The function of the vestibular organ in Hashimoto’s thyroiditis

Introduction: The aim of the study was to identify the prognostic factors and the relationship between vertigo and the results of objective assessment of the vestibular organ and the levels of thyroid status in patients with Hashimoto’s thyroiditis. Material and methods: The study population consisted of 28 women with Hashimoto’s thyroiditis and coexisting chronic vertigo. In all patients, audiological assessment of hearing (tonal audiometry and impedance audiometry), Dix-Hallpike manoeuvre, caloric test, and kinetic tests (rotary chair test and swing chair test) were evaluated. Thyroid hormone levels [thyroid-stimulating hormone (TSH), free thyroxine (FT4)] and thyroid antibodies [autoantibodies against thyroid peroxidase (anti-TPO) and thyroglobulin (anti-TG)] were determined. The relationships between age, weight, height, and BMI and the results of the objective assessment of the vestibular organ were calculated. Results: In the study group the mean age was 48 years and the mean BMI was 26.425. Normal hearing was found in 15 patients (54%). BPPV (n = 19), followed by Meniere’s disease (n = 7) and vestibular neuronitis (n = 2), were the causes of chronic vertigo in this group of patients. The analysis of the objective assessment of the vestibular organ showed decreased excitability of the labyrinth in 15 patients (54%). Twenty-four patients presented with normal TSH and FT4 levels (85%). All patients presented with elevated anti-TPO and anti-TG levels. Conclusion: No correlation was found between age, weight, height, BMI, and the results of thyroid function tests or the assessment of the vestibular organ. We did not confirm the negative influence of thyroid levels or the increase in thyroid antibodies on the abnormal results of the rotary chair test or the caloric test

miR-125b-5p, miR-155-3p, and miR-214-5p and target E2F2 gene in oral squamous cell carcinoma

It is known that E2F2 (E2F transcription factor 2) plays an important role as controller in the cell cycle. This study aimed to analyse the expression of the E2F2 gene and E2F2 protein and demonstrate E2F2 target microRNAs (miRNAs) candidates (miR-125b-5p, miR-155-3p, and miR-214-5p) in oral squamous cell carcinoma tumour and margin samples. The study group consisted 50 patients. The E2F2 gene and miRNAs expression levels were assessed by qPCR, while the E2F2 protein was assessed by ELISA. When analysing the effect of miRNAs expression on E2F2 gene expression and E2F2 protein level, we observed no statistically significant correlations. miR-125b-5p was downregulated, while miR-155-3p, and miR-214-5p were upregulated in tumour samples compared to margin. We observed a difference between the miR-125b-5p expression level in smokers and non-smokers in margin samples. Furthermore, HPV-positive individuals had a significantly higher miR-125b-5p and miR-214-5p expression level compared to HPV-negative patients in tumour samples. The study result showed that the E2F2 gene is not the target for analysed miRNAs in OSCC. Moreover, miR-155-3p and miR-125b-5p could play roles in the pathogenesis of OSCC. A differential expression of the analysed miRNAs was observed in response to tobacco smoke and HPV status

miR-125b-5p, miR-155-3p, and miR-214-5p and target E2F2 gene in oral squamous cell carcinoma

It is known that E2F2 (E2F transcription factor 2) plays an important role as controller in the cell cycle. This study aimed to analyse the expression of the E2F2 gene and E2F2 protein and demonstrate E2F2 target microRNAs (miRNAs) candidates (miR-125b-5p, miR-155-3p, and miR-214-5p) in oral squamous cell carcinoma tumour and margin samples. The study group consisted 50 patients. The E2F2 gene and miRNAs expression levels were assessed by qPCR, while the E2F2 protein was assessed by ELISA. When analysing the effect of miRNAs expression on E2F2 gene expression and E2F2 protein level, we observed no statistically significant correlations. miR-125b-5p was downregulated, while miR-155-3p, and miR-214-5p were upregulated in tumour samples compared to margin. We observed a difference between the miR-125b-5p expression level in smokers and non-smokers in margin samples. Furthermore, HPV-positive individuals had a significantly higher miR-125b-5p and miR-214-5p expression level compared to HPV-negative patients in tumour samples. The study result showed that the E2F2 gene is not the target for analysed miRNAs in OSCC. Moreover, miR-155-3p and miR-125b-5p could play roles in the pathogenesis of OSCC. A differential expression of the analysed miRNAs was observed in response to tobacco smoke and HPV status

PFAPA syndrome – periodic fever, aphtous stomatitis, pharyngitis and adenitis

PFAPA syndrome, diagnosed mainly in children under 5 years of age is characterized by periodic episodes of fever, accompanied by aphthous stomatitis, pharyngitis and cervical lymphadenopathy. Clinical symptoms of this syndrome, recommendations concerning diff erential diagnosis, as well as methods of treatment were presented in this paper.Zespół PFAPA, rozpoznawany głównie u dzieci poniżej 5 roku życia, charakteryzuje się nawrotowym występowaniem epizodów gorączkowych, z towarzyszącym aftowym zapaleniem jamy ustnej, zapaleniem gardła i powiększeniem węzłów chłonnych szyjnych. W pracy omówiono objawy kliniczne zespołu, przedstawiono zalecenia dotyczące diagnostyki różnicowej oraz metody leczenia

Opieka okołooperacyjna u chorych poddanych funkcjonalnej endoskopowej chirurgii zatok przynosowych (FESS)

Ostateczny sukces i wynik leczenia pacjentów poddawanych funkcjonalnej endoskopowej chirurgii zatok przynosowych (FESS) zależy od prawidłowego przygotowania pacjenta do zabiegu, postępowania okołooperacyjnego oraz pooperacyjnego. Postępowanie przed operacją FESS w przypadkach przewlekłego zapalenia nosa i zatok przynosowych obejmują: stosowanie glikokortykosteroidów donosowych i doustnych, płukanie jam nosa oraz – w wybranych przypadkach – antybiotykoterapię. Postępowanie to wynika z „Europejskich wytycznych na temat zapalenia nosa i zatok przynosowych oraz polipów nosa – EPOS 2012”. Na ograniczenie występowania śród- i pooperacyjnego krwawienia pozwala śródoperacyjne zastosowanie wkładek obkurczających błonę śluzową nosa, pozycji anty-Trendelenburga, kontrolowanego podciśnienia oraz kwasu traneksamowego. Po wykonanym zabiegu często zaleca się zastosowanie tamponady, następnie opatrunku chroniącego jamę nosa, a po roztamponowaniu wykonywane jest instrumentalne oczyszczanie jam nosa. Ponadto opieka pooperacyjna w dużej mierze została przeniesiona na pacjenta, dlatego podkreśla się znaczenie edukacji pacjenta, dokładne przekazanie mu instrukcji postępowania, a także przeszkolenie w odpowiednim stosowaniu zaleconych preparatów do płukania nosa i zatok przynosowych oraz glikokortykosteroidów donosowych. Stosowanie glikokortykosteroidów miejscowych ma udowodnione działanie zmniejszające ryzyko nawrotu choroby i jest uzasadnione, gdy mamy pewność, że mają one fizyczną możliwość dotarcia do błony śluzowej nosa. Skuteczność płukania nosa można zwiększyć poprzez zastosowanie preparatów z pojemników pozwalających na odpowiednią aplikację (dokładne przyleganie do przedsionka nosa, kąt 45°) oraz wygenerowanie dostatecznego ciśnienia (płukanie całej jamy nosa – 120 mbar), a użycie odpowiedniego składu płynu przyspiesza gojenie i zmniejsza dolegliwości. Zastosowanie badań in vitro oraz metod symulacji komputerowej pozwala przewidzieć skuteczność płukania poszczególnych zatok

Perioperative care of patients undergoing Functional Endoscopic Sinus Surgery

The final success and outcomes of patients treatment undergoing Functional Endoscopic Sinus Surgery depends on the correct preparation for surgery, perioperative and postoperative care. Proceedings before FESS in case of chronic rhinosinusitis arise from „European position paper on rhinosinusitis and nasal polyps 2012” and includes pretreatment with local nasal and systemic steroids, sinus irrigation, as well as in some cases antibiotic therapy. Reduction of intra- and post-operative bleeding is possible by intraoperative use of gauze local vasoconstricting inserts, reverse Trendelenburg position, reduction of blood pressure and application of tranexamic acid. After the surgery the use of nasal packing is often recommended. Moreover postoperative care has been largely transferred to the patient and therefore we are highlighting how important is education of patient, providing accurate information and training in the appropriate use of prescribed preparations for na-posal irrigation and nasal steroids. The use of steroids was proved to reduce the risk of recurrence of the disease and it is reasonable when we are sure that they have an opportunity to reach physically to whole mucous membrane of the nose. The effectiveness of nasal irrigation can be enhanced by use of the containers enabling the appropriate application (the exact adherence to the nasal vestibule , at an angle 45° ) and generating sufficient pressure ( rinse of the entire nasal cavity –120 mbar) and the use of appropriate fluid composition accelerates healing and reduce pain. Use of in vitro studies and computational fluid dynamics simulations allow to predict the effectiveness of rinsing different paranasal sinuses

Bilateral vestibular hypofunction: a literature review and a case report

Obustronna arefleksja, inaczej wypadnięcie funkcji błędników, to rzadkie schorzenie części obwodowej narządu równowagi, którego głównym objawami są uporczywe, chroniczne zawroty głowy oraz towarzysząca ruchom ciała oscylopsja. Przewlekły, uciążliwy charakter objawów i trudności z utrzymaniem równowagi oraz wykonywaniem precyzyjnych ruchów mogą stać się przyczyną rezygnacji chorego z aktywności zawodowej. Nierzadko długi okres od wystąpienia objawów choroby do diagnozy, która powinna bazować na badaniach obiektywnych części obwodowej narządu równowagi, drastycznie zmniejsza szanse na poprawę motoryki chorych oraz znacząco pogarsza komfort ich życia. Choroba najczęściej pojawia się u aktywnych zawodowo pacjentów w 6 dekadzie życia i może być przyczyną utraty źródła dochodów. W publikacji przedstawiono opis przypadku i metodykę badań wykonanych u pacjenta z obustronną arefleksją błędników, do której doszło na skutek podania gentamycyny w przebiegu ropowicy kciuka. Analizy przypadku dokonano na podstawie przeglądu literatury na temat diagnostyki i leczenia obustronnej arefleksji błędników.Bilateral vestibular hypofunction (BVH) is a rare disorder of the peripheral part of the balance organ, which may cause chronic vertigo and oscillopsia accompanying body movements. The chronic and severe nature of the symptoms and difficulties in maintaining balance and performing precise movements may cause the patient’s withdrawal from professional activity. A frequently long period from the onset of the symptoms to the diagnosis of BVH, which should be based on the objective examination of the peripheral part of the vestibular organ, drastically reduces the chances of improving the patient’s precise movement motility and significantly deteriorates the quality of life. Due to the fact that this disease most often affects professionally active patients in the sixth decade of their life, it can become the cause of a loss of the source of income. The publication presents a case report and examination methods of a patient with BVH caused by the administration of gentamicin in the course of phlegmon of the thumb. The case analysis was performed on the basis of a literature review on the diagnosis and treatment of patients with BVH

Czy choroba Hashimoto może być przyczyną zawrotów głowy?

Vertigo and balance disorders are common symptoms reported by approximately 15–20% of the adult population worldwide. For many years thyroid diseases have been suspected as the cause of vertigo by ENT physicians. Almost every patient hospitalised due to severe vertigo is investigated for thyroid disease as a suspected cause of acute vestibulopathy. The issue presented in this paper is related to a difficult and poorly understood relationship between autoimmune thyroid disease and peripheral vertigo

Does Thyroid Hormone Metabolism Correlate with the Objective Assessment of the Vestibular Organ in Patients with Vertigo?

The aim of this study was to assess the relationship between the results of the objective assessment of the vestibular organ in patients with peripheral vertigo with Hashimoto’s thyroiditis and thyroid hormone metabolism. Twenty eight women with Hashimoto’s thyroiditis and chronic vertigo were enrolled in the study. Patients underwent audiological assessment of hearing, Dix–Hallpike test, videonystagmography with caloric test, head impulse test (HIT) and cervical vestibular-evoked myogenic potentials (cVEMPs). Levels of thyroid hormones and anti-thyroid antibodies were determined. Relationships between age, weight, height, BMI and the results of the objective assessment of the vestibular organ were calculated. The mean age in the study group was 48 years, while the mean BMI was 26.425. The causes of peripheral vertigo in the study group were benign paroxysmal positional vertigo (BPPV) (n = 19), Meniere’s disease (n = 7) and vestibular neuronitis (n = 2). No correlation was found between age, weight, height, BMI and the results of thyroid function tests or the objective assessment of the vestibular organ. The study did not confirm the influence of thyroid metabolism (i.e., thyroid hormone levels or the increase in antithyroid antibodies) on the results of cVEMP or the directional preponderance in the caloric test

The Prevalence of High- and Low-Risk Types of HPV in Patients with Squamous Cell Carcinoma of the Head and Neck, Patients with Chronic Tonsillitis, and Healthy Individuals Living in Poland

Human papillomavirus (HPV) is a virus with the potential to infect human epithelial cells and an etiological agent of many types of cancer, including head and neck cancer. The aim of the study was to determine the prevalence of HPV infection in patients with head and neck squamous cell carcinoma (HNSCC), patients with chronic tonsillitis, and healthy individuals, and to establish high- and low-risk HPV genotypes in these groups. The objectives also comprised the delineation of the relationship between the infection with high- or low-risk HPV subtypes and clinicopathological and demographic characteristics of the study groups. This study was composed of 76 patients diagnosed with HNSCC, 71 patients with chronic tonsillitis, and 168 cases without either of these conditions (the control group). HPV detection and identification of subtypes were performed on isolated DNA using a test which allowed detection of 33 common high-risk and low-risk HPV subtypes. The prevalence of HPV infection was 42.1%, 25.4%, and 37.5% in HNSCC, chronic tonsillitis, and control groups, respectively. HPV 16 was the most prevalent genotype in all groups and the non-oncogenic HPV 43/44 was frequent in HNSCC patients. This analysis provides insight into the prevalence of oral oncogenic and non-oncogenic HPVs in patients with head and neck cancer, patients with chronic tonsillitis and healthy individuals, and leads to the conclusion that further investigations are warranted to examine a larger cohort of patients focusing on high- and low-risk HPV genotypes. Efforts should be focused on screening and prevention strategies, and therefore, it is important to introduce tools for effective detection of HPV genotypes. Furthermore, given the role of vaccines against oral HPV infection, our observations lead to the suggestion that HPV vaccination should be of considerable importance in public health strategies