Potential Impact of the Financial Crisis on Outpatient Hospital Visits due to Otorhinolaryngologic Disorders in Crete, Greece

The public health effect of financial crises has been emphasized in previous studies. In addition, a series of otorhinolaryngologic disorders and manifestations has been related to psychological factors in the literature. Such conditions include temporomandibular joint disorders, laryngopharyngeal reflux, chronic tinnitus, and vertigo. Focusing on the outpatient database records of a large hospital in Crete, Greece, the objective of this retrospective study was to explore possible occurrence variations within the prementioned otorhinolaryngologic morbidity which may be potentially attributed to increased levels of socioeconomic stress. Results revealed that although the total number of visits between two periods - before and after the beginning of the financial crisis in Greece - was comparable, a significant increase in the diagnosis of two disorders, namely vertigo and tinnitus was found. In addition, a trend toward increased rate of diagnosis for reflux and temporomandibular joint disorders was noted. Potential implications of these findings are discussed. In conclusion, health care providers in this as well as in other countries facing similar socio-economic conditions should be aware of potential changes in the epidemiologic figures regarding specific medical conditions

Clinical Applications for Tissue Engineering in Rhinology

Tissue engineering implies a number of established techniques in several fields in medicine. A thorough review of current clinical applications for tissue engineering in rhinology is addressed. Current status, as well as, published in vivo studies is presented. Moreover, relevant clinical applications and future perspectives of tissue engineering are demonstrated. There is a lack of high quality clinical studies in the literature regarding the role of tissue engineering in the rhinology field. Further research is needed to translate this concept from bench to bedside

Nonmicrosurgical reconstruction of the auricle after traumatic amputation due to human bite

BACKGROUND: Traumatic auricular amputation due to human bite is not a common event. Nonetheless, it constitutes a difficult challenge for the reconstructive surgeon. Microsurgery can be performed in some cases, but most microsurgical techniques are complex and their use can only be advocated in specialized centers. Replantation of a severed ear without microsurgery can be a safe alternative as long as a proper technique is selected. METHODS: We present two cases, one of a partial and one of a total traumatic auricular amputation, both caused by human bites, that were successfully managed in our Department. The technique of ear reattachment as a composite graft, with partial burial of the amputated part in the retroauricular region, as first described by Baudet, was followed in both cases. RESULTS AND DISCUSSION: The prementioned technique is described in detail, along with the postoperative management and outcome of the patients. In addition, a brief review of the international literature regarding ear replantation is performed. CONCLUSION: The Baudet technique has been used successfully in two cases of traumatic ear amputation due to human bites. It is a simple technique, without the need for microsurgery, and produces excellent aesthetic results, while preserving all neighboring tissues in case of failure with subsequent need for another operation

The cadherin–catenin complex in laryngeal squamous cell carcinoma

Abnormal Wnt signaling and impaired cell–cell adhesion due to abnormal E-cadherin and β-catenin function have been implicated in many cancers, but have not been fully explored in laryngeal squamous cell carcinoma. In this study, β-catenin cellular location and E-cadherin expression levels were analyzed in 16 laryngeal squamous cell carcinomas (LSCCs) (9 glottic and 7 supraglottic) and 11 samples of non-tumoral inflammatory larynx tissue, using immunohistochemical methods. All non-tumoral tissues showed equally strong membranous expression of β-catenin, while cytoplasmic expression was found in only 3 of the 11 samples. By contrast, whereas 8/9 glottic LSCCs exhibited only membranous expression of β-catenin, 6/7 supraglottic LSCCs displayed both membranous and cytoplasmic expression (p = 0.003). Strong E-cadherin staining was observed in 9/11 non-tumoral tissues and 7/9 glottic LSCCs, whereas 4/7 supraglottic LSCCs exhibited weak expression. Reduced membrane expression of E-cadherin and cytoplasmic retention of β-catenin in supraglottic LSCC seems to be related with more aggressive biological behavior which has been described in clinical studies. Further research is required to clarify the involvement of β-catenin in the mechanism associated with malignant transformation in laryngeal tissues

A multidisciplinary hyper-modeling scheme in personalized in silico oncology : coupling cell kinetics with metabolism, signaling networks, and biomechanics as plug-in component models of a cancer digital twin

The massive amount of human biological, imaging, and clinical data produced by multiple and diverse sources necessitates integrative modeling approaches able to summarize all this information into answers to specific clinical questions. In this paper, we present a hypermodeling scheme able to combine models of diverse cancer aspects regardless of their underlying method or scale. Describing tissue-scale cancer cell proliferation, biomechanical tumor growth, nutrient transport, genomic-scale aberrant cancer cell metabolism, and cell-signaling pathways that regulate the cellular response to therapy, the hypermodel integrates mutation, miRNA expression, imaging, and clinical data. The constituting hypomodels, as well as their orchestration and links, are described. Two specific cancer types, Wilms tumor (nephroblastoma) and non-small cell lung cancer, are addressed as proof-of-concept study cases. Personalized simulations of the actual anatomy of a patient have been conducted. The hypermodel has also been applied to predict tumor control after radiotherapy and the relationship between tumor proliferative activity and response to neoadjuvant chemotherapy. Our innovative hypermodel holds promise as a digital twin-based clinical decision support system and as the core of future in silico trial platforms, although additional retrospective adaptation and validation are necessary

Microsatellite DNA instability in allergic rhinitis, bronchial astha and COPD: comparison between the upper and lower respiratory tract

Microsatellite DNA also known as simple sequence repeats, are iterations of 1-6 bp nucleotide motifs. They are present in both coding and non-coding regions of the chromosome. They constitute a large fraction of non-coding DNA. Recently DNA mismatch repair system (MMR) has been investigated in molecular medicine microsatellite DNA alterations are considered as indicating an ineffective MMR system. Microsatellite (MS) loss of heterozygosity (LOH) and microsatellite instability (MSI) have been reported. In a number of human malignancies LOH and MSI have seen been reported in various benign diseases including asthma, chronic obstructive pulmonary disease, sarcoidosis and idiopathic pulmonary fibrosis. Genetic alterations at the MS level could be used as a genetic screening tool in molecular epidemiology allowing genes that may play a key role in the pathogenesis of these diseases. The aim of this study was to assess the presence of MSI and/or LOH in nasal cytologic samples of patients with allergic rhinitis (AR), bronchial asthma and COPD nasal brush samples and peripheral blood were obtained from 20 patients with allergic rhinitis, 20 patients with COPD and 8 healthy adults (control group). In addition sputum samples were obtained by induction from the COPD Group DNA was extracted and analyzed for MSI and LOH using 6 markers in the allergic rhinitis group and 9 markers in the COPD group. No MSI and/or LOH were noted in the AR or the control group, no MSI was detected in the nasal cytological samples of the COPD patients MSI was detected in the sputum samples of 7 patients with COPD (35%). These results suggest that although MSI and LOH are detectable phenomena in sputum not to be the case for nasal cytologic samples of patients with AR. Furthermore MSI probably is a specific finding for the target organ of COPD i.e. the lungs despite the fact that inflammation coexists in the nasal mucosa of COPD patients.Το μικροδορυφορικό DNA αποτελείται από βραχείες διαδοχικά επαναλαμβανόμενες νουκλεοτιδικές αλληλουχίες χωρίς κωδικοποιητική λειτουργία. Ο σχεδιασμός γενετικών δεικτών, όπως είναι οι δείκτες για το μικροδορυφορικό DNA, παρέχει τη δυνατότητα έρευνας σε ολόκληρο το γονιδίωμα για ανεύρεση αστάθειας καθώς και συσχετίσεων της αστάθειας με την εμφάνιση παθολογικών καταστάσεων σε πληθυσμούς ατόμων υπό έλεγχο. Με τον τρόπο αυτό είναι δυνατόν να αποκαλυφθούν χρωμοσωμικές περιοχές στις οποίες ανιχνεύεται αστάθεια του μικροδορυφορικού DNA και οι οποίες πιθανόν να γειτονεύουν με γονίδια τα οποία εμπλέκονται στην εμφάνιση νοσημάτων. Το φαινόμενο της αστάθειας του μικροδορυφορικού DNA αντικατοπτρίζει άμεσα τις διαταραχές του μηχανισμού αποκατάστασης των λαθών κατά την αντιγραφή του DNA και έχει συνδεθεί με υψηλό δείκτη μεταλλάξεων. Η αστάθεια μικροδορυφορικού DNA αρχικά παρατηρήθηκε στον καρκίνο του παχέος εντέρου και στη συνέχεια στους περισσότερους καρκίνους αλλά και σε χρόνια νοσήματα που δεν σχετίζονται με καρκίνο, όπως η ΧΑΠ, το βρογχικό άσμα, η σαρκοείδωση και η ιδιοπαθής πνευμονική ίνωση. Σκοπός της μελέτης ήταν η διερεύνηση και σύγκριση της αστάθειας του μικροδορυφορικού DNA σε κυτταρολογικά δείγματα του ανώτερου και κατώτερου αναπνευστικού ασθενών με αλλεργική ρινίτιδα, με ή χωρίς συνύπαρξη βρογχικού άσθματος καθώς και σε ασθενείς με ΧΑΠ. Μελετήθηκαν 20 ασθενείς με αλλεργική ρινίτιδα, 20 ασθενείς με ΧΑΠ και ομάδα ελέγχου από 8 υγιείς ενήλικες. Στην ομάδα της αλλεργικής ρινίτιδας τα αποτελέσματα δεν ανέδειξαν αλλοιώσεις σε επίπεδο μικροδορυφορικού DNA, σε έξι (6) δείκτες. Στην ομάδα της ΧΑΠ, χρησιμοποιήθηκαν εννέα (9) δείκτες και ενώ ανευρέθηκε αστάθεια μικροδορυφορικού DNA στα πτύελα 7 ασθενών (35%) αντίθετα δεν ανευρέθηκαν αλλοιώσεις μικροδορυφορικού DNA στα ρινικά δείγματα των ίδιων ασθενών. Επιπλέον δεν βρέθηκαν αλλοιώσεις σε κανένα δείγμα από την ομάδα ελέγχου αν και η αστάθεια μικροδορυφορικού DNA έχει ανιχνευθεί σε πτύελα ασθενών με άσθμα. Ωστόσο στην παρούσα μελέτη δεν εντοπίστηκε σε ρινικά δείγματα ασθενών με αλλεργική ρινίτιδα. Επιπλέον στην ομάδα της ΧΑΠ τα αποτελέσματα επιβεβαίωσαν την εμφάνιση αστάθειας στα πτύελα όμως ήταν αρνητικά για τον ρινικό βλεννογόνο υποδεικνύοντας ότι η αστάθεια του μικροδορυφορικού DNA είναι ειδικό εύρημα για τον ιστό-στόχο της νόσου δηλαδή τους πνεύμονες