Instruments evaluating the clinical findings of laryngopharyngeal reflux: A systematic review

Objectives: To identify the instruments for evaluating the clinical findings (ICFs) of laryngopharyngeal reflux (LPR) designed for use with regard to diagnosis and treatment effectiveness. Methods: The PubMed, Scopus, and Cochrane databases were used to search for subject headings following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) recommendations. Three investigators retrieved relevant studies published between 1990 and 2018 describing the evolution of laryngopharyngeal findings throughout LPR treatment. Issues of clinical relevance, that is, LPR diagnosis, treatments, and signs assessed for diagnosis or as therapeutic outcomes, were assessed. The investigators also evaluated the psychometric properties (conceptual model, content validity, consistency, reliability, concordance, convergent validity, known-groups validity, responsiveness to change, and interpretability) of the ICF. The risk of bias was assessed with the tool of the Clarity Group and Evidence Partners. Results: The search identified 1,227 publications with a total of 4,735 LPR patients; of these studies, 53 met the inclusion criteria. Of these 53 studies, we identified 10 unvalidated and six validated ICFs. None of the validated ICFs included all the psychometric properties. The main identified deficiencies related to ICF psychometric validation included variable construct validity, disparate and uncertain reliabilities, and a lack of interpretability. The lack of consideration of certain LPR laryngeal and extralaryngeal signs is the main weakness of ICFs, biasing content, and construct validities. Conclusion: The low specificity of LPR signs, the lack of consideration of many findings, and the absence of a gold standard for diagnosis constitute barriers to the further validation of these ICFs. Additional studies are needed to develop complete and reliable ICFs. Laryngoscope, 2018

Six-month smell and taste recovery rates in coronavirus disease 2019 patients: a prospective psychophysical study

Background The long-term recovery rate for coronavirus disease 2019 related chemosensory disturbances has not yet been clarified. Methods Olfactory and gustatory functions were assessed with psychophysical tests in patients in the first seven days from coronavirus disease 2019 onset and one, two, three and six months after the first evaluation. Results A total of 300 patients completed the study. The improvement in olfactory function was significant at the two-month follow up. At the end of the observation period, 27 per cent of the patients still experienced a persistent olfactory disturbance, including anosmia in 5 per cent of cases. As for taste, the improvement in the psychophysical scores was significant only between the baseline and the 30-day control. At the 6-month evaluation, 10 per cent of the patients presented with a persistent gustatory disturbance with an incidence of complete ageusia of 1 per cent. Conclusion Six months after the onset of coronavirus disease 2019, about 6 per cent of patients still had a severe persistent olfactory or gustatory disturbance

Psychophysical Olfactory Tests and Detection of COVID-19 in Patients With Sudden Onset Olfactory Dysfunction: A Prospective Study

Objective: To investigate the coronavirus disease 2019 (COVID-19) status of patients with initial sudden olfactory anosmia (ISOA) through nasopharyngeal swabs for reverse transcription–polymerase chain reaction (RT-PCR) analysis and to explore their olfactory dysfunctions with psychophysical olfactory evaluation. Methods: A total of 78 ISOA patients were recruited from April 6, 2020, to April 10, 2020, through a public call of University of Mons (Mons, Belgium). Patients benefited from nasopharyngeal swabs and fulfilled the patient-reported outcome questionnaire. Among them, 46 patients performed psychophysical olfactory evaluation using olfactory identification testing. Based on the duration of the ISOA, 2 groups of patients were compared: patients with olfactory dysfunction duration ≤12 days (group 1) and those with duration >12 days (group 2). Results: In group 1, 42 patients (87.5%) had a positive viral load determined by RT-PCR and 6 patients (12.5%) were negative. In group 2, 7 patients (23%) had a positive viral load and 23 patients (77%) were negative. The psychophysical olfactory evaluation reported that anosmia and hyposmia occurred in 24 (52%) and 11 (24%) patients, respectively. Eleven patients were normosmic. The viral load was significantly higher in patients of group 1 compared with those of group 2. Conclusions: Coronavirus disease 2019 was detected in a high proportion of ISOA patients, especially over the first 12 days of olfactory dysfunction. Anosmia is an important symptom to consider in the detection of COVID-19 infection

Delivery of a drug molecule to thyroid cancer cells via EGFR targeting

peer reviewedThe anaplastic thyroid carcinoma (ATC) is the most aggressive thyroid cancer and is characterized by a high mortality rate, occurring within 2-6 months from diagnosis. The current systemic treatment is based on conventional therapies. New molecular targeted therapies are explored and are aimed to limit the systemic effects [1,2]. Our strategy consists of bringing a PIP3-targeted therapeutic peptide (TP) (PIP3-P2 and P3 peptides) directly into the thyroid cancer cells thanks to a vector peptide (VP) targeted to EGFR (EGFR-P5 and P20 peptides). The TP and VP peptides were identified using the phage display technology. The binding of VP to their target was evaluated by immunohistochemistry on biopsies of ATC, subsequent to the validation of total and phosphorylated EGFR expression on the same cases. The staining of these biomarkers is important on all cases, which confirms the receptor overexpression and overactivation in ATC. The staining obtained with peptides is similar, which suggests their good specificity and affinity. Detection of total and phosphorylated EGFR on ATC cells (8505C) by immunofluorescence confirmed that peptides bind the receptor and act as non-competitive antagonists of EGF. To evaluate the binding of TP to their target, they were detected on several cases of ATC. Before confirming their binding, the presence of PIP3 and phosphorylated AKT was validated by an important staining on all these cases, revealing their overactivation. The labelling observed with peptides is comparable to that of PIP3, suggesting that peptides bind this biomarker with good affinity and specificity. Aiming to evaluate the therapeutic efficacy of these peptides, apoptotic cell death was demonstrated by the immunofluorescent detection of activated caspase 3 on 8505C cells. Finally, the most promising TP and VP were coupled via streptavidin and their efficacy was assessed by the detection of activated caspase 3 on 8505C cells. This peptide combination appears as promising since the mortality rate was 100% and the labelling was more localized implying that the VP delivers TP directly into the ATC cells. REFERENCES [1] Tiedje V et al. Endocr Relat Cancer. 2018;25(3):R153-R161. 10.1530/ERC-17-0435. [2] Li Z et al. Exp Ther Med. 2019;18(4):2369-2377. 10.3892/etm.2019.7869.5177 - Télévie-Burtea - Targeted therapy of thyroid cancer - Fédération Wallonie Bruxelle

Correlations Between Olfactory Psychophysical Scores and SARS-CoV-2 Viral Load in COVID-19 Patients

Objectives/Hypothesis: The aim of this study was to evaluate the correlations between the severity and duration of olfactory dysfunctions (OD), assessed with psychophysical tests, and the viral load on the rhino-pharyngeal swab determined with a direct method, in patients affected by coronavirus disease 2019 (COVID-19). Study design: Prospective cohort study. Methods: Patients underwent psychophysical olfactory assessment with Connecticut Chemosensory Clinical Research Center test and determination of the normalized viral load on nasopharyngeal swab within 10 days of the clinical onset of COVID-19. Results: Sixty COVID-19 patients were included in this study. On psychophysical testing, 12 patients (20% of the cohort) presented with anosmia, 11 (18.3%) severe hyposmia, 13 (18.3%) moderate hyposmia, and 10 (16.7%) mild hyposmia with an overall prevalence of OD of 76.7%. The overall median olfactory score was 50 (interquartile range [IQR] 30–72.5) with no significant differences between clinical severity subgroups. The median normalized viral load detected in the series was 2.56E+06 viral copies/106 copies of human beta-2microglobulin mRNA present in the sample (IQR 3.17E+04–1.58E+07) without any significant correlations with COVID-19 severity. The correlation between viral load and olfactory scores at baseline (R2 = 0.0007; P =.844) and 60-day follow-up (R2 = 0.0077; P =.519) was weak and not significant. Conclusions: The presence of OD does not seem to be useful in identifying subjects at risk for being super-spreaders or who is at risk of developing long-term OD. Similarly, the pathogenesis of OD is probably related to individual factors rather than to viral load and activity. Level of evidence: 4 Laryngoscope, 2021

Correlations between IL-6 serum level and olfactory dysfunction severity in COVID-19 patients: a preliminary study

Background: Interleukin 6 (IL-6) is a proinflammatory cytokine that is secreted by cells infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and it is widely recognized as a negative prognostic factor. The purpose of this study was to analyze the correlations between the olfactory scores determined by psychophysical tests and the serum levels of IL-6 in patients affected by coronavirus disease 2019 (COVID-19) Methods: Patients underwent psychophysical olfactory assessment with Connecticut Chemosensory Clinical Research Center test and IL-6 plasma level determination within 10 days of the clinical onset of COVID-19. Results: Seventy-four COVID-19 patients were included in this study. COVID-19 staged as mild in 34 patients, moderate in 26 and severe in 14 cases. There were no significant differences in olfactory scores across the different COVID-19 severity groups. In the patient series, the median plasma level of IL-6 was 7.7 pg/mL (IQR 3.7–18.8). The concentration of IL-6 was found to be significantly correlated with the severity of COVID-19 with a directly proportional relationship. The correlation between IL-6 plasma concentrations and olfactory scores was weak (rs = 0.182) and not significant (p = 0.12). Conclusions: In COVID-19 patients, psychophysical olfactory scores did not show significant correlations with the plasma levels of a well-recognized negative prognostic factor such as IL-6. This observation casts some shadows on the positive prognostic value of olfactory dysfunctions

Non-traumatic myositis ossificans mimicking a malignant neoplasm in an 83-year-old woman: a case report

<p>Abstract</p> <p>Introduction</p> <p>Myositis ossificans is a benign, self-limiting condition that usually affects young, athletically active men. To the best of our knowledge, this case report describes the oldest recorded patient with myositis ossificans.</p> <p>Case presentation</p> <p>Our patient was an 83-year-old Japanese woman who presented with a one week history of a palpable mass in the left thigh. She had a history of surgery for transverse colon cancer and lung cancer at the ages of 73 and 80, respectively. Clinical and radiological examinations suggested a malignant neoplasm such as metastatic carcinoma or extraskeletal osteosarcoma. A diagnosis of myositis ossificans was made by core needle biopsy. Our patient was asymptomatic and had no recurrence at one year follow-up.</p> <p>Conclusion</p> <p>Clinicians should consider myositis ossificans as a possible diagnosis for a soft tissue mass in the limb of an older patient, thereby avoiding unnecessarily aggressive therapy.</p