The effect of a Heat and Moisture Exchanger (Provox® HME) on pulmonary protection after total laryngectomy: a randomized controlled study

The goal of this randomized controlled study was to investigate the effect of Heat and Moisture Exchanger use on pulmonary symptoms and quality of life aspects in laryngectomized patients. Eighty laryngectomized patients were included and randomized into an HME and Control group. The effect of the HME was evaluated by means of Tally Sheets and Structured Questionnaires. The results showed a significant decrease in the frequency of coughing, forced expectoration, and stoma cleaning in the HME group. There were trends for the prosthetic speakers to report more fluent speech with the HME and for the HME group to report fewer sleeping problems. In conclusion, this study, performed in Poland, confirms the results of previous studies performed in other countries, showing that pulmonary symptoms decrease significantly with HME use and that related aspects such as speech and sleeping tend to improve, regardless of country or climate

Olbrzymi gruczolak wielopostaciowy nosa i zatok przynosowych

Gruczolak wielopostaciowy jest nowotworem niezłośliwym, wywodzącym się z gruczołów ślinowych. Jest najczęstszym nowotworem zarówno dużych jak i małych gruczołów ślinowych. Zaledwie 1% ogółu gruczolaków wielopostaciowych stanowią te rozwijające się w jamach nosa i zatok. Obraz histopatologiczny gruczolaka wielopostaciowego wywodzącego się z małych gruczołów ślinowych charakteryzuję się wzmożoną komponentą komórkową i zmniejszoną stromalną w stosunku do gruczolaka dużych gruczołów ślinowych. Pomimo że jest guzem łagodnym, powinien być traktowany jako klinicznie niepewny. Transformacja złośliwa może wystąpić w 2-10% przypadków. Celem niniejszej pracy było przedstawienie przypadku 37-letniego pacjenta z olbrzymim gruczolakiem wielopostaciowym jam nosa i zatok przynosowych powodującym rozległą destrukcję ścian zatok przynosowych i oczodołów

Giant pleomorphic adenoma of nasal cavities and paranasal sinuses

Pleomorphic adenoma is benign tumor of the salivary glands. It is the most common neoplazm both major and minor salivary glands. Only in 1% of cases pleomorphic adenoma occur in the sinonasal cavities. The histopalogical wiew of pleomorphic adenomas originating from small salivary glands is different in higher cellularity and lower stromal component than those from major salivary glands. It is a benign tumor but it should be treated as a clinically uncertain. Malignant transformation of pleomorphic adenoma can occur in 2-10% of cases, The aim of this study was to present he case of 37-year-old patient with giant pleomorphic adenoma of the sinonasal cavities causing extensive destruction of sinuses and orbits walls

Treatment results of lip carcinoma in Holy Cross District in Poland and treatment failures analysis

Objective: The assessment of cancer surgical treatment results, measured with oncological standards, linked with oncological treatment failures analysis, including also the occurrence of second primary cancer, create the basis for verification of applied treatment strategy. Material: 312 patients with lip carcinoma were treated primarily with surgery or in combination with post-surgical Rtg-therapy. Depending on local staging, in the most of cases the “V” or “W” resection with or without the vermilionectomy was performed. When resection required the reconstruction of lip defect, the Bernard-Burov method was the most commonly used. In cases where the regional I + II + III lymph node resection was performed it was followed by Rtg-therapy. Methods: Using the Kaplan-Meier method, the calculation of overall survival (OS), disease free survival (DFS) and disease specific survival (DSS) was done. The descriptive characteristic of oncologic treatment failures, including occurrence of second primary cancer was also presented.Results: The results of 3-years and 5-years overall, disease free and disease specific survivals have located within the limits presented in literature, what may be recognized as a support of applied treatment policy. In oncological treatment failures which have been recorded in 20,2%, the metastases to regional lymph nodes have dominated. In 76,2% treatment failures were observed in the first 3 years of follow up

Wyniki leczenia chorych z rakiem wargi w regionie świętokrzyskim i analiza przyczyn niepowodzeń

Wstęp: Ocena wyników leczenia chirurgicznego raka wargi – mierzona podstawowymi wskaźnikami onkologicznymi i połączona z analizą niepowodzeń terapeutycznych, do których zostały włączone przypadki drugich pierwotnych nowotworów – jest podstawą weryfikacji przyjętego modelu terapii. Materiał: Grupę badaną stanowiło 312 chorych z rakiem wargi leczonych chirurgicznie bądź w skojarzeniu z rentgenoterapią. W zależności od zaawansowania miejscowego, najczęściej wycięcie raka ograniczało się do wycięcia „V” lub „W” i wermilektomii, natomiast tam, gdzie zabieg wymagał rekonstrukcji ubytku, wśród możliwych sposobów rekonstrukcji dominowała metoda Bernarda-Burova. Resekcja regionalnych węzłów chłonnych regionu I + II + III w większości uzupełniona była pooperacyjną telegammaterapią. Metoda: W oparciu o metodę Kaplana-Meiera określono prawdopodobieństwo przeżycia całkowitego (OS), przeżycia bezobjawowego (DFS) i przeżycia zależnego od raka wargi (DSS). Przedstawiono charakterystykę opisową niepowodzeń, w tym występowania drugich pierwotnych ognisk złośliwych nowotworów. Wyniki: Uzyskane wyniki prawdopodobieństwa 3-letniego i 5-letniego przeżycia całkowitego, bezobjawowego i zależnego od raka wargi, mieściły się w granicach podawanych w podobnych zestawieniach w piśmiennictwie, potwierdzając pośrednio słuszność przyjętego modelu postępowania. Niepowodzenia onkologiczne tych terapii, w których dominowały przerzuty do regionalnych węzłów chłonnych, zanotowano u 20,2% ogółu pacjentów. Przy czym w 76,1% ujawniły się one w pierwszych 3 latach po przeprowadzonym leczeniu

DIAPH2, PTPRD and HIC1 Gene Polymorphisms and Laryngeal Cancer Risk

AIM, DIAPH2, PTPRD and HIC1 are the cell glycoprotein, which play an important role in the occurrence and development of tumors. This study was designed to assess the association between DIAPH2, PTPRD and HIC1 SNPs and laryngeal cancer risk. PATIENTS AND METHODS: This study including 267 patients with histologically confirmed laryngeal cancer and 157 controls. The relationship between genetic variations DIAPH2 (rs6620138), PTPRD (rs3765142) and HIC1 (rs9901806) and the onset of laryngeal cancer were investigated. Statistical analysis to calculate the relationship between DIAPH2, PTPRD and HIC1 genes polymorphism and pathogenesis of laryngeal cancer. RESULTS: The results showed that rs6620138 DIAPH2 polymorphism could increase the onset risk of laryngeal cancer. Statistically significant differences in allele distribution of rs6620138 DIAPH2 and rs9901806 HIC1 in the case and control groups subgroups. CONCLUSIONS: This study results suggested that genetic variation of rs6620138 DIAPH2 polymorphism is related to the susceptibility to laryngeal cancer. Our results provide a basis to begin basic research on the role of DIAPH2 gene in the pathogenesis of laryngeal cancer

Efficacy of Ceragenins in Controlling the Growth of Oral Microorganisms: Implications for Oral Hygiene Management

Ensuring proper dental hygiene is of paramount importance for individuals’ general well-being, particularly for patients receiving medical care. There is a prevailing utilization of conventional oral hygiene items, including toothbrushes and mouthwashes, which have gained widespread acceptance; nevertheless, their limitations encourage investigating novel options in this domain. Our study indicates that ceragenins (CSAs) being lipid analogs of host defense peptides, well-recognized for their wide-ranging antimicrobial properties, may be a potentially efficacious means to augment oral hygiene in hospitalized individuals. We demonstrate that ceragenins CSA-13, CSA-44, and CSA-131 as well as undescribed to date CSA-255 display potent antimicrobial activities against isolates of fungi, aerobic, and anaerobic bacteria from Candida, Streptococcus, Enterococcus, and Bacteroides species, which are well-recognized representatives of microbes found in the oral cavity. These effects were further confirmed against mono- and dual-species fungal and bacterial biofilms. While the ceragenins showed similar or slightly diminished efficacy compared to commercially available mouthwashes, they demonstrated a highly favorable toxicity profile toward host cells, that may translate into better maintenance of host mucosal membrane stability. This suggests that incorporating ceragenins into oral hygiene products could be a valuable strategy for reducing the risk of both oral cavity-localized and secondary systemic infections and for improving the overall health outcomes of individuals receiving medical treatment

Biofilm Growth Causes Damage to Silicone Voice Prostheses in Patients after Surgical Treatment of Locally Advanced Laryngeal Cancer

Voice prosthesis implantation with the creation of a tracheoesophageal fistula is the gold standard procedure for voice rehabilitation in patients after a total laryngectomy. All patients implanted with a voice prosthesis (VP) have biofilms of fungi and bacteria grow on their surface. Biofilm colonization is one of the main reasons for VP degradation that can lead to VP dysfunction, which increases the high risk of pneumonia. In a 20-month evaluation period, 129 cases of prostheses after replacement procedures were investigated. Microbiological examination of the biofilms revealed that there were four of the most common fungi species (Candida spp.) and a large variety of bacterial species present. We studied the relationship between the time of proper function of Provox VP, the microorganism composition of the biofilm present on it, and the degradation level of the silicone material. Evaluation of the surface of the removed VP using an atomic force microscope (AFM) has demonstrated that biofilm growth might drastically change the silicone’s mechanical properties. Changes in silicone stiffness and thermal properties might contribute to the failure of VP function. Our data can serve in future studies for the development of methods to prevent or inhibit biofilm formation on the VP surface that would translate to an increase in their durability and safety

Ceragenin-mediated disruption of Pseudomonas aeruginosa biofilms.

BackgroundMicrobial biofilms, as a hallmark of cystic fibrosis (CF) lung disease and other chronic infections, remain a desirable target for antimicrobial therapy. These biopolymer-based viscoelastic structures protect pathogenic organisms from immune responses and antibiotics. Consequently, treatments directed at disrupting biofilms represent a promising strategy for combating biofilm-associated infections. In CF patients, the viscoelasticity of biofilms is determined mainly by their polymicrobial nature and species-specific traits, such as Pseudomonas aeruginosa filamentous (Pf) bacteriophages. Therefore, we examined the impact of microbicidal ceragenins (CSAs) supported by mucolytic agents-DNase I and poly-aspartic acid (pASP), on the viability and viscoelasticity of mono- and bispecies biofilms formed by Pf-positive and Pf-negative P. aeruginosa strains co-cultured with Staphylococcus aureus or Candida albicans.MethodsThe in vitro antimicrobial activity of ceragenins against P. aeruginosa in mono- and dual-species cultures was assessed by determining minimum inhibitory concentration (MIC) and minimum bactericidal/fungicidal concentration (MBC/MFC). Inhibition of P. aeruginosa mono- and dual-species biofilms formation by ceragenins alone and in combination with DNase I or poly-aspartic acid (pASP) was estimated by the crystal violet assay. Additionally, the viability of the biofilms was measured by colony-forming unit (CFU) counting. Finally, the biofilms' viscoelastic properties characterized by shear storage (G') and loss moduli (G"), were analyzed with a rotational rheometer.ResultsOur results demonstrated that ceragenin CSA-13 inhibits biofilm formation and increases its fluidity regardless of the Pf-profile and species composition; however, the Pf-positive biofilms are characterized by elevated viscosity and elasticity parameters.ConclusionDue to its microbicidal and viscoelasticity-modifying properties, CSA-13 displays therapeutic potential in biofilm-associated infections, especially when combined with mucolytic agents

Assessment of Ceragenins in Prevention of Damage to Voice Prostheses Caused by Candida Biofilm Formation

This study aimed to investigate the potential application of ceragenins (CSAs) as new candidacidal agents to prevent biofilm formation on voice prostheses (VPs). The deterioration of the silicone material of VPs is caused by biofilm growth on the device which leads to frequent replacement procedures and sometimes serious complications. A significant proportion of these failures is caused by Candida species. We found that CSAs have significant candidacidal activities in vitro (MIC; MFC; MBIC), and they effectively eradicate species of yeast responsible for VP failure. Additionally, in our in vitro experimental setting, when different Candida species were subjected to CSA-13 and CSA-131 during 25 passages, no tested Candida strain showed the significant development of resistance. Using liquid chromatography–mass spectrometry (LC-MS), we found that VP immersion in an ethanol solution containing CSA-131 results in silicon impregnation with CSA-131 molecules, and in vitro testing revealed that fungal biofilm formation on such VP surfaces was inhibited by embedded ceragenins. Future in vivo studies will validate the use of ceragenin-coated VP for improvement in the life quality and safety of patients after a total laryngectomy