Retrospective study of a series of choanal atresia patients

Introduction Although it has been more than 250 years since the first description of choanal atresia (CA), there are still doubts about this abnormality. The differences between unilateral and bilateral forms are seldom discussed. Objectives Aggregate data from patients diagnosed with CA, grouping patients with unilateral and bilateral forms. Methods Retrospective study. Results Eighteen patients were included: 12 (66.6%) presented bilateral atresia, of which 77.8% were mixed bony-membranous type and 22.2% were pure bony type. From the 12 patients with bilateral atresia, 10 presented related malformations, 3 of whom had CHARGE syndrome (coloboma, heart defects, choanal atresia, retardation of growth and development, genitourinary problems, ear abnormalities). From the remaining 6 patients with unilateral atresia, only 2 showed malformations, 1 renal and 1 cardiac. All patients with unilateral atresia needed only 1 surgical procedure, and patients with the bilateral form needed amedian of 2.85 interventions (p ¼ 0.003). The median age of surgical procedure in the unilateral group was 6 years, ranging from 6 months to 18 years, and in the bilateral group was 25 days, ranging from 6 days to 6 years (p ¼ 0.003). The median interval between diagnosis and surgery was 9 months in the unilateral group, ranging from 1 month to 18 years, and in the bilateral group was 1 day, ranging from 1 day to 2 months (p ¼ 0.001). Discussion and Conclusions Success rates with the endoscopic approach vary from 62 to 100%. Nonetheless, most of these reports present results without considering the number of compromised sides. In our opinion, unilateral and bilateral cases involve distinct patients (taking into account the related malformations), have diverging clinical presentations, and show discrepant restenosis rates and therefore could be considered in different groups of analysis

Campylobacter concisus Impairs Sodium Absorption in Colonic Epithelium via ENaC Dysfunction and Claudin-8 Disruption

The epithelial sodium channel (ENaC) can increase the colonic absorptive capacity for salt and water. Campylobacter concisus is a common pathogenic epsilonproteobacterium, causing enteritis and diarrhea. It can induce barrier dysfunction in the intestine, but its influence on intestinal transport function is still unknown. Therefore, our study aimed to characterize C. concisus effects on ENaC using the HT-29/B6-GR/MR (epithelial cell line HT-29/B6 transfected with glucocorticoid and mineralocorticoid receptors) cell model and mouse colon. In Ussing chambers, C. concisus infection inhibited ENaC-dependent Na+ transport as indicated by a reduction in amiloride-sensitive short circuit current (-55%, n = 15, p < 0.001). This occurred via down-regulation of β- and γ-ENaC mRNA expression and ENaC ubiquitination due to extracellular signal-regulated kinase (ERK)1/2 activation, predicted by Ingenuity Pathway Analysis (IPA). In parallel, C. concisus reduced the expression of the sealing tight junction (TJ) protein claudin-8 and induced claudin-8 redistribution off the TJ domain of the enterocytes, which facilitates the back leakage of Na+ ions into the intestinal lumen. In conclusion, C. concisus caused ENaC dysfunction via interleukin-32-regulated ERK1/2, as well as claudin-8-dependent barrier dysfunction-both of which contribute to Na+ malabsorption and diarrhea

Subsedação é um fato de risco para o desenvolvimento de estenose subglóticaem crianças intubadas

Objective: To analyze the level of sedation in intubated children as a risk factor for the development of subglottic stenosis (SGS). Methods: All patients between 30 days and 5 years of age who required endotracheal intubation in the pediatric intensive care unit between 2013 and 2014 were included in this prospective study. They were monitored daily and COMFORT-B scores were obtained. Flexible fiber-optic laryngoscopy was performed within eight hours of extubation, and repeated seven to ten days later if the first examination showed moderate to severe laryngeal injuries. If these lesions persisted and/or if the child developed symptoms in the follow-up period, microlaryngoscopy under general anesthesia was performed to evaluate for SGS. Results: The study included 36 children. Incidence of SGS was 11.1%. Children with SGS had a higher percentage of COMFORT-B scores between 23 and 30 (undersedated) than those who did not develop SGS (15.8% vs. 3.65%, p = 0.004). Conclusion: Children who developed SGS were less sedated than children who did notdevelop SGS.Objetivo: Analisar o nível de sedac¸ão em crianc¸as intubadas como um fator de risco para odesenvolvimento de estenose subglótica (ES).Métodos: Todos os pacientes entre 30 dias e cinco anos que necessitaram de intubac¸ão endo-traqueal na Unidade de Terapia Intensiva Pediátrica entre 2013 e 2014 foram incluídos nesteestudo prospectivo. Eles foram monitorados diariamente e foram obtidos os escores da escalaComfort-B. Foi feita laringoscopia com tubo flexível de fibra óptica em oito horas da extubac¸ãoe repetida 7-10 dias depois, caso o primeiro exame tivesse mostrado lesões laríngeas mode-radas a graves. Caso essas lesões tivessem persistido e/ou caso a crianc¸a tivesse desenvolvidosintomas no período de acompanhamento, foi feita microlaringoscopia sob anestesia geral paraavaliar a ES.Resultados: Incluímos 36 crianc¸as. A incidência da ES foi de 11,1%. As crianc¸as com ES apre-sentaram um maior percentual de escores da escala Comfort-B entre 23 e 30 (subsedados) queos que não desenvolveram ES (15,8% em comparac¸ão com 3,65%, p = 0,004).Conclusão: As crianc¸as que desenvolveram ES foram menos sedadas do que as que não desen-volveram

Estudo transversal para a avaliação de pacientes com otite média crônica sem tratamento clínico e cirúrgico prévios

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Atlas de otorrinolaringologia

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Search for supersymmetry in pp collisions at s\sqrt{s} = 13 tev in the single-lepton final state using the sum of masses of large-radius jets

Results are reported from a search for supersymmetric particles in proton-proton collisions in the final state with a single lepton, multiple jets, including at least one b-tagged jet, and large missing transverse momentum. The search uses a sample of proton-proton collision data at $\sqrt{s}$ = 13 TeV recorded by the CMS experiment at the LHC, corresponding to an integrated luminosity of 35.9  $fb^{−1}$. The observed event yields in the signal regions are consistent with those expected from standard model backgrounds. The results are interpreted in the context of simplified models of supersymmetry involving gluino pair production, with gluino decay into either on- or off-mass-shell top squarks. Assuming that the top squarks decay into a top quark plus a stable, weakly interacting neutralino, scenarios with gluino masses up to about 1.9 TeV are excluded at 95% confidence level for neutralino masses up to about 1 TeV