Giant antrochoanal polyp presenting as oropharyngeal mass

Antrochoanal polyps are benign mucosal lesions emerging from the maxillary sinus. The primary symptoms are nasal obstruction and rhinorrhea. Endoscopic and radiological appearance of the disease is typical. These polyps are usually presented unilaterally, although bilateral presentation is also possible. In this paper, we report a case of atypically giant antrochoanal polyp in a 13-year-old child. The patient’s primary complaint was a sensation of lump in her throat. The examination revealed a mass behind soft palate. The excised polyp had the histological characteristic of an angiomatous antrochoanal polyp. Because of the unusual dimension, the combined transoral and endonasal endoscopic approach was performed for complete polyp excision. We discussed the clinical, histopathological and immunohistochemical characteristics of choanal polyps in comparison to inflammatory nasal polyps, and the applicable surgical techniques for treatment of these polyps

Is tinnitus an early voice of masked hypertension? High masked hypertension rate in patients with tinnitus

Objectives: Tinnitus is hearing a sound without any external acoustic stimulus. There are some clues of hypertension can cause tinnitus in different ways. The aim of the study was to evaluate the relationship between tinnitus and masked hypertension including echocardiographic parameters and severity of tinnitus. Methods: This study included 88 patients with tinnitus of at least 3 months duration and 85 age and gender-matched control subjects. Tinnitus severity index was used to classify the patients with tinnitus. After a complete medical history, all subjects underwent routine laboratory examination, office blood pressure measurement, hearing tests and ambulatory blood pressure monitoring. Masked hypertension is defined as normal office blood pressure measurement and high ambulatory blood pressure level. Results: Baseline characteristics in patients and controls were similar. Prevalence of masked hypertension was significantly higher in patients with tinnitus than controls (18.2% vs 3.5%, p = 0.002). Office diastolic BP (76 ± 8.1 vs. 72.74 ± 8.68, p = 0.01), ambulatory 24-H diastolic BP (70.2 ± 9.6 vs. 66.9 ± 6.1, p = 0.07) and ambulatory daytime diastolic BP (73.7 ± 9.5 vs. 71.1 ± 6.2, p = 0.03) was significantly higher in patients with tinnitus than control group. Tinnitus severity index in patients without masked hypertension was 0 and tinnitus severity index in patients with masked hypertension were 2 (1–5). Conclusion: This study demonstrated that masked hypertension must be kept in mind if there is a complaint of tinnitus without any other obvious reason

Synthesis and characterization of sericin-capped gold nanoparticles

Erdemli, Ozge/0000-0001-8606-8863;WOS: 000435972700023In this study, sericin-capped gold nanoparticles (S-AuNP) were synthesized by using the silk sericin isolated from Bombyx mori silkworm cocoon. Sericin solutions having different concentrations (0.25%, 0.5 ve 1) and pH values (8 and 12) were added to fixed amount of gold salt (1 mM) to obtain experimental groups (S-AuNP0.25, S-AuNP0.5, S-AuNP1). Red color shift and distinct surface plasmon resonance (SPR) peaks observed at 520-530 nm wavelenghts in all groups were indicative of nanoparticle synthesis. However, these red color shift and peaks were not clear in pH 12. According to FTIR analyses, N-H, O-H and C=0 functional groups of sericin might have played a role in reduction reaction. In TEM images, both the average particle size and distribution of S-AuNPs increased with increasing sericin concentration. Sericin rendered the surface charge of nanoparticles negative and the increase in negative zeta potential of S-AuNP0.5 and S-AuNP1 showed that they were more stable in water than S-AuNP0.25. This result was confirmed with stability in salt experiments. S-AuNP0.25 lost its stability in salt after 1 day incubation, but the other groups remained stable as long as 7 days. As a whole, the most convenient group was assumed to be S-AuNP0,5. Such nanoparticles sythesized in this manner could have potential applications in biomedical sector such as nanosized drug delivery systems and so on

Influence of size and site of perforation on fat graft myringoplasty

WOS: 000345266000003PubMed: 25199735Objectives: In this retrospective study, we investigated the outcomes of fat graft myringoplasty (FGM) in different perforation sizes and locations. The outcomes were evaluated in terms of closure rates and audiological test results. Methods: The study population included 172 patients who were operated between 2007 and 2012. 161 had unilateral and 11 had bilateral chronic otitis media; and 183 ears were operated by FGM. The patients were divided into two groups based on size as small and larger (size of 30% TM was defined as a medium-large perforations); and two groups based on location of perforation [anterior and other (non-anteriorly located)]. Patients' follow-ups were performed between 1 and 5 years; and follow-up examinations were performed with otoendoscopy. Air conduction (AC) thresholds and air-bone gap (ABG) were evaluated both preoperative year and postoperative 1st year. Results: The total perforation closure rate was 84.7%. In this study, we found out that FGM is effective closing medium-large perforations just as small perforations with the success rate of 79.1% and 86.4% respectively (p > 0.05). When audiological outcomes were evaluated in both groups. AC values got lower and ABC values improved postoperatively, whereas regarding AC thresholds and ABC improvement among the size groups, patients with small perforations had significantly better postoperative results (p < 0.05). In terms of perforation location, closure rates were 85.2% in anteriorly perforations and 84.5% in the other located perforations. Audiological outcomes demonstrated that in both groups, AC values got lower and ABC values improved postoperatively; and hearing results were not different in anteriorly located perforations and other locations. Conclusion: Fat graft myringoplasty (FGM) may be used in all small and medium-large, and anteriorly and other located perforations. Although hearing improvement was detected in each of the small; and medium-large perforations; patients with small perforations had more satisfied audiological outcome than medium-large perforations. (C) 2014 Elsevier Ireland Ltd. All rights reserved.Continuous Education and Scientific Research AssociationExcept data collection, preparation of this paper including designing and planning was supported by "Continuous Education and Scientific Research Association.

Mortality risk factors among critically ill children with MIS-C in PICUs: a multicenter study

Background: This study evaluated of clinical characteristics, outcomes, and mortality risk factors of a severe multisystem inflammatory syndrome in children admitted to a the pediatric intensive care unit. Methods: A retrospective multicenter cohort study was conducted between March 2020 and April 2021 at 41 PICUs in Turkey. The study population comprised 322 children diagnosed with multisystem inflammatory syndrome. Results: The organ systems most commonly involved were the cardiovascular and hematological systems. Intravenous immunoglobulin was used in 294 (91.3%) patients and corticosteroids in 266 (82.6%). Seventy-five (23.3%) children received therapeutic plasma exchange treatment. Patients with a longer duration of the PICU stay had more frequent respiratory, hematological, or renal involvement, and also had higher D-dimer, CK-MB, and procalcitonin levels. A total of 16 patients died, with mortality higher in patients with renal, respiratory, or neurological involvement, with severe cardiac impairment or shock. The non-surviving group also had higher leukocyte counts, lactate and ferritin levels, and a need for mechanical ventilation. Conclusions: In cases of MIS-C, high levels of D-dimer and CK-MB are associated with a longer duration of PICU stay. Non-survival correlates with elevated leukocyte counts and lactate and ferritin levels. We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality. Impact: MIS-C is a life-threatening condition.Patients need to be followed up in the intensive care unit.Early detection of factors associated with mortality can improve outcomes.Determining the factors associated with mortality and length of stay will help clinicians in patient management.High D-dimer and CK-MB levels were associated with longer PICU stay, and higher leukocyte counts, ferritin and lactate levels, and mechanical ventilation were associated with mortality in MIS-C patients.We were unable to show any positive effect of therapeutic plasma exchange therapy on mortality