Diagnostic challenges in cervical tuberculous lymphadenitis: A review.

Tuberculosis is a very serious disease and incidence is once again on the rise. Lymph node tuberculosis is one of the most common extrapulmonary manifestations of tuberculosis. In differential diagnosis of chronic, painless cervical lymphadenopathy, cervical tuberculous lymphadenitis should be kept in mind. A high index of suspicion is needed for diagnosis of tuberculous lymphadenitis, which is known to mimic a number of pathological conditions. This article reviews epidemiology, clinical manifestations, and diagnostic techniques for cervical tuberculous lymphadenitis.

How does parental smoking affect nasal mucociliary clearance in children?

Correlation between passive smoking and nasal mucociliary clearance (MCC) in pediatric population has not been reported before. Therefore, in this study, we aimed to investigate the relationship between environmental tobacco smoke and nasal MCC in children whose parents smoke in or outside the house. Three groups of subjects were evaluated: control group (group 1) with 18 children who were not exposed to environmental smoke, 15 passive smokers living with at least one adult household member smoking outside the house (group 2), 17 passive smokers living with at least one adult household member smoking inside the house (group 3). Parents of children were asked to answer our questions regarding their smoking history, and nasal MCC time was assessed for all individuals of the 3 groups. The mean MCC value in control group, group 2 and group 3 were 7.33 ± 2.91, 10.00 ± 4.78 and 12.41 ± 3.44, respectively. Differences between the mean nasal MCC values of the groups were statistically significant (p < 0.01). The comparison of MCC values between control group and group 2 did not reveal significant difference, but since p value was very close to significance level, in larger series it could be significant. (p = 0.067). Also, when we compared the MCC values between group 2 and group 3, there was no significant difference (p = 0.173). But, the difference between MCC values of control group and group 3 was statistically significant (p < 0.001). Parental smoking both inside or outside the house seemed to increase nasal mucociliary clearance time when they are compared with healthy controls. Further studies with larger study groups also measuring direct quantitative doses of smoking are needed to verify this important issue.

Histopathological characteristics of nasal polyps in smokers and non-smokers.

OBJECTIVE: It is known that cigarette smoking causes squamous metaplasia in upper and lower airways. We hypothesized that in patients with nasal polyposis, nasal polyps of smokers might reveal some histopathological changes and there might be an increased neoplasia risk. Therefore, in this study, we aimed to explore the effects of smoking on nasal polyp histopathology and clinical measures. STUDY DESIGN: Retrospective chart review. SETTING: Fatih Sultan Mehmet Education and Research Hospital. MATERIAL AND METHODS: Thirty smoker and 47 non-smoker patients with nasal polyposis who underwent endoscopic sinus surgery between 2007 and 2011 were enrolled in this study to assess effect of smoking on histopathological characteristics of nasal polyps and clinical measures such as endoscopy score, computed tomography score of Lund-Mackay, Nasal Obstruction Symptom Evaluation (NOSE) Scale, presence of allergy and asthma, and blood eosinophil level. RESULTS: No statistically significant differences were found between smoker and non-smoker groups with regard to histopathological findings. Also, there were no significant correlation defined by endoscopy, computed tomography, and NOSE scores of patients between 2 groups. Smoking did not have a significant effect on the presence of allergy or asthma. But blood eosinophil levels were found to be significantly high in the smoker group. CONCLUSION: This is the first clinical study that investigates the effect of smoking on nasal polyp histopathology. In spite of the fact that smoking is associated with histopathological changes in respiratory mucosa, we did not find any significant change in histopathological characteristics of nasal polyps in smokers.