Suppl 5:S119-S125. [PMID: 35717307 PMCID: PMC9801028 DOI: 10.1016/j.bjorl.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2022] [Revised: 05/12/2022] [Accepted: 05/30/2022] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES To evaluate the acquisition of surgical skills by otolaryngology residents and established the minimum number of dissections of a lamb's model to be performed before practicing on human patients. METHODS Nineteen second-year otolaryngology residents performed ten dissections each, five on each nasal cavity, always practicing the same three surgical procedures on the lamb model. Each student's training lasted 2-months, and the entire training intervention lasted 4-years, over four generations of residents. All dissections were recorded and were selected at random for examination by two independent otolaryngology surgeons, who were otherwise not involved in the research. Assessment of the 190 dissections used an instrument validated for surgical training of medical residents. RESULTS To a 1% significance level, statistical analysis revealed increased performance and satisfactory results were observed after the sixth dissection. Furthermore, after the eighth dissection, skill acquisition was relevant and sustained. CONCLUSION Training in endoscopic nasal surgery on a lamb's head model improves surgical skills and handling of surgical instruments. Our results showed the relevance of the lamb model for training in otolaryngology surgery, impacting on patient safety. LEVEL OF EVIDENCE: 2
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Affiliation(s)
- Henrique F de Oliveira
- Universidade de Brasília (UnB), Faculdade de Medicina, Programa de Pós-Graduação em Ciências Médicas, Brasília, DF, Brazil.
| | - Valdes Roberto Bollela
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Prática Médica, Ribeirão Preto, SP, Brazil; Foundation for Advancement of International Medical Education and Research, Philadelphia, United States
| | - Wilma Terezinha Anselmo-Lima
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Donald Matthew Pianto
- Universidade de Brasília (UnB), Programa de Pós-Graduação em Computação Aplicada, Departamento de Ciência da Computação, Brasília, DF, Brazil
| | | | - Márcio Nakanishi
- Universidade de Brasília (UnB), Faculdade de Medicina, Departamento de Otorrinolaringologia, Brasília, DF, Brazil
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5
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Silveira MLC, Tamashiro E, Santos ARD, Martins RB, Faria FM, Silva LECM, Torrieri R, de C Ruy P, Silva WA, Arruda E, Anselmo-Lima WT, Valera FCP. miRNA-205-5p can be related to T2-polarity in Chronic Rhinosinusitis with Nasal Polyps. Rhinology 2021; 59:567-576. [PMID: 34608897 DOI: 10.4193/rhin21.109] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND microRNAs (miRNAs) are directly associated with inflammatory response, but their direct role in CRSwNP (chronic rhinosinusitis with nasal polyps) remains evasive. This study aimed to compare the expression of several miRNAs in tissue samples obtained from patients with CRSwNP and controls and to evaluate if miRNAs correlate to a specific inflammatory pattern (T1, T2, T17, and Treg) or intensity of symptoms in CRSwNP. METHODS nasal polyps (from patients with CRSwNP - n=36) and middle turbinate mucosa (from control patients - n=41) were collected. Microarray determined human mature miRNA expression, and the results obtained were validated by qPCR. miRNAs that were differentially expressed were then correlated to cytokine proteins (by Luminex), tissue eosinophilia, and SNOT-22. RESULTS After microarray and qPCR analyses, six microRNAs were up-regulated in CRSwNP samples when compared with controls: miR-205-5p, miR-221-3p, miR-222-3p, miR-378a-3p, miR-449a and miR-449b-5p. All these miRNAs are directly implicated with cell cycle regulation and apoptosis, and to a minor extent, with inflammation. Importantly, miR-205-5p showed a significantly positive correlation with IL-5 concentration and eosinophil count at the tissue and with the worst SNOT-22 score. CONCLUSIONS miRNA 205-5p was increased in CRSwNP compared to controls, and it was especially expressed in CRSwNP patients with higher T2 inflammation (measured by both IL-5 levels and local eosinophilia) and worst clinical presentation. This miRNA may be an interesting target to be explored in patients with CRSwNP.
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Affiliation(s)
- M L C Silveira
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - E Tamashiro
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - A R D Santos
- Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - R B Martins
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - F M Faria
- Department of Pathology and Legal Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - L E C M Silva
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - R Torrieri
- Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - P de C Ruy
- Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - W A Silva
- Genomics Medical Center, Clinics Hospital at Ribeirao Preto Medical School, University of Sao Paulo, Brazil.,Department of Genetics, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - E Arruda
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Virology Research Center, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - W T Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
| | - F C P Valera
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirao Preto Medical School, University of Sao Paulo, Brazil
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Rivelli GG, Perez AC, Silva PHR, Gomes ECDL, Moreira CPDS, Tamashiro E, Valera FCP, Anselmo-Lima WT, Pianetti GA, Silva-Cunha A. Biodegradable Electrospun Nanofibers: A New Approach For Rhinosinusitis Treatment. Eur J Pharm Sci 2021; 163:105852. [PMID: 33862240 DOI: 10.1016/j.ejps.2021.105852] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 03/10/2021] [Accepted: 04/12/2021] [Indexed: 12/18/2022]
Abstract
Biodegradable polymeric nanofibers containing mometasone furoate can be a new approach to drug delivery to treat chronic rhinosinusitis, providing controlled steroid delivery to the sinonasal mucosa. This study aimed to develop biodegradable polymeric nanofibers and explore the safety of these fibers in an in vivo rabbit model. The nanofibers' development has been optimized using the Response Surface Methodology (RSM) obtained with Design of Experiments (DoE) with the best conditions related to the polymer concentration and proportion of solvents used in the electrospinning process. The nanofibers were prepared, operating as a determinant factor, the nanofiber formation and its diameter evaluated by Scanning Electron Microscopy (SEM). The ideal system obtained was assessed by SEM, thermogravimetric analysis (TGA), X-ray diffraction (XRD), differential scanning calorimetry (DSC), assay, and drug delivery by UHLPC validated method. The results showed that the drug is dispersed in the polymeric matrix, is stable, and showed sustained release kinetics in a bio-relevant nasal environment (Higuchi model kinetics). In vivo tests, the level of inflammation at the animals' mucosa which received the nanofiber with the mometasone furoate was lower than those that received the nanofibers without the drug (α = 0.05). Histopathology analysis showed that the polymeric nanofibers containing mometasone are safe when topically applied on the sinonasal mucosa, opening a new horizon in chronic rhinosinusitis treatment.
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Affiliation(s)
- Graziella Gomes Rivelli
- Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG. 31270-901, Brazil
| | - André Coura Perez
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP. 14049-900, Brazil
| | | | | | | | - Edwin Tamashiro
- Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP. 14049-900, Brazil
| | | | | | - Gérson Antônio Pianetti
- Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG. 31270-901, Brazil
| | - Armando Silva-Cunha
- Faculty of Pharmacy, Federal University of Minas Gerais, Belo Horizonte, MG. 31270-901, Brazil.
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Martins CAN, Deus MMD, Abile IC, Garcia DM, Anselmo-Lima WT, Miura CS, Valera FCP. Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ*) into Brazilian Portuguese. Braz J Otorhinolaryngol 2021; 88 Suppl 1:S63-S69. [PMID: 33972191 PMCID: PMC9734256 DOI: 10.1016/j.bjorl.2021.03.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 02/11/2021] [Accepted: 03/15/2021] [Indexed: 12/16/2022] Open
Abstract
INTRODUCTION Obstructive sleep apnea is a frequent entity in childhood that can lead to important consequences for the health and children's quality of live. Polysomnography is the gold-standard exam to diagnose obstructive sleep apnea, but it is expensive, complex, and poorly affordable in Brazil. The pediatric sleep questionnaire has shown to be a valuable screening test for obstructive sleep apnea. It is a simple questionnaire with good sensitivity and specificity compared to polysomnography in the countries where it has been validated. OBJECTIVE Translation and cross-cultural adaptation of the pediatric sleep questionnaire (PSQ), into Brazilian Portuguese. METHODS The translation of the PSQ into Brazilian Portuguese was carried out in accordance with good practices. The validated and adapted questionnaire was applied to parents/caregivers of 60 children (40 of them with obstructive sleep apnea and 20 controls) aged 2-18 years. Retest was applied to 30 children with obstructive sleep apnea. The following tests were performed: internal consistency, test-retest, validation of questionnaire (the latter by ROC curve). RESULTS Brazilian PSQ has shown high internal consistency by Cronbach's alpha (0.86 for the total test, 0.83 for subscale "snoring", 0.64 for "sleepiness" and 0.65 for "behavior"). Test-retest presented a correlation of 0.89 for subscale "snoring", 0.93 for "sleepiness" and 0.86 for "behavior". Accuracy by ROC curve was 0.99. Nine was considered the optimal value to discriminate patients with obstructive sleep apnea from controls, with a sensitivity of 0.92 and specificity of 1.0. CONCLUSION The translation and cross-cultural adaptation of the PSQ into Brazilian Portuguese proved to be successful. In places with difficult access to polysomnography, PSQ can be a useful tool in screening and follow-up of children with obstructive sleep apnea.
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Orlandi RR, Kingdom TT, Smith TL, Bleier B, DeConde A, Luong AU, Poetker DM, Soler Z, Welch KC, Wise SK, Adappa N, Alt JA, Anselmo-Lima WT, Bachert C, Baroody FM, Batra PS, Bernal-Sprekelsen M, Beswick D, Bhattacharyya N, Chandra RK, Chang EH, Chiu A, Chowdhury N, Citardi MJ, Cohen NA, Conley DB, DelGaudio J, Desrosiers M, Douglas R, Eloy JA, Fokkens WJ, Gray ST, Gudis DA, Hamilos DL, Han JK, Harvey R, Hellings P, Holbrook EH, Hopkins C, Hwang P, Javer AR, Jiang RS, Kennedy D, Kern R, Laidlaw T, Lal D, Lane A, Lee HM, Lee JT, Levy JM, Lin SY, Lund V, McMains KC, Metson R, Mullol J, Naclerio R, Oakley G, Otori N, Palmer JN, Parikh SR, Passali D, Patel Z, Peters A, Philpott C, Psaltis AJ, Ramakrishnan VR, Ramanathan M, Roh HJ, Rudmik L, Sacks R, Schlosser RJ, Sedaghat AR, Senior BA, Sindwani R, Smith K, Snidvongs K, Stewart M, Suh JD, Tan BK, Turner JH, van Drunen CM, Voegels R, Wang DY, Woodworth BA, Wormald PJ, Wright ED, Yan C, Zhang L, Zhou B. International consensus statement on allergy and rhinology: rhinosinusitis 2021. Int Forum Allergy Rhinol 2021; 11:213-739. [PMID: 33236525 DOI: 10.1002/alr.22741] [Citation(s) in RCA: 357] [Impact Index Per Article: 119.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 11/09/2020] [Indexed: 02/06/2023]
Abstract
I. EXECUTIVE SUMMARY BACKGROUND: The 5 years since the publication of the first International Consensus Statement on Allergy and Rhinology: Rhinosinusitis (ICAR-RS) has witnessed foundational progress in our understanding and treatment of rhinologic disease. These advances are reflected within the more than 40 new topics covered within the ICAR-RS-2021 as well as updates to the original 140 topics. This executive summary consolidates the evidence-based findings of the document. METHODS ICAR-RS presents over 180 topics in the forms of evidence-based reviews with recommendations (EBRRs), evidence-based reviews, and literature reviews. The highest grade structured recommendations of the EBRR sections are summarized in this executive summary. RESULTS ICAR-RS-2021 covers 22 topics regarding the medical management of RS, which are grade A/B and are presented in the executive summary. Additionally, 4 topics regarding the surgical management of RS are grade A/B and are presented in the executive summary. Finally, a comprehensive evidence-based management algorithm is provided. CONCLUSION This ICAR-RS-2021 executive summary provides a compilation of the evidence-based recommendations for medical and surgical treatment of the most common forms of RS.
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Affiliation(s)
| | | | | | | | | | - Amber U Luong
- University of Texas Medical School at Houston, Houston, TX
| | | | - Zachary Soler
- Medical University of South Carolina, Charleston, SC
| | - Kevin C Welch
- Feinberg School of Medicine, Northwestern University, Chicago, IL
| | | | | | | | | | - Claus Bachert
- Ghent University, Ghent, Belgium.,Karolinska Institute, Stockholm, Sweden.,Sun Yatsen University, Gangzhou, China
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - David A Gudis
- Columbia University Irving Medical Center, New York, NY
| | - Daniel L Hamilos
- Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | | | - Richard Harvey
- University of New South Wales and Macquarie University, Sydney, New South Wales, Australia
| | | | | | | | | | - Amin R Javer
- University of British Columbia, Vancouver, British Columbia, Canada
| | | | | | | | | | | | | | | | | | | | | | - Valerie Lund
- Royal National Throat Nose and Ear Hospital, UCLH, London, UK
| | - Kevin C McMains
- Uniformed Services University of Health Sciences, San Antonio, TX
| | | | - Joaquim Mullol
- IDIBAPS Hospital Clinic, University of Barcelona, Barcelona, Spain
| | | | | | | | | | | | | | | | | | | | - Alkis J Psaltis
- University of Adelaide, Adelaide, South Australia, Australia
| | | | | | | | - Luke Rudmik
- University of Calgary, Calgary, Alberta, Canada
| | - Raymond Sacks
- University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | | | | | | | | | | | | | | | | | | | - De Yun Wang
- National University of Singapore, Singapore, Singapore
| | | | | | | | - Carol Yan
- University of California San Diego, La Jolla, CA
| | - Luo Zhang
- Capital Medical University, Beijing, China
| | - Bing Zhou
- Capital Medical University, Beijing, China
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9
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Proenca-Modena JL, de Souza Cardoso R, Criado MF, Milanez GP, de Souza WM, Parise PL, Bertol JW, de Jesus BLS, Prates MCM, Silva ML, Buzatto GP, Demarco RC, Valera FCP, Tamashiro E, Anselmo-Lima WT, Arruda E. Human adenovirus replication and persistence in hypertrophic adenoids and palatine tonsils in children. J Med Virol 2019; 91:1250-1262. [PMID: 30815882 PMCID: PMC7166372 DOI: 10.1002/jmv.25441] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2017] [Revised: 02/25/2019] [Accepted: 02/26/2019] [Indexed: 12/31/2022]
Abstract
The role of human adenovirus (HAdV) infection in different acute diseases, such as febrile exudative tonsillitis, conjunctivitis, and pharyngoconjunctival fever is well established. However, the relationships, if any, of HAdV persistence and reactivation in the development of the chronic adenotonsillar disease is not fully understood. The present paper reports a 3-year cross-sectional hospital-based study aimed at detecting and quantifying HAdV DNA and mRNA of the HAdV hexon gene in adenoid and palatine tonsil tissues and nasopharyngeal secretions (NPS) from patients with adenotonsillar hypertrophy or recurrent adenotonsillitis. HAdV C, B, and E were detectable in nearly 50% of the patients, with no association with the severity of airway obstruction, nor with the presence of recurrent tonsillitis, sleep apnea or otitis media with effusion (OME). Despite the higher rates of respiratory viral coinfections in patients with HAdV, the presence of other viruses, including DNA and RNA viruses, had no association with HAdV replication or shedding in secretions. Higher HAdV loads in adenoids showed a significant positive correlation with the presence of sleep apnea and the absence of OME. Although this study indicates that a significant proportion (~85%) of individuals with chronic adenotonsillar diseases have persistent nonproductive HAdV infection, including those by HAdV C, B, and E, epithelial and subepithelial cells in tonsils seem to be critical for HAdV C production and shedding in NPS in some patients, since viral antigen was detected in these regions by immunohistochemistry in four patients, all of which were also positive for HAdV mRNA detection.
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Affiliation(s)
- José Luiz Proenca-Modena
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Ricardo de Souza Cardoso
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Miriã Ferreira Criado
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Guilherme Paier Milanez
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - William Marciel de Souza
- Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Pierina Lorencini Parise
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Jéssica Wildgrube Bertol
- Department of Genetics, Evolution, Microbiology and Immunology, Institute of Biology, University of Campinas (UNICAMP), Campinas, São Paulo, Brazil
| | - Bruna Lais Santos de Jesus
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | | | - Maria Lúcia Silva
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Guilherme Pietrucci Buzatto
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Ricardo Cassiano Demarco
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
| | - Eurico Arruda
- Department of Cell Biology, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.,Department of Cell Biology, Virology Research Center, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, São Paulo, Brazil
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Anselmo-Lima WT, Pignatari SSN. BJORL: moving forward, always. Braz J Otorhinolaryngol 2018; 84:673-674. [PMID: 30301702 PMCID: PMC9442871 DOI: 10.1016/j.bjorl.2018.09.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Affiliation(s)
| | - Shirley Shizue Nagata Pignatari
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
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11
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Piltcher OB, Kosugi EM, Sakano E, Mion O, Testa JRG, Romano FR, Santos MCJ, Di Francesco RC, Mitre EI, Bezerra TFP, Roithmann R, Padua FG, Valera FCP, Lubianca Neto JF, Sá LCB, Pignatari SSN, Avelino MAG, Caixeta JADS, Anselmo-Lima WT, Tamashiro E. How to avoid the inappropriate use of antibiotics in upper respiratory tract infections? A position statement from an expert panel. Braz J Otorhinolaryngol 2018; 84:265-279. [PMID: 29588108 PMCID: PMC9449220 DOI: 10.1016/j.bjorl.2018.02.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 02/01/2018] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Bacterial resistance burden has increased in the past years, mainly due to inappropriate antibiotic use. Recently it has become an urgent public health concern due to its impact on the prolongation of hospitalization, an increase of total cost of treatment and mortality associated with infectious disease. Almost half of the antimicrobial prescriptions in outpatient care visits are prescribed for acute upper respiratory infections, especially rhinosinusitis, otitis media, and pharyngotonsillitis. In this context, otorhinolaryngologists play an important role in orienting patients and non-specialists in the utilization of antibiotics rationally and properly in these infections. OBJECTIVES To review the most recent recommendations and guidelines for the use of antibiotics in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, adapted to our national reality. METHODS A literature review on PubMed database including the medical management in acute otitis media, acute rhinosinusitis, and pharyngotonsillitis, followed by a discussion with a panel of specialists. RESULTS Antibiotics must be judiciously prescribed in uncomplicated acute upper respiratory tract infections. The severity of clinical presentation and the potential risks for evolution to suppurative and non-suppurative complications must be taken into 'consideration'. CONCLUSIONS Periodic revisions on guidelines and recommendations for treatment of the main acute infections are necessary to orient rationale and appropriate use of antibiotics. Continuous medical education and changes in physicians' and patients' behavior are required to modify the paradigm that all upper respiratory infection needs antibiotic therapy, minimizing the consequences of its inadequate and inappropriate use.
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Affiliation(s)
- Otávio Bejzman Piltcher
- Universidade Federal do Rio Grande do Sul (UFRGS), Faculdade de Medicina (FAMED), Departamento de Oftalmologia e Otorrinolaringologia, Porto Alegre, RS, Brazil
| | - Eduardo Macoto Kosugi
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Eulalia Sakano
- Universidade Estadual de Campinas (UNICAMP), Departamento de Otorrinolaringologia e Oftalmologia, Campinas, SP, Brazil
| | - Olavo Mion
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Disciplina de Otorrinolaringologia, São Paulo, SP, Brazil
| | - José Ricardo Gurgel Testa
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Fabrizio Ricci Romano
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Otorrinolaringologia, São Paulo, SP, Brazil; Hospital Infantil Sabará, Otorrinolaringologia, São Paulo, SP, Brazil
| | - Marco Cesar Jorge Santos
- Hospital Paranaense de Otorrinolaringologia (IPO), Instituto Paranaense de Otorrinolaringologia, Curitiba, PR, Brazil
| | - Renata Cantisani Di Francesco
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), Disciplina de Otorrinolaringologia, São Paulo, SP, Brazil
| | - Edson Ibrahim Mitre
- Faculdade de Ciências Médicas da Santa Casa de São Paulo, São Paulo, SP, Brazil
| | - Thiago Freire Pinto Bezerra
- Universidade Federal de Pernambuco (UFPE), Departamento de Cirurgia, Divisão de Otorrinolaringologia, Recife, PE, Brazil
| | - Renato Roithmann
- Universidade Luterana do Brasil, Faculdade de Medicina, Porto Alegre, RS, Brazil
| | - Francini Greco Padua
- Universidade de São Paulo (USP), Faculdade de Medicina (FM), São Paulo, SP, Brazil; Hospital Albert Einstein, São Paulo, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - José Faibes Lubianca Neto
- Universidade Federal de Ciências da Saúde de Porto Alegre, Hospital da Criança Santo Antônio, Serviço de Otorrinolaringologia Pediátrica, Porto Alegre, RS, Brazil
| | - Leonardo Conrado Barbosa Sá
- Universidade do Estado do Rio de Janeiro (UERJ), Faculdade de Ciências Médicas, Disciplina de Otorrinolaringologia, Rio de Janeiro, RJ, Brazil
| | - Shirley Shizue Nagata Pignatari
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Melissa Ameloti Gomes Avelino
- Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil; Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil
| | | | - Wilma Terezinha Anselmo-Lima
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Edwin Tamashiro
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto (FMRP), Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil.
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12
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Avelino MAG, Maunsell R, Valera FCP, Lubianca Neto JF, Schweiger C, Miura CS, Chen VG, Manrique D, Oliveira R, Gavazzoni F, Picinin IFDM, Bittencourt P, Camargos P, Peixoto F, Brandão MB, Sih TM, Anselmo-Lima WT. First Clinical Consensus and National Recommendations on Tracheostomized Children of the Brazilian Academy of Pediatric Otorhinolaryngology (ABOPe) and Brazilian Society of Pediatrics (SBP). Braz J Otorhinolaryngol 2017; 83:498-506. [PMID: 28807655 PMCID: PMC9444758 DOI: 10.1016/j.bjorl.2017.06.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Revised: 06/06/2017] [Accepted: 06/06/2017] [Indexed: 12/03/2022] Open
Abstract
Introduction Tracheostomy is a procedure that can be performed in any age group, including children under 1 year of age. Unfortunately health professionals in Brazil have great difficulty dealing with this condition due to the lack of standard care orientation. Objective This clinical consensus by Academia Brasileira de Otorrinolaringologia Pediátrica (ABOPe) and Sociedade Brasileira de Pediatria (SBP) aims to generate national recommendations on the care concerning tracheostomized children. Methods A group of experts experienced in pediatric tracheostomy (otorhinolaryngologists, intensive care pediatricians, endoscopists, and pediatric pulmonologists) were selected, taking into account the different regions of Brazil and following inclusion and exclusion criteria. Results The results generated from this document were based on the agreement of the majority of participants regarding the indications, type of cannula, surgical techniques, care, and general guidelines and decannulation. Conclusion These guidelines can be used as directives for a wide range of health professionals across the country that deal with tracheostomized children.
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Affiliation(s)
- Melissa A G Avelino
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil; Universidade Federal de Goiás (UFG), Goiânia, GO, Brazil; Pontifícia Universidade Católica de Goiás (PUC-GO), Goiânia, GO, Brazil; Universidade Federal de Goiás (UFG), Hospital das Clínicas, Unidade de Cabeça e Pescoço, Goiânia, GO, Brazil.
| | - Rebecca Maunsell
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Oftalmo/Otorrinolaringologia, Campinas, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Universidade São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - José Faibes Lubianca Neto
- Universidade Federal de Ciências da Saúde de Porto Alegre (UFCSPA), Porto Alegre, RS, Brazil; Hospital da Criança Santo Antônio, Serviço de Otorrinolaringologia Pediátrica, Porto Alegre, RS, Brazil
| | - Cláudia Schweiger
- Universidade Federal do Rio Grande do Sul (UFRGS), Programa de Pós-graduação em Saúde da Criança e do Adolescente, Porto Alegre, RS, Brazil; Hospital de Clínicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Carolina Sponchiado Miura
- Universidade São Paulo (USP), Hospital das Clínicas da Faculdade de Medicina de Ribeirão Preto, Ribeirão Preto, SP, Brazil
| | - Vitor Guo Chen
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil; Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, São Paulo, SP, Brazil
| | - Dayse Manrique
- Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), São Paulo, SP, Brazil; Associação de Assistência a Criança Deficiente (AACD), Clínica de Otorrinolaringologia, São Paulo, SP, Brazil
| | | | | | - Isabela Furtado de Mendonça Picinin
- Serviço de Assistência Integral à Criança Traqueostomizada (SAIT), Belo Horizonte, MG, Brazil; Universidade José do Rosário Vellano (UNIFENAS), Curso de Medicina, Belo Horizonte, MG, Brazil; Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas (HC), Pneumologia Pediátrica, Belo Horizonte, MG, Brazil
| | - Paulo Bittencourt
- Serviço de Assistência Integral à Criança Traqueostomizada (SAIT), Belo Horizonte, MG, Brazil
| | - Paulo Camargos
- Universidade Federal de Minas Gerais (UFMG), Hospital das Clínicas (HC), Pneumologia Pediátrica, Belo Horizonte, MG, Brazil
| | - Fernanda Peixoto
- Universidade Federal de Goiás (UFG), Unidade de Terapia Intensiva, Goiânia, GO, Brazil
| | - Marcelo Barciela Brandão
- Universidade Estadual de Campinas (UNICAMP), Faculdade de Ciências Médicas, Departamento de Pediatria, Campinas, SP, Brazil
| | - Tania Maria Sih
- Universidade de São Paulo (FMUSP), Faculdade de Medicina, São Paulo, SP, Brazil; International Society for Otitis Media (ISOM), São Paulo, SP, Brazil
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13
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Dinarte VRP, Santos ARDD, Araújo LFD, Reis MGAD, Tamashiro E, Valera FCP, Silva Júnior WAD, Anselmo-Lima WT. Polymorphisms in chronic rhinosinusitis with nasal polyps - a systematic review. Braz J Otorhinolaryngol 2017; 83:705-711. [PMID: 28400178 PMCID: PMC9449184 DOI: 10.1016/j.bjorl.2017.03.002] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2016] [Revised: 01/29/2017] [Accepted: 03/01/2017] [Indexed: 12/14/2022] Open
Abstract
INTRODUCTION Chronic rhinosinusitis with nasal polyps is a multifactorial disease with a complex pathophysiology involving multiple genetic and environmental factors. OBJECTIVE The purpose of this work review is to focus on the importance of genetic studies in chronic rhinosinusitis with nasal polyps besides the several barriers that exists for its understanding. METHODS A systematic review on studies of association between single nucleotide polymorphisms and chronic rhinosinusitis with nasal polyps based on a PubMed/Medline and Periódicos CAPES search of all articles published between January 2005 and January 2015 was made. The search was guided on studies containing the terms polymorphisms, rhinosinusitis, and polyps. RESULTS Two studies found an association of MMP-9 and MMP-2 polymorphisms and chronic rhinosinusitis with nasal polyps, but not in patients with recurrent nasal polyps. Other studies found an association of nasal polyps with MMP-9 polymorphisms, but not with MMP-2 ones. There is evidence of an association of LTC4S, NOS2A, PTGDR, MET, COX-2, OSF-2, and LF polymorphisms and the risk of developing nasal polyps, especially when combined with chronic allergic rhinitis and asthma. CONCLUSION Genetic studies on chronic rhinosinusitis with nasal polyps are promising and may offer insights into its pathophysiology, which is likely affected by multiple genetic factors.
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Affiliation(s)
- Vanessa Ramos Pires Dinarte
- Escola de Medicina de Marília, Departamento de Otorrinolaringologia, Divisão de Otorrinolaringologia, Marília, SP, Brazil
| | - Anemari Ramos Dinarte Dos Santos
- Hemocentro de Ribeirão Preto, Centro Regional de Hemoterapia, Laboratório de Genética Molecular e Bioinformática (LGMB), Ribeirão Preto, SP, Brazil
| | - Luiza Ferreira de Araújo
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Genética, Ribeirão Preto, SP, Brazil
| | | | - Edwin Tamashiro
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
| | - Wilson Araújo da Silva Júnior
- Hemocentro de Ribeirão Preto, Centro Regional de Hemoterapia, Laboratório de Genética Molecular e Bioinformática (LGMB), Ribeirão Preto, SP, Brazil; Centros de Pesquisa, Inovação e Difusão/Fundação de Amparo à Pesquisa do Estado de São Paulo (Cepid/Fapesp), Centro de Terapia Celular, Departamento de Genética, São Paulo, SP, Brazil; Hospital das Clínicas, Universidade de São Paulo (HCFMRP/USP), Faculdade de Medicina de Ribeirão Preto, Center for Medical Genomics, Ribeirão Preto, SP, Brazil; Universidade de São Paulo (USP), Lista dos Núcleos de Apoio à Pesquisa (NAPs), Center for Integrative Systems Biology (CISBi), São Paulo, SP, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Universidade de São Paulo (USP), Faculdade de Medicina de Ribeirão Preto, Departamento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Ribeirão Preto, SP, Brazil
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Martins RB, Rocha LP, Prates MM, Gagliardi TB, Biasoli B, Leite MJ, Buzatto G, Hyppolito MA, Aragon DC, Tamashiro E, Valera FCP, Arruda E, Anselmo-Lima WT. Respiratory DNA viruses are undetectable in nasopharyngeal secretions from adenotonsillectomized children. PLoS One 2017; 12:e0174188. [PMID: 28306724 PMCID: PMC5357011 DOI: 10.1371/journal.pone.0174188] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2016] [Accepted: 03/03/2017] [Indexed: 01/12/2023] Open
Abstract
Respiratory viruses are frequently detected in association with chronic tonsillar hypertrophy in the absence of symptoms of acute respiratory infection (ARI). The present analysis was done in follow-up to a previous clinical study done by this same group. Nasopharyngeal washes (NPWs) were obtained from 83 of 120 individuals at variable times post adenotonsillectomy, in the absence of ARI symptoms. A look back at virus detection results in NPWs from the same 83 individuals at the time of tonsillectomy revealed that 73.5% (61/83) were positive for one or more viruses. The overall frequency of respiratory virus detection in post-tonsillectomy NPWs was 58.8%. Rhinovirus (RV) was the agent most frequently detected, in 38 of 83 subjects (45.8%), followed by enterovirus in 7 (8.4%), human metapneumovirus in 6 (7.2%), human respiratory syncytial virus in 3 (3.6%) and human coronavirus in 1 (1.2%). Remarkably, there was no detection of adenovirus (HAdV) or human bocavirus (HBoV) in asymptomatic individuals in follow-up of adenotonsillectomy. In keeping with persistence of respiratory DNA viruses in human tonsils, tonsillectomy significantly reduces asymptomatic shedding of HAdV and HBoV in NPWs.
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Affiliation(s)
- Ronaldo Bragança Martins
- Departments of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
- * E-mail:
| | - Lucas Penna Rocha
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Mirela Moreira Prates
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Talita Bianca Gagliardi
- Departments of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Balduino Biasoli
- Departments of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Marcelo Junqueira Leite
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Guilherme Buzatto
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Miguel Angelo Hyppolito
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Davi Casale Aragon
- Department of Pediatrics, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Edwin Tamashiro
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Fabiana Cardoso Pereira Valera
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Eurico Arruda
- Departments of Cell Biology, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto of University of São Paulo, Ribeirão Preto, Brazil
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de Felício CM, da Silva Dias FV, Folha GA, de Almeida LA, de Souza JF, Anselmo-Lima WT, Trawitzki LVV, Valera FCP. Orofacial motor functions in pediatric obstructive sleep apnea and implications for myofunctional therapy. Int J Pediatr Otorhinolaryngol 2016; 90:5-11. [PMID: 27729152 DOI: 10.1016/j.ijporl.2016.08.019] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2016] [Revised: 08/22/2016] [Accepted: 08/24/2016] [Indexed: 12/26/2022]
Abstract
OBJECTIVES The purposes of this study were (1) to identify possible differences in muscular and orofacial functions between children with obstructive sleep apnea (OSA) and with primary snoring (PS); (2) to examine the standardized difference between normal values of myofunctional scores and those of subjects with OSA or PS; and (3) to identify the features associated with OSA. METHODS Participants were 39 children (mean age 8 ± 1.2 years) of which, 27 had a diagnosis of OSA and 12 had PS. All participants were examined by an otorhinolaryngologist and underwent overnight polysomnography. Orofacial characteristics were determined through a validated protocol of orofacial myofunctional evaluation with scores (OMES), surface electromyography of masticatory muscles, and measurements of maximal lip and tongue strength. Reference values in the OMES were included to quantify the standardized difference (effect size = ES) relative to the groups studied and in the regression analysis. RESULTS The OSA group had lower scores in breathing and deglutition, more unbalanced masticatory muscle activities than PS group (P < 0.05), but both groups had similar reductions in orofacial strength. OSA had a large ES (Cohen's d > 0.8) in all analysed OMES scores, while PS group showed small and medium differences in breathing and mastication scores, respectively. The mobility of the stomatognathic components score was the most important to contribute for group status (57%, P < 0.0001) in the regression analysis. CONCLUSION Children with tonsillar hypertrophy and OSA had relevant impairments in orofacial functions and lesser muscular coordination than children with PS.
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Affiliation(s)
- Cláudia Maria de Felício
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil.
| | - Franciele Voltarelli da Silva Dias
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Gislaine Aparecida Folha
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Leila Azevedo de Almeida
- Department of Neurosciences and Behavioral Sciences, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Jaqueline Freitas de Souza
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Luciana Vitaliano Voi Trawitzki
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo - USP, Ribeirão Preto, SP, Brazil; Craniofacial Research Support Center, University of São Paulo - USP, Ribeirão Preto, SP, Brazil
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Demarco R, Strose A, Araújo M, Valera FCP, Moribe I, Anselmo-Lima WT. Endoscopic Revision of External Dacryocystorhinostomy. Otolaryngol Head Neck Surg 2016; 137:497-9. [PMID: 17765783 DOI: 10.1016/j.otohns.2007.03.023] [Citation(s) in RCA: 39] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2006] [Accepted: 03/13/2007] [Indexed: 11/17/2022]
Abstract
OBJECTIVES: To observe the benefit of endoscopic surgery for the treatment of lacrimal duct obstruction in revisional surgeries after external dacryocystorhinostomy. STUDY DESIGN AND SETTING: Retrospective nonrandomized study. Eleven cases of recurrent lacrimal duct obstruction after external dacryocystorhinostomy were submitted to endoscopic dacryocystorhinostomy. RESULTS: The rate of success after revisional surgery was 90.9%. The major causes of failure of the external approach were the presence of granulation tissue, septal deviations and synechiae near the opening of the fistula, inadequate removal of the bony wall adjuvant the lacrimal sac, technical error in the localization of the lacrimal sac, and excessive perioperative bleeding that impaired the surgical field. CONCLUSION: Endoscopic dacryocystorhinostomy in revisional cases proved to be a safe technique of low morbidity, permitting effective resolution of the lacrimal obstructions. SIGNIFICANCE: Endoscopic surgery allows greater visibility of the lacrimal sac and its neighbor anatomic alterations and leads to better results.
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Affiliation(s)
- Ricardo Demarco
- Department of Ophthalmology, Otorhinolaryngology-Head and Neck Surgery, University Hospital, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil-USP
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Spies JW, Valera FCP, Cordeiro DL, de Mendonça TN, Leite MGJ, Tamashiro E, Arruda LK, Anselmo-Lima WT. The role of aspirin desensitization in patients with aspirin-exacerbated respiratory disease (AERD). Braz J Otorhinolaryngol 2015; 82:263-8. [PMID: 26601997 PMCID: PMC9444683 DOI: 10.1016/j.bjorl.2015.04.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2014] [Revised: 04/15/2015] [Accepted: 04/16/2015] [Indexed: 12/30/2022] Open
Abstract
Introduction Aspirin-exacerbated respiratory disease (AERD) consists of a classic tetrad: moderate/severe asthma, chronic rhinosinusitis, nasal polyps, and intolerance to aspirin or other nonsteroidal anti-inflammatory drugs. Clinical control with drugs, surgery, and desensitization are treatment options. Objective To evaluate the efficacy and tolerability of aspirin desensitization in patients with AERD. Methods Periodic symptom assessment and endoscopy in patients with AERD undergoing surgery who were desensitized. Results Seventeen patients were desensitized. Eight patients completed the desensitization and were followed for a minimum of a one-year period (mean 3.1 years). These patients showed improvement in all symptoms. Moreover, surgical reassessment was not indicated in any of these patients and there was a decrease in costs with medication and procedures. Eight patients did not complete desensitization, mainly due to procedure intolerance and uncontrolled asthma, whereas another patient was lost to follow-up. Conclusion Aspirin desensitization, when tolerated, was effective in patients with AERD and with poor clinical/surgical response.
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Affiliation(s)
- Jonas Willian Spies
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Daniel Loiola Cordeiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Taís Nociti de Mendonça
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Marcelo Gonçalves Junqueira Leite
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Luiza Karla Arruda
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Ribeirão Preto, SP, Brazil.
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Dantas IDP, Valera FCP, Zappelini CEM, Anselmo-Lima WT. Prevalence of rhinitis symptoms among textile industry workers exposed to cotton dust. Int Arch Otorhinolaryngol 2015; 17:26-30. [PMID: 25991990 PMCID: PMC4423310 DOI: 10.7162/s1809-97772013000100005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2012] [Accepted: 10/07/2012] [Indexed: 11/05/2022] Open
Abstract
Introduction: The respiratory tract is one of the main points of entry of foreign substances into the body. Because of its location, the respiratory tract is heavily exposed to harmful agents, such as gases, vapors, or aerosols. Aim: Our objective was to evaluate the symptoms of occupational rhinitis in workers exposed to cotton dust. Method: The prospective study population consisted of workers from the “Nova Esperança” Cooperative of Nova Odessa (Sao Paulo), who were studied between September and December 2008. Data were collected through an individually and privately answered questionnaire designed by the author considering the clinical criteria for rhinitis. Results: Using the questionnaire, we evaluated a total of 124 workers. Among these patients, 63.7% complained of nasal obstruction, 57.2% of nasal itching, 46.7% of rhinorrhea, and 66.1% of sneezing. Of the patients considered to have very serious symptoms, 9% had nasal obstruction; 9%, itching; 4%, rhinorrhea; and 6.4%, sneezing. Discussion: Aerosol agents in the environment can clearly aggravate and even initiate rhinitis. From the standpoint of pathogenesis, the mechanisms of classical allergic airway inflammation involving mast cells, IgE, histamine, eosinophils, and lymphocytes may be responsible for the development of rhinitis after exposure to high molecular weight allergens such as proteins derived from animals and plants. This study showed a strong relationship between the occupational exposures associated with work in the cotton textile industry and the symptoms of rhinitis. Conclusion: Analysis of the data clearly showed the occurrence of rhinitis symptoms in these patients, demonstrating that the prevention and treatment of this condition in the workplace is extremely important.
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Affiliation(s)
- Ivan de Picoli Dantas
- Otorhinolaryngologist. PhD Student, University Hospital, Faculty of Medicine of Ribeirão Preto, Universidade de São Paulo (HCFMRP-USP)
| | - Fabiana Cardoso Pereira Valera
- Postdoctoral in Otorhinolaryngology. Professor, Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, HCFMRP-USP
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Kuroishi RCS, Garcia RB, Valera FCP, Anselmo-Lima WT, Fukuda MTH. Deficits in working memory, reading comprehension and arithmetic skills in children with mouth breathing syndrome: analytical cross-sectional study. SAO PAULO MED J 2015; 133:78-83. [PMID: 25271880 PMCID: PMC10496631 DOI: 10.1590/1516-3180.2013.7630011] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 09/04/2013] [Accepted: 06/11/2014] [Indexed: 11/22/2022] Open
Abstract
CONTEXT AND OBJECTIVE Mouth breathing syndrome is very common among school-age children, and it is possibly related to learning difficulties and low academic achievement. In this study, we investigated working memory, reading comprehension and arithmetic skills in children with nasal and mouth breathing. DESIGN AND SETTING Analytical cross-sectional study with control group conducted in a public university hospital. METHODS 42 children (mean age = 8.7 years) who had been identified as mouth breathers were compared with a control group (mean age = 8.4 years) matched for age and schooling. All the participants underwent a clinical interview, tone audiometry, otorhinolaryngological evaluation and cognitive assessment of phonological working memory (numbers and pseudowords), reading comprehension and arithmetic skills. RESULTS Children with mouth breathing had poorer performance than controls, regarding reading comprehension (P = 0.006), arithmetic (P = 0.025) and working memory for pseudowords (P = 0.002), but not for numbers (P = 0.76). CONCLUSION Children with mouth breathing have low academic achievement and poorer phonological working memory than controls. Teachers and healthcare professionals should be aware of the association of mouth breathing with children's physical and cognitive health.
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Affiliation(s)
- Rita Cristina Sadako Kuroishi
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil
| | - Ricardo Basso Garcia
- Department of Psychology, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto (FFCLRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil
| | - Marisa Tomoe Hebihara Fukuda
- Department of Ophthalmology, Otolaryngology and Head and Neck Surgery, Faculdade de Medicina de Ribeirão Preto (FMRP), Universidade de São Paulo (USP), Ribeirão Preto, São Paulo, Brasil
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Costa DB, Anselmo-Lima WT, Tamashiro E, Enoki C, Valera FCP. The impact of Metzembaum septoplasty on nasal and facial growth in children. Braz J Otorhinolaryngol 2013; 79:454-9. [PMID: 23929145 PMCID: PMC9442431 DOI: 10.5935/1808-8694.20130081] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Accepted: 03/27/2013] [Indexed: 11/20/2022] Open
Abstract
Several studies have investigated the effects of septoplasty on facial growth in children, with conflicting results. However, just handful of those employed objective measures or evaluated patients after facial growth completion. Objective This study assesses the effects of the Metzenbaum septoplasty, which preserves the perichondrium and growth-related areas on nasal and facial growth in children. Method We included those children submitted to surgery before the age of 14 and who had 16 years or years of follow up. Sixteen patients were selected. We evaluated the following parameters: clinical satisfaction (nasal patency and aesthetics), anthropometric measurements and cephalometry. Scientific design: cross-sectional historical cohort. Results The mean age at surgery was 13 years, children were assessed on average 4.3 years after surgery. Only one patient had anthropometric and cephalometric values below normal, but no aesthetics or patency complaints. Four other patients complained about their nasal aesthetics and three had patency complaints. Conclusion The Metzenbaum septoplasty appears to be a safe technique to correct caudal septum deviations. This technique had no significant impact on facial growth of the patients assessed.
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Affiliation(s)
- Denise Barreiro Costa
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Medical School of Ribeirão Preto, University of São Paulo, Avenida Bandeirantes no. 3900, Ribeirão Preto - SP, Brazil
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Costa EC, Sabino HAC, Miura CS, de Azevedo CB, de Menezes UP, Valera FCP, Anselmo-Lima WT. Atopy and adenotonsillar hypertrophy in mouth breathers from a reference center. Braz J Otorhinolaryngol 2013; 79:663-7. [PMID: 24474475 PMCID: PMC9442386 DOI: 10.5935/1808-8694.20130123] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Accepted: 06/16/2013] [Indexed: 01/30/2023] Open
Abstract
Mouth breathers use the oral cavity as their principal breathing route. The main causes include: adenotonsillar hypertrophy and inflammatory diseases such as allergic rhinitis. Objective To look for atopy, the main allergens involved and to check for atopy as a comorbidity with the degree of hypertrophy of the tonsils and adenoids in mouth breathers. Method A historical cohort study with cross-sectional review of 308 medical charts of patients treated at a mouth breather care center of a tertiary hospital in the period of 2008–2010. We collected data on the mouth breather's clinical history and we ran otolaryngological exams, flexible nasal endoscopy and skin prick test to aeroallergens. Results Of 308 patients, 36% were positive on allergy testing, with 95 % of atopic patients being positive for mites. Among all patients, 46% had adenoid hypertrophy; of these, 37% were atopic and 47% had tonsillar hypertrophy, and among these, 33% were atopic. Conclusion We found no direct correlation between atopy and the degree of tonsils and adenoid hypertrophy observed among the mouth-breathing patients assessed. si.
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Affiliation(s)
- Emanuel Capistrano Costa
- MD; Resident Physician, University Hospital, School of Medicine of Ribeirão Preto, University of Sãc Paulo
| | | | - Carolina Sponchiado Miura
- MD; Resident Physician, University Hospital, School of Medicine of Ribeirão Preto, University of Sãc Paulo
| | - Carolina Brotto de Azevedo
- MD; Resident Physician, University Hospital, School of Medicine of Ribeirão Preto, University of Sãc Paulo
| | - Ullissis Pádua de Menezes
- MD; Resident Physician, University Hospital, School of Medicine of Ribeirão Preto, University of Sãc Paulo
| | | | - Wilma Terezinha Anselmo-Lima
- Senior Associate Professor; Associate Professor, School of Medicine of Ribeirão Preto, University of São Paulo
- Send correspondence to: Wilma Terezinha Anselmo-Lima. Av. Bandeirantes, n 3900. Vila Monte Alegre. Ribeirão Preto - SP. Brasil. CEP: 14049-900. Tel: +55 (016) 3602-2862. Fax: +55 (016) 3602-2860
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Mello JFD, Mion ODG, Andrade NAD, Anselmo-Lima WT, Stamm AEC, Almeida WLDC, Cavalcante Filho PO, Castro JDCE, Padua FGDM, Romano FR, Santos RDP, Roitmann R, Voegels RL, Meirelles RC, Sá LCB, Moacyr MT, Santos MCJD, Guimarães RES. Brazilian Academy of Rhinology position paper on topical intranasal therapy. Braz J Otorhinolaryngol 2013; 79:391-400. [PMID: 23743757 PMCID: PMC9443840 DOI: 10.5935/1808-8694.20130067] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2011] [Accepted: 10/07/2012] [Indexed: 11/20/2022] Open
Abstract
This documents aims at educating those who treat sinonasal diseases - both general practitioners and specialists - about topical nasal treatments. By means of scientific evidence reviews, the Brazilian Academy of Rhinology provides its practical and updated guidelines on the most utilized topical nasal medication, except for the drugs that have topical antibiotics in their formulas.
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de Mello Júnior JF, de Godoy Mion O, de Andrade NA, Anselmo-Lima WT, Stamm AEC, de Cerqueira Almeida WL, Filho POC, de Carvalho e Castro J, de Melo Padua FG, Romano FR, de Paulo Santos R, Roitmann R, Voegels RL, Meirelles RC, Sá LCB, Moacyr MT, Santos MCJD, Guimarães RES. Brazilian academy of rhinology position paper on topical intranasal therapy. Braz J Otorhinolaryngol 2013. [DOI: 10.5935/1808-8694.20130120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Perez AC, Cunha Junior ADS, Fialho SL, Silva LM, Dorgam JV, Murashima ADAB, Silva AR, Rossato M, Anselmo-Lima WT. Assessing the maxillary sinus mucosa of rabbits in the presence of biodegradable implants. Braz J Otorhinolaryngol 2013; 78:40-6. [PMID: 23306566 PMCID: PMC9446343 DOI: 10.5935/1808-8694.20120031] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2012] [Accepted: 08/23/2012] [Indexed: 11/25/2022] Open
Abstract
In an attempt to improve the quality of life of patients with vitreous humor disease, ophthalmologists began offering steroid-eluting biodegradable implants to their patients. These implants can be used as an alternative treatment for CRS and this is why this experimental study was carried out on rabbit maxillary sinuses. Objective This study aims to assess the histology of the mucosa of the maxillary sinuses of rabbits after the placement of a prednisolone-eluting biodegradable implant. Method Eighteen rabbits were randomly divided into two groups: group 1 - subjects had drug-eluting implants placed on their left maxillary sinuses; group 2 - subjects had non-drug-eluting implants placed on their left maxillary sinuses. The right maxillary sinuses served as the controls. After seven, 14, and 28 days three rabbits in each group were randomly picked to have their tissue inflammatory response assessed. Results Levels of mucosal inflammation were not significantly different between the groups with and without drug-eluting implants and the control group, or when the groups with drug-eluting implants and non-drug-eluting implants were compared. Conclusion Signs of toxicity or mucosal inflammation were not observed in the maxillary sinuses of rabbits given prednisolone-eluting implants or non-drug-eluting implants.
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Affiliation(s)
- André Coura Perez
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes no. 3900, Ribeirão Preto - SP, Brazil.
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Cavallari FE, Valera FCP, Gallego AJ, Malinsky RR, Küpper DS, Milanezi C, Silva JSD, Tamashiro E, Anselmo-Lima WT. Expression of RANTES, eotaxin-2, ICAM-1, LFA-1 and CCR-3 in chronic rhinosinusitis patients with nasal polyposis. Acta Cir Bras 2013; 27:645-9. [PMID: 22936091 DOI: 10.1590/s0102-86502012000900010] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2012] [Accepted: 07/05/2012] [Indexed: 11/21/2022] Open
Abstract
PURPOSE To compare gene expression of the chemokines RANTES and eotaxin-2, its receptor, CCR-3, adhesion molecule ICAM-1 and its receptor LFA-1 in eosinophilic polyps and in control normal nasal mucosa. METHODS Gene expression was quantified by Real Time PCR in polyps (n=35) and in healthy nasal mucosa (n=15). RESULTS Eosinophilic polyps showed a higher expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa. CONCLUSION Eosinophilic polyps present greater expression of eotaxin-2 and RANTES, but not of CCR-3, ICAM-1 or LFA-1 compared to control nasal mucosa.
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Affiliation(s)
- Fransérgio Emílio Cavallari
- Department of Ophtalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirao Preto, USP, Sao Paulo-SP, Brazil
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de Souza JF, Grechi TH, Anselmo-Lima WT, Trawitzki LVV, Valera FCP. Mastication and deglutition changes in children with tonsillar hypertrophy. Braz J Otorhinolaryngol 2013; 79:424-8. [PMID: 23929140 PMCID: PMC9442428 DOI: 10.5935/1808-8694.20130076] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 04/14/2013] [Indexed: 11/20/2022] Open
Affiliation(s)
- Jaqueline Freitas de Souza
- Speech and Hearing Therapist (Speech and Hearing Therapist, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo)
| | - Tais Helena Grechi
- PhD (Speech and Hearing Therapist, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo)
| | - Wilma Terezinha Anselmo-Lima
- Associate Professor (Associate Professor of Otorhinolaryngology, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo)
| | - Luciana Vitaliano Voi Trawitzki
- PhD (Professor of Speech and Hearing Therapy, Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto, University of São Paulo)
| | - Fabiana Cardoso Pereira Valera
- Post-doctoral degree holder (Professor, School of Medicine of Ribeirão Preto, University of São Paulo). Faculty of Medicine of Ribeirão Preto - University of São Paulo
- Send correspondence to: Fabiana Cardoso Pereira Valera. Av. Bandeirantes, nº 3900, 12º andar. Ribeirão Preto - SP. Brazil. CEP: 14049-900. Tel: 55 (16) 3602-2862. Fax: 55 (16) 3602-2860.
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Proenca-Modena JL, Pereira Valera FC, Jacob MG, Buzatto GP, Saturno TH, Lopes L, Souza JM, Paula FE, Silva ML, Carenzi LR, Tamashiro E, Arruda E, Anselmo-Lima WT. High rates of detection of respiratory viruses in tonsillar tissues from children with chronic adenotonsillar disease. PLoS One 2012; 7:e42136. [PMID: 22870291 PMCID: PMC3411673 DOI: 10.1371/journal.pone.0042136] [Citation(s) in RCA: 66] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2012] [Accepted: 07/02/2012] [Indexed: 11/23/2022] Open
Abstract
Chronic tonsillar diseases are an important health problem, leading to large numbers of surgical procedures worldwide. Little is known about pathogenesis of these diseases. In order to investigate the role of respiratory viruses in chronic adenotonsillar diseases, we developed a cross-sectional study to determine the rates of viral detections of common respiratory viruses detected by TaqMan real time PCR (qPCR) in nasopharyngeal secretions, tonsillar tissues and peripheral blood from 121 children with chronic tonsillar diseases, without symptoms of acute respiratory infections. At least one respiratory virus was detected in 97.5% of patients. The viral co-infection rate was 69.5%. The most frequently detected viruses were human adenovirus in 47.1%, human enterovirus in 40.5%, human rhinovirus in 38%, human bocavirus in 29.8%, human metapneumovirus in 17.4% and human respiratory syncytial virus in 15.7%. Results of qPCR varied widely between sample sites: human adenovirus, human bocavirus and human enterovirus were predominantly detected in tissues, while human rhinovirus was more frequently detected in secretions. Rates of virus detection were remarkably high in tonsil tissues: over 85% in adenoids and close to 70% in palatine tonsils. In addition, overall virus detection rates were higher in more hypertrophic than in smaller adenoids (p = 0.05), and in the particular case of human enteroviruses, they were detected more frequently (p = 0.05) in larger palatine tonsils than in smaller ones. While persistence/latency of DNA viruses in tonsillar tissues has been documented, such is not the case of RNA viruses. Respiratory viruses are highly prevalent in adenoids and palatine tonsils of patients with chronic tonsillar diseases, and persistence of these viruses in tonsils may stimulate chronic inflammation and play a role in the pathogenesis of these diseases.
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Affiliation(s)
- Jose Luiz Proenca-Modena
- Department of Cell Biology, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Marcos Gerhardinger Jacob
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Guilherme Pietrucci Buzatto
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Tamara Honorato Saturno
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Lucia Lopes
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Jamila Mendonça Souza
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Flavia Escremim Paula
- Department of Cell Biology, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Maria Lucia Silva
- Department of Cell Biology, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Lucas Rodrigues Carenzi
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Edwin Tamashiro
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Eurico Arruda
- Department of Cell Biology, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
- Virology Research Center, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
| | - Wilma Terezinha Anselmo-Lima
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, School of Medicine of Ribeirao Preto of University of São Paulo, Ribeirao Preto, Brazil
- * E-mail:
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Park DM, Carvalho TLL, Franci JAA, Anselmo-Lima WT. Influence of treatment with intranasal corticosteroids on the nasal mucosa, weight, and corticosteroid concentration in rats. Am J Rhinol Allergy 2011; 26:e46-9. [PMID: 22182666 DOI: 10.2500/ajra.2012.26.3702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND The effect of intranasal corticosteroids on the nasal epithelium mucosa is an important parameter of treatment safety. This study was designed to examine whether treatment with topical corticosteroids in patients with allergic rhinitis causes atrophic nasal mucosal changes, when compared with systemic corticosteroids, in rats. METHODS Male Wistar rats were treated daily during 7 weeks with topical administration with 10 microliters of normal saline (control group), 10 microliters of mometasone furoate group, 10 microliters of triamcinolone acetonide (T group), and 8 mg/kg of daily subcutaneous injections of methylprednisolone sodium succinate (MP group). Body weight was evaluated weekly. At the end of the treatment, rats were killed by decapitation to collect blood for determination of corticosterone levels and nasal cavities were prepared for histological descriptive analyses. RESULTS Treatment with T and MP decreased body weight. Plasma corticosterone concentration was significantly reduced by MP treatment and presented a clear tendency to decrease after T treatment. Histological changes observed in group T included ripples, cell vacuolization, increase in the number of nuclei, and decrease in the number of cilia in the epithelial cells. CONCLUSION Growth and corticosterone concentration were impaired by T and MP at the same proportion, suggesting a role of this hormone in body gain. With the exception of T, intranasal or systemic treatment with the corticosteroids evaluated in this study did not affect nasal mucosa.
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Affiliation(s)
- Danielle Morello Park
- Department of Ophthalmology, Otolaryngology, and Head and Neck Surgery, School of Medicine, University of São Paulo, Ribeirão Preto, SP, Brazil
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Ganança FF, Gouveia MDCL, Anselmo-Lima WT. A very important step: indexation in Thomson Reuters - Journal Citation Reports. Braz J Otorhinolaryngol 2011. [PMCID: PMC9443765 DOI: 10.1590/s1808-86942011000500001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Valera FCP, Scrideli C, Queinoz R, Gonzaiga Tone L, Anselmo-Lima WT. NF-kappaB expression predicts clinical outcome for nasal polyposis. Rhinology 2011; 48:408-41. [PMID: 21442076 DOI: 10.4193/rhino09.161] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE To correlate clinical prognosis to the expression of p65, c-Fos, GRalpha and GRbeta in patients with nasal polyps. METHODS A biopsy was obtained at the first evaluation for patients with nasal polyps (20), and at rhinoplasty for control mucosa (8). Patients with nasal polyps were treated with glucocorticoids and followed for at least 30 months. The expression of each gene (p65, c-Fos, GRalpha and GRbeta) was determined by Real Time-PCR and correlated to clinical outcome. The indication for surgery was considered the end-point of resistance to glucocorticoid therapy. RESULTS Patients with nasal polyps presented a higher expression of p65 (P<0.05), and a lower expression of GRalpha (P<0.0001), and of GRalpha/GRbeta relation (P<0.0001) than controls. The nasal polyps patients with higher expression of p65 correlated with a poorer response to glucocorticoids (P<0.05), with a four-fold higher risk for surgery to control symptoms. CONCLUSION Patients with nasal polyps presented higher gene expression of p65, and a reduced expression of GRalpha and of GRalpha/GRbeta relation than controls. Higher p65 (NFkappaB) expression at diagnosis was also associated to a worst response to medical treatment, suggesting this could be considered as one mechanism of cell resistance to glucocorticoid treatment in patients with nasal polyps.
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Affiliation(s)
- F Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and neck Surgery, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil
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Mantovani K, Bisanha AA, Demarco RC, Tamashiro E, Martinez R, Anselmo-Lima WT. Análise microbiológica em secreção de seio maxilar nos pacientes com rinossinusite crônica. Braz J Otorhinolaryngol 2010. [PMID: 20963334 PMCID: PMC9450736 DOI: 10.1590/s1808-86942010000500002] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract There isn't definitive and consistent data concerning the distribution of bacterial species in patients with Chronic Sinusitis (CS). The variability of the results from studies in CS may be due to the different techniques used as collection method, variations in culture methods, previous antibiotic use, and difficulty in distinguishing bacterial flora from pathogenic agents. Study design Clinical prospective. Aim To identify the incidence of microorganisms in patients with CRS by growing bacteria from the secretion of the maxillary sinus. Patients and Methods Cross-sectional study in 62 patients that had undergone FESS for treatment of chronic sinusitis; cultures from the maxillary sinus were obtained. Results 62 samples, 33 (53.2%) had no growth; 29 (45.2%) counts of aerobic bacteria; one case (1.6%) of fungus growth; we did not find anaerobic bacteria. Pseudomonas aeruginosa was the one more frequently found - 8 samples (27.6%), Staphylococcus aureus and Staphylococcus epidermidis in 4 samples each; Streptococcus pneumoniae in 3 samples (10.4%); other Gram negative agents in 17 samples (31%). Conclusion In the present study we concluded that Pseudomonas aeruginosa, other Gram negatives bacteria and Staphylococcus spp were the representatives of the bacterial flora found in the paranasal sinuses of patients with CS.
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Faidiga GB, Carenzi LR, Yassuda CC, Silveira F, Lago TD, Leite MGJ, Anselmo-Lima WT. Avaliação tardia em rinoplastia estética em um centro acadêmico de referência. Braz J Otorhinolaryngol 2010. [PMID: 20835529 PMCID: PMC9446188 DOI: 10.1590/s1808-86942010000400006] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Plastic surgery is based on improving esthetic for the patient. In most services, the surgery outcome is evaluated in a subjective manner. Aim to objectively assess the degree of patient satisfaction one year after rhinoplasty using the Rhinoplasty Outcome Evaluation questionnaire at a referral academic center. Materials and Methods 69 patients operated in the otorhinolaryngology service were selected. The patients were operated upon by third year residents during the period from January to December 2007 and answered the questionnaire translated by the authors of this study. Results we obtained a mean value of 73.25% of satisfaction for primary rhinoplasty and a mean value of 72.02% of satisfaction for secondary rhinoplasty. Conclusion the level of satisfaction presented by the patients was considered to be very good.
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Abstract
OBJETIVO: o presente estudo propõe-se a comparar as dimensões da nasofaringe e as características esqueléticas avaliadas por exame cefalométrico, em indivíduos com padrões morfológicos distintos. MÉTODOS: foram utilizadas 90 telerradiografias de pacientes de ambos os gêneros, de 12 a 16 anos de idade, as quais foram igualmente divididas em três grupos distintos, referentes aos padrões morfológicos - braquifacial, mesofacial e dolicofacial. Foram realizadas medições específicas da região nasofaringeana (ad1-Ptm, ad2-Ptm, ad1-Ba, ad2-S0, (ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100, e Ptm-Ba) e relativas ao padrão esquelético da face. RESULTADOS: observou-se que os pacientes dolicofaciais apresentaram menor profundidade sagital óssea (Ptm-Ba) e da via aérea da nasofaringe (ad1-Ptm e ad2-Ptm). Sugere-se que essas diferenças estejam relacionadas a um posicionamento relativamente mais posterior da maxila, comum a esses pacientes. Todavia, não foram detectadas diferenças quanto à espessura de tecido mole na parede posterior nasofaringeana (ad1-Ba e ad2-S0), ou à sua proporção em relação a toda a área delimitada para a nasofaringe [(ad1-ad2-S0-Ba-ad1/Ptm-S 0-Ba-Ptm) X 100]. CONCLUSÃO: sugere-se, portanto, que as características faciais de excesso vertical encontradas em pacientes dolicofaciais podem ocorrer, dentre outros fatores, em virtude da obstrução da via aérea nasofaringeana, uma vez que tais dimensões se apresentaram menores para os dolicofaciais.
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Matsumoto MAN, Itikawa CE, Pereira Valera FC, Faria G, Anselmo-Lima WT. Long-Term Effects of Rapid Maxillary Expansion on Nasal Area and Nasal Airway Resistance. Am J Rhinol Allergy 2010; 24:161-5. [DOI: 10.2500/ajra.2010.24.3440] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Background Rapid maxillary expansion (RME) may improve the nasal respiratory pattern. This study was performed to evaluate the effect of RME on the nasal cavity by acoustic rhinometry and computed rhinomanometry and to determine nasal and maxillary width by posteroanterior cephalometric radiography, up to 30 months after the orthodontic procedure. Methods Twenty-seven children with oral breathing, ranging in age from 7 to 10 years, and with mixed dentition were selected. The children had unior bilateral posterior crossbite involving deciduous canines and the first permanent molars. All subjects were submitted to nasofibroscopy, acoustic rhinometry, and computed rhinomanometry and posteroanterior cephalometric radiography at four different times, i.e., before expansion, immediately, 90 days and 30 months after expansion. Results The mean linear left-to-right nasal cavity lateral prominence and left-to-right jugal points cephalometric measures increased considerably after expansion and this increase was maintained throughout the period of evaluation. There was an immediate significant decrease in nasal resistance, up to 90 days after RME, but the nasal resistance increased 30 months after the procedure. The acoustic rhinometry results did not show any difference in values throughout time. Conclusion RME significantly increased nasal and maxillary width as measured by frontal cephalometry, but the nasal mucosal effects were more subtle. Also, the influence of RME on nasal resistance was not stable, and nasal resistance values returned to close to the initial ones after 30 months.
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Affiliation(s)
| | - Carla Enoki Itikawa
- Department of Children's Clinical Preventive Dentistry, School of Dentistry of Ribeirão Preto
| | - Fabiana Cardoso Pereira Valera
- Department of Otorhinolaryngology, University Hospital, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
| | - Gisele Faria
- Department of Children's Clinical Preventive Dentistry, School of Dentistry of Ribeirão Preto
| | - Wilma Terezinha Anselmo-Lima
- Department of Otorhinolaryngology, University Hospital, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, SP, Brazil
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Scanavine ABA, Navarro JAC, Megale SRMDCL, Anselmo-Lima WT. Anatomical study of the sphenopalatine foramen. Braz J Otorhinolaryngol 2010; 75:37-41. [PMID: 19488558 PMCID: PMC9442255 DOI: 10.1016/s1808-8694(15)30829-6] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2007] [Accepted: 02/12/2007] [Indexed: 11/23/2022] Open
Abstract
Anatomical variations of the sphenopalatine foramen may correspond to alterations at the arterial nasal irrigation input, which is a relevant condition to treat severe epistaxis through ligation of the sphenopalatine artery. Aim: To study the sphenopalatine foramen in terms of its numeric variation and its location on the lateral nasal wall in relation to the bony ethmoidal crest of the palatine bone. Materials and methods: The anatomical studies were carried out in 54 hemifaces. Results: the sphenopalatine foramen presented the following numeric variation: single (87%, or 47 specimens), double (11,1%, or 6 specimens), and triple (1.9% or one specimen); it was located at the superior nasal meatus in 81.5%, or 44 specimens; 14.8% (8 specimens) between the middle and superior nasal meatus and in the middle nasal meatus in only one case (1.9%). Conclusion: We have been able to show a numeric variation of the SPF, its relation with the bony ethmoidal crest and its location in the superior meatus, middle meatus, and in both.
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Affiliation(s)
- Fabiana Cardoso Pereira Valera
- Department of Ophthalmology, Otorhinolaryngology, and Head and Neck Surgery, School of Medicine of Ribeirão Preto-University of São Paulo. Ribeirão Preto, São Paulo, Brazil.
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Valera FCP, Queiroz R, Scrideli C, Tone LG, Anselmo-Lima WT. Evaluating budesonide efficacy in nasal polyposis and predicting the resistance to treatment. Clin Exp Allergy 2008; 39:81-8. [PMID: 19068102 DOI: 10.1111/j.1365-2222.2008.03144.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Cell resistance to glucocorticoids is a major problem in the treatment of nasal polyposis (NP). OBJECTIVES The objectives of this study were to observe the effect of budesonide on the expression of IL-1beta, TNF-alpha, granulocyte macrophage-colony stimulating factor, intercellular adhesion molecule (ICAM)-1, basic fibroblast growth factor, eotaxin-2, glucocorticoid receptor (GR)-alpha, GR-beta, c-Fos and p65 in nasal polyps and to correlate their expression to clinical response. METHODS Biopsies from nasal polyps were obtained from 20 patients before and after treatment with topical budesonide. Clinical response to treatment was monitored by a questionnaire and nasal endoscopy. The mRNA levels of the studied genes were measured by real-time quantitative (RQ)-PCR. RESULTS There was a significant decrease in the expression of TNF-alpha (P<0.05), eotaxin-2 (P<0.05) and p65 (P<0.05) in NP after treatment. Poor responders to glucocorticoids showed higher expression of IL-1beta (3.74 vs. 0.14; P<0.005), ICAM-1 (1.91 vs. 0.29; P<0.05) and p65 (0.70 vs. 0.16; P<0.05) before treatment. Following treatment, IL-1beta (4.18 vs. 0.42; P<0.005) and GR-beta (0.95 vs. 0.28; P<0.05) mRNA expression was higher in this group. CONCLUSION Topical budesonide reduced the expression of TNF-alpha, eotaxin-2 and p65. Poor responders to topical budesonide exhibit higher levels of IL-1beta, ICAM-1 and nuclear factor (NF)-kappaB at diagnosis and higher expression of both IL-1beta and GR-beta after treatment. These results emphasize the anti-inflammatory action of topical budesonide at the molecular level and its importance in the treatment of NP. Nevertheless, IL-1beta, ICAM-1 and NF-kappaB may be associated with primary resistance to glucocorticoids in NP, whereas higher expression of GR-beta in poor responders only after glucocorticoid treatment may represent a secondary drug resistance mechanism in this disease.
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Affiliation(s)
- F C P Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, São Paulo, Brazil.
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Abstract
BACKGROUND The treatment and prognosis of nasal polyposis (NP) may be influenced by transcription factors, but their expression is poorly understood. OBJECTIVE To determine the expression of transcription factors [(nuclear factor-kappaB) NF-kappaB and (activator protein) AP-1], cytokines [IL-1beta, TNF-alpha and (granulocytes and macrophage colony-stimulating factor) GM-CSF], growth factor (b-FGF), chemokine (eotaxin-2) and adhesion molecule (ICAM-1) in NP in comparison with nasal mucosa controls. Methods Cross-sectional study. Twenty biopsies of nasal polyps were compared with eight middle turbinate biopsies. p65, c-Fos, IL-1beta, TNF-alpha, ICAM-1, b-FGF, eotaxin-2 and GM-CSF were analysed through RQ-PCR, and p65 and c-Fos were also analysed through Western blotting. RESULTS NF-kappaB expression was increased in patients with NP when compared with control mucosa (P<0.05), whereas AP-1 expression did not differ significantly between groups. Expressions of IL-1beta, eotaxin-2 and b-FGF were also increased in patients with NP compared with controls (P<0.05). CONCLUSIONS The transcription factor NF-kappaB is more expressed in NP than in control mucosa. This is important in NP because NF-kappaB can induce the transcription of cytokines, chemokines and adhesion molecules, which play an important role in the inflammatory process. Moreover, transcription factors influence the response to corticosteroids, which are the basis of NP treatment. Transcription factor AP-1 does not seem to have a significant role in the pathological process.
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Affiliation(s)
- F C P Valera
- Department of Ophthalmology, Otorhinolaryngology and Head and Neck Surgery, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, Brazil.
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Bandos RD, Rodrigues de Mello V, Ferreira MDS, Rossato M, Anselmo-Lima WT. Clinical and ultrastructural study after partial inferior turbinectomy. Braz J Otorhinolaryngol 2007; 72:609-16. [PMID: 17221052 PMCID: PMC9443527 DOI: 10.1016/s1808-8694(15)31016-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2005] [Accepted: 08/03/2006] [Indexed: 11/22/2022] Open
Abstract
We report clinical and histological results obtained after partial inferior turbinectomy (PIT), surgery indicated for the treatment of chronic nasal obstruction. Methods Twenty patients were divided into two groups submitted to PIT plus septoplasty and PIT alone. The patients were reassessed clinically and histologically by means of a biopsy of the regenerated areas in the inferior turbinates at two different times after PIT, i.e., after 8 to 12 months (group A) and after two years (group B). Results The clinical results proved to be satisfactory for the relief of nasal obstruction in group A and unsatisfactory in group B. However, better histological results with better recovery and epithelial differentiation of the regenerated mucosa of the inferior turbinates after PIT were observed in group B. Conclusion Surgery proved to be effective on a short-term but not on a long-term basis, and histological recovery did not accompany improvement of clinical signs and symptoms.
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Affiliation(s)
- Rogério Dutra Bandos
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Departmento de Oftalmologia, Otorrinolaringologia e Cirurgia de Cabeça e Pescoço, Hospital das Clínicas, Brazil
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Enoki C, Valera FCP, Lessa FCR, Elias AM, Matsumoto MAN, Anselmo-Lima WT. Effect of rapid maxillary expansion on the dimension of the nasal cavity and on nasal air resistance. Int J Pediatr Otorhinolaryngol 2006; 70:1225-30. [PMID: 16497390 DOI: 10.1016/j.ijporl.2005.12.019] [Citation(s) in RCA: 58] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2005] [Revised: 12/29/2005] [Accepted: 12/31/2005] [Indexed: 11/27/2022]
Abstract
INTRODUCTION Atresia of the maxilla is a transverse skeletal dysplasia, possibly associated with respiratory problems. For its correction, rapid maxillary expansion is a feasible orthodontic process. OBJECTIVE To evaluate the effect of rapid maxillary expansion on the nasal cavity by acoustic rhinometry and computed rhinomanometry. MATERIAL AND METHODS Twenty-nine children of both sexes with oral and/or mixed breathing, ranging in age from 7 to 10 years and with mixed dentition were selected. The children had uni- or bilateral posterior crossbite involving deciduous canines and the first permanent molars and were not being submitted to any otorhinolaryngologic or orthodontic treatment. All subjects were submitted to rhinologic exams and orthodontic documentation at three different times, i.e., before expansion and immediately and 90 days after expansion. RESULTS There was no difference in the minimal cross-sectional area at the level of the valve and inferior nasal turbinate between the periods analyzed, but there was a statistically significant reduction in nasal resistance after expansion. CONCLUSION On the basis of the present results, we may conclude that rapid maxillary expansion may lessen the nasal resistance. Although there was no difference in nasal geometry. Thus, this procedure may improve nasal respiration, but cannot be indicated for this purpose by itself.
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Affiliation(s)
- Carla Enoki
- Department of Pathology, Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo, Ribeirão Preto, SP, Brazil
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Rizzatti EG, Falcão RP, Panepucci RA, Proto-Siqueira R, Anselmo-Lima WT, Okamoto OK, Zago MA. Gene expression profiling of mantle cell lymphoma cells reveals aberrant expression of genes from the PI3K-AKT, WNT and TGFbeta signalling pathways. Br J Haematol 2005; 130:516-26. [PMID: 16098065 DOI: 10.1111/j.1365-2141.2005.05630.x] [Citation(s) in RCA: 126] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Microarray studies have revealed the differential expression of several genes in mantle cell lymphoma (MCL), but it is unknown which of these differences are dependent on the transformed MCL cell itself or on the tumour microenvironment. To investigate which genes and signalling pathways are aberrantly expressed in MCL cells we used oligonucleotide microarrays to perform gene expression profiling of both purified leukaemic MCL cells and their normal counterparts, the naive B cells. A total of 106 genes were differentially expressed at least threefold in MCL cells compared with naive B cells; 63 upregulated and 43 downregulated. To validate the microarray results in a larger set of samples, we selected 10 differentially expressed genes and quantified their expression by real-time polymerase chain reaction in peripheral blood of MCL patients (n=21), purified MCL cells (n=6) and naive B cells (n=4), obtaining fully concordant results. A computer-assisted approach was used to procure specific molecular signalling pathways that were aberrantly expressed in MCL cells. Several genes related to apoptosis and to the PI3K/AKT, WNT and tumour growth factor beta signalling pathways were altered in MCL cells when compared with naive B cells. These pathways may play a significant role in the pathogenesis of MCL and deserve further investigation as candidates for new therapeutic targets.
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Affiliation(s)
- Edgar Gil Rizzatti
- Department of Clinical Medicine, Ribeirão Preto Medical School, University of São Paulo, Ribeirão Preto, SP, Brazil
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Küpper DS, Demarco RC, Resende R, Anselmo-Lima WT, Valera FCP, Moribe I. Dacriocistorrinostomia endoscópica nasal: resultados e vantagens sobre a abordagem externa. ACTA ACUST UNITED AC 2005. [DOI: 10.1590/s0034-72992005000300015] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
A Dacriocistorrinostomia (DCR) consiste em criar uma via de drenagem lacrimal para a cavidade nasal, tendo como objetivo restabelecer a drenagem permanente deste sistema excretor previamente obstruído. OBJETIVO: Relatar nossos resultados com a técnica de DCR endoscópica, expondo vantagens e desvantagens em relação à técnica externa. FORMA DE ESTUDO: Coorte histórica. MATERIAL E MÉTODO: Foram analisadas retrospectivamente trinta e duas dacriocistorrinostomias realizadas pela Disciplina de Otorrinolaringologia de março de 2002 a janeiro de 2004 em pacientes com obstrução pós-saco lacrimal comprovada por dacriocistografia (DCG). Todos foram submetidos à sondagem com sonda de Crawford. RESULTADOS: Dos vinte e dois pacientes analisados, a cirurgia foi bilateral em dez totalizando trinta e dois procedimentos, sendo vinte e nove cirurgias primárias e três casos revisionais de insucessos com DCR externa. Nossa taxa de sucesso foi de 79,12%. CONCLUSÕES: A DCR endoscópica mostrou ser uma técnica segura, com baixa morbidade, além de evitar cicatrizes faciais e manter o mecanismo de bomba lacrimal, com resultados semelhantes à DCR externa.
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Küpper DS, Demarco RC, Resende R, Anselmo-Lima WT, Valera FCP, Moribe I. [Endoscopic nasal dacryocystorhinostomy: results and advantages over the external approach]. Braz J Otorhinolaryngol 2005; 71:356-60. [PMID: 16446941 PMCID: PMC9450531 DOI: 10.1016/s1808-8694(15)31335-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
UNLABELLED Dacryocystorhinostomy (DCR) is a procedure used to create a lachrymal drainage pathway into the nasal cavity in order to reestablish the permanent drainage of a previously obstructed excretory system. AIM to report our results obtained with endoscopic DCR technique, describing its advantages and disadvantages STUDY DESIGN Historic cohort. MATERIAL AND METHOD we retrospectively analyzed thirty-two dacryocystorhinostomies performed at the Otorhinolaryngology Discipline from March 2002 to January 2004 on patients with post-lachrymal sac obstruction confirmed by dacryocystorhinography (DCG). In all cases, the patients were submitted to probing with Crawford probe. RESULTS surgery was bilateral in ten of the twenty-two analyzed patients, totaling thirty-two procedures, twenty-nine of which were primary surgeries and three revision procedures after unsuccessful external DCR. Our success rate was 79.12%. CONCLUSIONS endoscopic DCR proved to be a safe and low morbidity technique, which also avoids facial scars and maintains the mechanism of the lachrymal pump, with results similar to those obtained with external DCR.
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Abstract
Previous studies have demonstrated that acoustic rhinometry (AR) has a considerable utility in measuring nasal patency and in detecting the nasal cycle. This study was performed in 10 patients with chronic rhinosinusitis who were submitted to endoscopic sinus surgery. AR was used to determine minimum nasal cross-sectional area and volume as the indices of the nasal patency in all patients on the day before the surgery and 3 months postoperatively. We did not find any significant alteration when comparing the pattern of fluctuation, the periodicity, and the amplitude of the nasal cycle demonstrated by patients in the pre and postoperative periods, confirming that this surgery does not have any adverse effect on this physiologic cycle.
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Affiliation(s)
- W T Anselmo-Lima
- Faculty of Medicine of Ribeirão Preto-University of São Paulo, Brazil
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Abstract
A total of 45 children aged 4-12 years were studied at the Rhinosinusology out-patient clinic of HCFMRP. The patients complained of marked nasal obstruction refractory to any clinical treatment, and a cavum X-ray showed no sign of airway obstruction. All children were submitted to nasal fiberoptic examination in order to determine the number of false-negative results. The examinations showed 12 cases of severe hypertrophy of adenoid vegetations (27%) and 19 cases of moderate hypertrophy (42%). Furthermore, we detected six cases of hypertrophy of the turbinate cauda (13.3%) and three cases of posterior septal deviation (6.6%). These data suggest the importance of the indication of this examination, which permits a tri-dimensional and dynamic evaluation of the cavum area.
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Affiliation(s)
- B B Souza
- Department of Opthalmology and Otorhinolaryngology, Faculty de Medicina de Ribeirao, University de Sao Paulo, Avenue Bandeirantes 3900, 14049-900 Ribeirao Preto, Sao Paulo, Brazil
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Abstract
The middle turbinate and nasal septum are innervated by the anterior ethmoidal nerve, a branch of the ophthalmic division of the trigeminal nerve. As reported in the classical work of Wolff (1948), stimulation of these regions causes pain in the medial canthus of the supraorbital region. Periorbital pain due to middle turbinate compression against the septum or the lateral wall of the nose may be due to congestion of the nasal mucosa or to pneumatization of the middle turbinate (concha bullosa). The diagnosis is made by exclusion and requires a high index of suspicion, anterior rhinoscopy, computerized tomography (CT), and confirmation by the lidocaine test. We present five cases of middle turbinate headache syndrome, all with concha bullosa. Four were treated surgically by partial middle turbinectomy and septoplasty more than 1 year ago, with excellent results. One patient refused surgical treatment which was suggested after failure of medical treatment with antihistamines, decongestants, and a topical corticosteroid, and continues to be symptomatic. Despite the small number of cases studied, the authors concluded that the procedure used was effective for the resolution of headache.
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Affiliation(s)
- W T Anselmo-Lima
- Department of Ophthalmology, Faculty of Medicine of Ribeirão Preto, University of São Paulo, Brazil
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Abstract
The study of CSF fistulae, and especially those involving otolaryngological anomalies, must be based on the search for the causative problem of recurrent meningitis. Congenital malformations, post-traumatic and post-operative situations or even diseases involving the cranial bones are basic causes that should be studied. Currently, cranial trauma is the most usual cause of CSF fistulae, with the possibility of recurrent bacterial meningitis.
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Affiliation(s)
- M V Moura-Ribeiro
- Faculdade de Medicina de Ribeirão Preto, Universidade de São Paulo (USP), Brasil
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