New inflammatory parameters in laryngopharyngeal reflux.

OBJECTIVES: To investigate new inflammatory markers in patients with laryngopharyngeal reflux and determine whether these inflammatory parameters change in response to laryngopharyngeal reflux treatment. METHODS: Complete blood count was evaluated to obtain platelet count and mean platelet volume and calculate neutrophil-to-lymphocyte ratio and platelet-to-lymphocyte ratio. Laryngopharyngeal reflux patients underwent three-month lansoprazole treatment. RESULTS: The study included 45 laryngopharyngeal reflux patients (9 men (20 per cent); mean age, 37.4 ± 11.6 years) and 35 healthy age- and sex-matched controls (7 men (20 per cent); mean age, 38.6 ± 8.9 years). The study group had significantly higher platelet-to-lymphocyte ratios and lower mean platelet volumes than the control group (p = 0.004 and p = 0.047, respectively). There was a significant correlation between platelet-to-lymphocyte ratios and initial inflammatory symptoms (reflux symptom index, p = 0.025; reflux finding score, p = 0.013). There was also a significant correlation between mean platelet volume increase and symptom resolution in the first and third months of treatment (p = 0.04 and p = 0.03, respectively). CONCLUSION: Platelet-to-lymphocyte ratio, a new inflammatory marker of chronic inflammation, was significantly higher in laryngopharyngeal reflux patients. Moreover, these patients had significantly lower mean platelet volume values, which increased with post-treatment symptom improvement.

Corticosteroid hypersensitivity in allergic rhinitis.

Corticosteroid hypersensitivity in allergic rhinitis. BACKGROUND: intranasal corticosteroid (IC) is the most effective treatment method in allergic rhinitis patients who are unresponsive to antihistamines. The literature reports an approximate 20% treatment failure for instances where IC is used for the treatment allergic rhinitis. Hypersensitivity reaction to corticosteroids may be one of the causes of this treatment failure. OBJECTIVE: to discover the incidence and confounding factors of corticosteroid hypersensitivity in patients with allergic rhinitis. METHODS: after 31 patients were excluded, 150 consecutive patients who were prospectively evaluated in our outpatient clinics with the diagnosis of allergic rhinitis and 50 age- and sex- matched healthy volunteers were included in this study. To diagnose allergic rhinitis, the symptoms of patients and a skin prick test were used. A skin patch test was used to determine corticosteroid hypersensitivity. Total IgE values and total eosinophil count were obtained for all patients. Total symptom scores were calculated for the severity of symptoms and to determine the response to therapy using intranasal corticosteroids. RESULTS: the incidence of corticosteroid hypersensitivity determined via the skin patch test was 14.0% (21 out of 150 patients). A difference was observed for patch test positivity results between the study and control groups (14% vs. 0%, respectively). Serum IgE levels and total eosinophil count were higher among patients who had corticosteroid hypersensitivity (p:0.005 and p:0.004, respectively). Patients unresponsive to intranasal corticosteroids had a higher incidence of corticosteroid hypersensitivity (71.4% vs. 4.4%, p<0.00 1). CONCLUSION: our study is the largest to date investigating CH in patients with allergic rhinitis and patients with allergic rhinitis have been found to have a high incidence (14%) of corticosteroid hypersensitivity, which may affect the response of patients to intranasal corticosteroid treatment.

Link between angiographic extent and severity of coronary artery disease and degree of sensorineural hearing loss.

AIMS: Atherosclerosis is a systemic disease that can affect the whole arterial tree. An important cause of neuronal degeneration is atherosclerosis, which may lead to sensorineural hearing loss. We aimed to investigate the relationship between the angiographic severity and extent of coronary artery disease, which is a surrogate of atherosclerotic burden, and the degree of sensorineural hearing loss. PATIENTS AND METHODS: Out of 381 consecutive patients who underwent coronary angiography for symptoms suggesting ischemic heart disease and who had ischemia detected by a noninvasive stress test, 265 patients [mean age, 61.5 ± 13.0 years; median age (25th-75th percentile), 59 years (50.5-67)], including 146 male (55.1 %) subjects met the eligibility criteria and were enrolled. Audiological measurements (hearing levels and discrimination scores) were performed before the coronary angiography. The Gensini score was calculated for each angiogram. RESULTS: There was a statistically significant positive correlation between the degree of hearing loss at all frequencies analyzed (250, 500, 1,000, 2,000, 4,000 Hz) and the Gensini score (p < 0.05 for all frequencies), which remained significant after adjustment according to age and other risk factors. A statistically significant negative correlation was observed between the Gensini score and the speech discrimination score (p < 0.05). CONCLUSION: The findings of this study suggest that the angiographic severity and extent of coronary artery disease are significantly and independently correlated with the degree of hearing loss. Sensorineural hearing loss was more prominent in patients with higher Gensini scores. We propose that the findings of this study warrant further research and should be verified in large-scale studies.

Cochlear implantation in chronic otitis media.

Patients with chronic otitis media (COM) may have profound sensorineural hearing loss either due to the disease process or secondary to a surgical procedure. Some patients who are candidates for cochlear implantation may have COM coincidentally. The patients in this group need special attention when cochlear implantation is applied. The aim of this study is to evaluate the potential risks and complications in patients with COM. Cochlear implantation was performed in six patients with COM or an infected radical cavity and profound hearing loss. Five of them underwent a two-stage operation, and one had a single-stage operation. Cochlear implantation was performed in all patients without complications. The follow-up period was uneventful. Although such patients have some potential risks, when certain surgical rules are followed very strictly cochlear implantation can be successfully performed in patients with COM.

Antioxidant defence system in a patient with cerebrovascular accident.

The increased production of reactive oxygen metabolites in the central nervous system may result in cellular damage and vascular-parenchymal injury. Vascular injury is also a cause of the vasoregulation deficiency. In this case report, a 60-year-old woman was admitted to the department of neurology, with a diagnosis of cerebrovascular accident. During 18 days of follow-up, the status of the antioxidant system was determined by measuring red cell superoxide dismutase and catalase activity. Red cell and plasma copper, zinc and magnesium concentrations were also measured. Red cell superoxide dismutase activity increased markedly by Day 2, reached a peak on Day 6 before decreasing to normal 18 days after the injury. Red cell catalase activity was below normal values during the whole of the 18-day study period and was at its lowest between days 6 and 7. Plasma copper, zinc and magnesium concentrations showed corresponding alterations.