Bone: the final frontier for Staphylococcus aureus penetration in chronic rhinosinusitis

The superantigenic properties of Staphylococcus aureus have been implicated in increasing the inflammatory process in airway diseases. Local formation of IgE antibodies against staphylococcal enterotoxins by secondary lymphoid tissue in nasal polyps has been demonstrated. Staphylococcus aureus is known to colonize the nasal mucosa, and has been found invading the nasal submucosa and intracellularly.Objective: To evaluate the limits of Staphylococcus aureus invasion in the upper airway.Material and methods: Inferior turbinate samples from 3 patients without sinus disease, 6 ethmoid samples from patients with chronic rhinosinusitis with nasal polyposis, and 6 ethmoid samples from patients with chronic rhinosinusitis without nasal polyposis were studied. A fluorescein-labeled PNA probe against Staphylococcus aureus was used to test for the presence of the bacterium in bone (after decalcification) and mucosa.Results: We found Staphylococcus aureus invading the nasal submucosa in patients with nasal polyposis, but no cases of Staphylococcus aureus positivity in bone. in conclusion, we cannot support the hypothesis of nasal bone as a reservoir for Staphylococcus aureus, releasing massive amounts of staphylococcal enterotoxins and eliciting an inflammatory reaction, as occurs with the nasal mucosa.Univ São Paulo, Dept Otorhinolaryngol, São Paulo, BrazilSão Paulo State Mil Police, Mil Police Hosp, São Paulo, BrazilFed Univ São Paulo Unifesp, Dept Otorhinolaryngol, São Paulo, BrazilFed Univ São Paulo Unifesp, Dept Immunol, São Paulo, BrazilFed Univ São Paulo Unifesp, Dept Otorhinolaryngol, São Paulo, BrazilFed Univ São Paulo Unifesp, Dept Immunol, São Paulo, BrazilWeb of Scienc

Convergence of two major pathophysiologic mechanisms in nasal polyposis : immune response to Staphylococcus aureus and airway remodeling

This review is addressed two pathophysiologic mechanisms implicated in the pathogenesis of nasal polyposis: the unique remodeling process found in nasal polyp tissue and the immune response of patients with nasal polyposis to Staphylococcus aureus. These two theories converge to the same direction in different aspects, including decreased extracellular matrix production, impaired T regulation and favoring of a Th2 immune response. In patients with nasal polyposis, an exaggerated immune response to Staphylococcus aureus may aggravate the airway remodeling process

Convergence of two major pathophysiologic mechanisms in nasal polyposis: immune response to Staphylococcus aureus and airway remodeling

This review is addressed two pathophysiologic mechanisms implicated in the pathogenesis of nasal polyposis: the unique remodeling process found in nasal polyp tissue and the immune response of patients with nasal polyposis to Staphylococcus aureus.\ud \ud These two theories converge to the same direction in different aspects, including decreased extracellular matrix production, impaired T regulation and favoring of a Th2 immune response.\ud \ud In patients with nasal polyposis, an exaggerated immune response to Staphylococcus aureus may aggravate the airway remodeling process

Evaluation of severe obstructive sleep apnea/hypopnea syndrome after maxillomandibular advancement surgery

Objective: To evaluate the effectiveness of the maxilomandibularadvancement surgery in patients suffering from obstructive sleepapnea/hypopnea syndrome by analysing it objectively and subjectively.Methods: Ten patients suffering from apnea/hypopnea syndrome indexabove 30 events per sleep hour, diagnosed by polysomnography wereexamined. The patients underwent physical, polysomnographic andcephalometric tests and were subjectively evaluated according to theEpworth Sleepness Scale. The data obtained was compared to theresults of the same group 6 months after the surgery. Results: Afterthe maxilomandibular advancement surgery, as related to an objectiveevaluation by polysomnography, the results were the following: 20% ofthe patents had a normal apnea/hypopnea index, 30% of the patientshad a moderate apnea/hypopnea index and 40% of the patients kepta severe apnea/hypopnea index, 60% of the patients had a 50%decrease in the apnea/hypopnea index and only 10% of the patientshad an increase in the apnea/hypopnea index. The average of thelowest oxyhemoglobin saturation in the preoperative was 63.4%, anda significant improvement was obtained after the maxilomandibularadvancement procedure when an average of 80.8%, and 70% of thepatients showed a lowest oxyhemoglobin saturation above 83%. Asfor the subjective evaluation using the Epworth Sleepness Scale,there was an improvement in 100% of the patients. Conclusions: Theobjective evaluation of the maxilomandibular advancement surgeryshowed that it was effective in 60% of the patients suffering fromsevere apnea/hypopnea index, while the subjective evaluation showedthat it was effective in 100% of the patients

A Case of Primary Nasal Chromoblastomycosis

ESCOLA PAULISTA MED,RUA BOTUCATU 740,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA MICOL,DEPT MICROBIOL IMUNOL & PARASITOL,BR-04023 SAO PAULO,SP,BRAZILCONSELHO NACL PESQUISAS,PESQUISADORA,BR-22290 RIO DE JANEIRO,RJ,BRAZILESCOLA PAULISTA MED,DISCIPLINA DOENCAS INFECCIOSAS & PARASITARIAS,DEPT MED,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA OTORRINOLARINGOL,DEPT OFTALMOL & OTORRINOLARINGOL,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,RUA BOTUCATU 740,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA MICOL,DEPT MICROBIOL IMUNOL & PARASITOL,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA DOENCAS INFECCIOSAS & PARASITARIAS,DEPT MED,BR-04023 SAO PAULO,SP,BRAZILESCOLA PAULISTA MED,DISCIPLINA OTORRINOLARINGOL,DEPT OFTALMOL & OTORRINOLARINGOL,BR-04023 SAO PAULO,SP,BRAZILWeb of Scienc