Elaborating clinical characteristics of COVID-19 by focusing on the symptoms concerning otolaryngologists

Novel coronavirus disease (COVID-19) has spread rapidly worldwide and penetrated most of the countries in a short time period, affecting millions of individuals. Otolaryngologists are on the frontlines of this pandemic. In this review, we discuss clinical symptoms concerning the ear, nose and throat (ENT) field. There are various clinical presentations of COVID-19 ranging from asymptomatic or mild disease to severe disease, causing pneumonia, multi-organ dysfunction, and death. Fever, cough, and fatigue are the most common symptoms of the disease. Dysfunctions in smell and taste have been also frequently reported. Questioning individuals for these dysfunctions may be a part of routine examination procedures of COVID-19 in the imminent future. In addition, unusual presentations have been reported from many countries. What is crucial about these rare presentations is that otolaryngologists must always be vigilant for a possible COVID-19 diagnosis in patients admitted even with classical ENT complaints to prevent exposure of the unprotected healthcare providers and delay in diagnosis. The role of otolaryngologists in diagnosing and managing COVID-19 patients is of utmost importance, considering the clinical scene built by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Most of the symptoms observed in COVID-19 are frequent reasons for applying to ENT clinics during daily routine, putting them under risk of catching the virus. Therefore, otolaryngologists must be fully equipped with protection and be alert for suspecting the novel disease during the pandemic era

Naczyniakowłókniakomięsak skóry błędnie rozpoznany jako guz ślinianki przyusznej – opis przypadku

Introduction: Angiomyolipoma is a benign tumor consisting of vascular structures, smooth muscle and adipose tissue. It is most commonly found in the kidneys and more rarely in the liver, lung, heart, intestines, nasal cavity, oral cavity and ear. Cutaneous angiomyolipomas are very rare and show some differences with non-cutaneous angiomyolipomas; these are mostly located in the distal extremities and are a result of traumas and HMB-45 antibody negativity and appear more frequently in men. Neither of the cases, except for one presented until today, had cellular atypia; thus, cutaneous angiomyolipomas are considered not to lead to malignant transformation. It is thought that total excision of the mass is indicated in the treatment of cutaneous angiomyolipoma. Case report: Our case presented to our clinic with a left preauricular mass which was thought to be a parotid mass after an initial physical examination. The MRI revealed that the mass did not originate from the parotid gland. The fine-needle aspiration biopsy (FNAB) was non-diagnostic and the mass was excised. The pathological examination revealed „angiomyolipoma”.Wprowadzenie: Naczyniakomięśniakotłuszczak jest łagodnym nowotworem, składającym się ze struktur naczyniowych, mięśni gładkich i tkanki tłuszczowej. Najczęściej pojawia się w nerkach, rzadziej w: wątrobie, płucach, sercu, jelitach, jamie nosowej, jamie ustnej i uchu. Naczyniakomięśniakotłuszczak skóry występuje bardzo rzadko i wykazuje pewne różnice w stosunku do postaci pozaskórnych, w tym: zazwyczaj lokalizuje się w dystalnych częściach kończyn w miejscu urazu, daje ujemny wynik w badaniu immunohistochemicznym z przeciwciałami HMB-45 i dotyczy częściej mężczyzn niż kobiet. We wszystkich przypadkach opisanych do tej pory, z jednym wyjątkiem, nie stwierdzano atypii komórkowej. W związku z tym uważa się, że naczyniakomięśniakotłuszczak skóry nie ulega transformacji złośliwej. Uważa się, że całkowite wycięcie masy jest właściwym leczeniem w postaci skórnej. Opis przypadku: W opisywanym przez nas przypadku pacjentka zgłosiła się do naszej kliniki ze zmianą guzowatą lewej okolicy przedusznej, którą po badaniu przedmiotowym uznano za wywodzącą się ze śliniaki przyusznej. Po przeprowadzeniu badania MRI stwierdzono, że masa nie pochodzi ze ślinianki przyusznej. Po niediagnostycznym wyniku FNAB zdecydowano o resekcji zmiany. Badanie histopatologiczne wskazało rozpoznanie „angiomyolipoma”

The Role of Indirect Laryngoscopy, Clinical and Ultrasonographic Assessment in Prediction of Difficult Airway.

Objectives Pre-operative airway evaluation is essential to decrease the proportion of possible mortality and morbidity due to difficult airway (DA). The study aimed to evaluate the accuracy of pre-operative ultrasonographic airway assessment (UAA) and indirect laryngoscopy (IL) in predicting DA. Study Design Prospective obsevational study. Methods Preoperative clinical examination (body mass index [BMI], mallampati classification [MP], thyromental distance, sternomental distance, neck circumference), UAA (epiglottis-skin distance [ESD], hyoid bone-skin distance [HSD], the thickness of tongue root [ToTR], anterior commissure-skin distance [ACSD]) and IL with the rigid 70-degree laryngoscope were performed to predict DA (Cormack-Lehane grade 3 and 4). The sensitivity, specificity, positive predictive value (PP), and negative predictive values of the parameters were assessed. Results Twenty-two of 140 (15.7%) patients were diagnosed with DA. The cut-off points of ESD, HSD, ToTR, ACSD, and BMI were 2.09 cm, 0.835 cm, 4.05 cm, 0.545 cm, and 27.10, respectively. AUC values were 0.874, 0.885, 0.871, 0.658, and 0.751 in the same order. AUC values for IL and MP were 0.773 and 0.925, respectively. MP and HSD had the best sensitivity (91%), IL grading had the best specificity (100%), and PP (100%) value among all measurements. The best-balanced sensitivity (91%), specificity (97%), and PP (88%) values were obtained by combining the IL with MP and ESD or with MP and HSD. Conclusions Ultrasonographic measurements and IL were found significantly correlated to predict DA. Combined parameters, the IL with MP and ESD or with MP and HSD, are the best parameters in predicting the DA. Level of Evidence 4Laryngoscope, 202

Olfactory dysfunction and coronavirus disease 2019 severity: a prospective cohort study.

© 2021 Cambridge University Press. All rights reserved.Objective. The primary goal of this study was to evaluate the association between olfactory dysfunction or taste impairment olfactory dysfunction and disease severity and radiological findings in coronavirus disease-2019. The secondary goal was to assess the prevalence, severity and course of olfactory dysfunction or taste impairment in patients with coronavirus disease 2019. Method. This prospective observational cohort study evaluated patients hospitalised with coronavirus disease 2019 between April 1 and 1 May 2020. olfactory dysfunction and taste impairment were evaluated by two questionnaires. Chest computed tomography findings and coronavirus disease 2019 severity were assessed. Results. Among 133 patients, 23.3 per cent and 30.8 per cent experienced olfactory dysfunction and taste impairment, respectively, and 17.2 per cent experienced both. The mean age was 56.03 years, and 64.7 per cent were male and 35.3 per cent were female. No statistically significant association was found between olfactory dysfunction (p = 0.706) and taste impairment (p = 0.35) with either disease severity or chest computed tomography grading. Conclusion. Olfactory dysfunction or taste impairment does not have prognostic importance in patients with coronavirus disease 2019

Subclinic arterial and left ventricular systolic impairment in autosomal dominant polycystic kidney disease with preserved renal functions

Subclinical atherosclerosis and cardiovascular events are common even in young normotensive patients with autosomal dominant polycystic kidney disease (ADPKD). Our aim was to examine the relationship between serum fibroblast growth factor-23 (FGF-23) levels, left ventricular global longitudinal strain (LV-GLS), arterial stiffness (AS), and carotid intima-media thickness (CIMT) in patients with ADPKD with preserved kidney function. The relationship between albuminuria, AS, LV-GLS, CIMT, 24-hour ambulatory blood pressure measurement, and FGF-23 was examined in 52 normotensive and hypertensive patients with ADPKD and a matched control group of 35 subjects. AS was assesed with brachial-ankle pulse wave velocity, LV-GLS was measured with speckle-tracking echocardiography. FGF-23 was measured with enzyme-linked immunosorbent assay. The microalbumin/creatinine ratio was significantly higher in the ADPKD group than in the control group (p?<?0.001). Serum FGF-23 levels were similar between the study and control group. LV-GLS value tended to be impaired and CIMT to be higher in the ADPKD group compared to controls (?18.1?+/-?2.6 vs. -19.4?+/-?3.1?%, p?=?0.08; 0.75?+/-?0.1 vs. 0.68?+/-?0.1 mm, p?=?0.09, respectively). The augmentation index was significantly higher in the ADPKD group than in the control group (26.2?+/-?12.5 vs. 16.4?+/-?11.2 mmHg/mmHg, p?=?0.01). Our study supports subclinical impairment in arterial and cardiac functions in the early period of ADPKD. However, none of these factors was found to be associated with serum FGF-23 levels