Dysphagia and dyspnea by lingual thyroid mass: An appropriate approach

Lingual thyroid is a rare embryological anomaly originated from the thyroid gland failure that descends from the foramen cecum to its normal eutopic pre-laryngeal site. The case in this study was a 39. year old female, presenting with the sensation of a foreign body, progressive dysphagia and dyspnea. Indirect laryngoscopy revealed a large well-defined mass in the tongue base. Imaging studies confirmed the diagnosis of large ectopic lingual thyroid. The surgery was performed via an external cervical approach due to the mass size. The decision on the best treatment looks into the mass position, size, symptoms, airway emergency and medical facilities. © 2014

Is there any association between adenoid biofilm and upper airway infections in pediatric patients?

Aim: To evaluate the association of the presence and extent of adenoid biofilms and the frequency of upper airway infections in children with upper airway obstruction. Material and Methods: This cross-sectional study was conducted from October 2014 to December 2015 on pediatric patients who were candidates for adenoidectomy due to obstructive sleep apnea. After removal of the adenoid tissue and fixation in 2.5 glutaraldehyde, the samples were sent to the electron microscopy unit. The extent of biofilm formation was examined using environmental scanning electron microscopy. These results were then confirmed using image analysis software. Results: Fifty-seven children with a mean age of 7.31 (±2.65) years were included in the study. Forty-three (75.4) were male and 14 (24.6) were female. The average number of upper airway infections during the last 12 months before adenoidectomy was 10.01 (±5.38). Biofilm structures were detected in all (100) samples. As the main outcome, the extent of biofilm grading exhibited a statistically significant correlation with the frequency of upper airway infections (p<0.001). There was no significant correlation between sex and adenoid size with the biofilm extent. Conclusion: The present study showed that the extent of adenoid biofilm had a significant relationship with the frequency of upper airway infection rate. It seems that the presence of a biofilm on the adenoid surface as a reservoir for microorganisms could cause chronic inflammation. © 2018 by Turkish Pediatric Association

Serum level of interleukin-6 in patients with oral tongue squamous cell carcinoma

Introduction: The clinical outcome of patients with squamous cell carcinoma (SCC) located in the head and neck has remained poor despite ongoing advances in diagnosis and management. Interleukin-6(IL-6) is a multi-functional cytokine that plays an important role in the process of cell differentiation and is increased in several malignancies. The aim of this study was to investigate the serum levels of interleukin-6 in patients with oral tongue SCC. Materials and Methods: In a cross-sectional study, 17 patients with oral tongue SCC were compared with the same number of age- and gender-matched healthy subjects. Serum IL-6 level fluctuation was determined using an immunological technique, before detecting its possible association with the subjects' age, gender, drinking and smoking history, cancer site, and disease severity. Results: The intensity of serum IL-6 in patients with oral tongue SCC was statistically significantly higher than that in healthy subjects (P<0.001). Serum IL-6 level was independent of the patients' age, gender, smoking and drinking history as well as cancer stage. Conclusion: IL-6 is a valuable biomarker in the diagnosis of oral tongue SCC. Its high sensitivity makes prediction of this condition possible, while this biomarker can also be used to screen high-risk patients

Serum level of interleukin-6 in patients with oral tongue squamous cell carcinoma

Introduction: The clinical outcome of patients with squamous cell carcinoma (SCC) located in the head and neck has remained poor despite ongoing advances in diagnosis and management. Interleukin-6(IL-6) is a multi-functional cytokine that plays an important role in the process of cell differentiation and is increased in several malignancies. The aim of this study was to investigate the serum levels of interleukin-6 in patients with oral tongue SCC. Materials and Methods: In a cross-sectional study, 17 patients with oral tongue SCC were compared with the same number of age- and gender-matched healthy subjects. Serum IL-6 level fluctuation was determined using an immunological technique, before detecting its possible association with the subjects' age, gender, drinking and smoking history, cancer site, and disease severity. Results: The intensity of serum IL-6 in patients with oral tongue SCC was statistically significantly higher than that in healthy subjects (P<0.001). Serum IL-6 level was independent of the patients' age, gender, smoking and drinking history as well as cancer stage. Conclusion: IL-6 is a valuable biomarker in the diagnosis of oral tongue SCC. Its high sensitivity makes prediction of this condition possible, while this biomarker can also be used to screen high-risk patients

Effect of adenotonsillectomy on ADHD symptoms of children with adenotonsillar hypertrophy and sleep disordered breathing

Background: Adenotonsillar hypertrophy is the most common etiologic agent for the obstruction of the upper airways in children, which might be associated with attention-deficit hyperactivity disorder (ADHD), one of the most common psychiatric disorders of childhood. Despite the concurrence of these two conditions, i.e., obstruction of the airways and ADHD, no exact etiologic relationship has been established between adenotonsillectomy (AT) and ADHD symptoms. This study was undertaken to evaluate the effect of AT on the ADHD symptoms in children with adenotonsillar hypertrophy and sleep disordered breathing (SDB). Methods: The design of the present study consisted of pre-test and post-test, followed by post hoc tests. Fifty-three children aged 3-12 were included in this study, selected from those referring to the Pediatric Hospital of Tabriz University of Medical Sciences, with SDB, adenotonsillar hypertrophy and ADHD based on DSM-IV criteria, by availability of the subjects undergoing adenotonsillectomy after evaluation of the severity of ADHD symptoms. The scores of ADHD symptoms were evaluated before AT and at 3- and 6-month postoperative intervals based on Conner's Parent Rating Scale-Revised (CPRS-R) Questionnaire. Repeated-measures ANOVA and Fisher's exact test were used for data analysis. Results: AT resulted in a significant decrease in the severity of ADHD symptoms (oppositional behavior, cognitive disorders, inattention, hyperactivity and ADHD index) at 3- and 6-month postoperative intervals (P<. 0.001), with more significant decreases at 6-month postoperative interval compared to 3-month interval (P<. 0.001). Conclusions: Based on the results of this pilot study, AT in children with SDB associated with ADHD resulted in a significant decrease in the severity of ADHD symptoms. © 2015 Elsevier Ireland Ltd

Biofilm formation on three different endotracheal tubes : a prospective clinical trial

BACKGROUND: Biofilm formation on endotracheal tubes (ETTs) is an early and frequent event in mechanically ventilated patients. The biofilm is believed to act as a reservoir for infecting microorganisms and thereby contribute to development and relapses of ventilator-associated pneumonia (VAP). Once a biofilm has formed on an ETT surface, it is difficult to eradicate. This clinical study aimed to compare biofilm formation on three widely used ETTs with different surface properties and to explore factors potentially predictive of biofilm formation. METHODS: We compared the grade of biofilm formation on ETTs made of uncoated polyvinyl chloride (PVC), silicone-coated PVC, and PVC coated with noble metals after &gt; 24 h of mechanical ventilation in critically ill patients. The comparison was based on scanning electron microscopy of ETT surfaces, biofilm grading, surveillance and biofilm cultures, and occurrence of VAP. RESULTS: High-grade (score ≥ 7) biofilm formation on the ETTs was associated with development of VAP (OR 4.17 [95% CI 1.14-15.3], p = 0.031). Compared to uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation (OR 0.18 [95% CI 0.06-0.59], p = 0.005, and OR 0.34 [95% CI 0.13-0.93], p = 0.036, respectively). No significant difference was observed between silicon-coated ETTs and noble-metal-coated ETTs (OR 0.54 [95% CI 0.17-1.65], p = 0.278). In 60% of the oropharyngeal cultures and 58% of the endotracheal cultures collected at intubation, the same microorganism was found in the ETT biofilm at extubation. In patients who developed VAP, the causative microbe remained in the biofilm in 56% of cases, despite appropriate antibiotic therapy. High-grade biofilm formation on ETTs was not predicted by either colonization with common VAP pathogens in surveillance cultures or duration of invasive ventilation. CONCLUSION: High-grade biofilm formation on ETTs was associated with development of VAP. Compared to the uncoated PVC ETTs, the silicone-coated and noble-metal-coated PVC ETTs were independently associated with reduced high-grade biofilm formation. Further research on methods to prevent, monitor, and manage biofilm occurrence is needed. TRIAL REGISTRATION: ClinicalTrials.gov NCT02284438 . Retrospectively registered on 21 October 2014.Export Date: 15 July 2020; Article</p