Possible role of endoplasmic reticulum stress in the pathogenesis of chronic adenoiditis and adenoid hypertrophy: A prospective, parallel-group study.

Background: Adenoid tissue is a first-line host defense secondary lymphoid organ, especially in childhood. The endoplasmic reticulum (ER) is required to maintain balanced cellular activity. With impaired ER functions, protein accumulation occurs, resulting in ER stress, which plays a role in the etiopathogenesis of many diseases. Objective: We aimed to investigate the relationship between ER stress and adenoid tissue disorders, thereby elucidating the mechanisms of immunity-related diseases. Methods: Fifty-four pediatric patients (>3 years old) who underwent adenoidectomy for chronic adenoiditis (CA) or adenoid hypertrophy (AH) were enrolled in this prospective, parallel-group clinical study. Adenoids were divided into two groups (CA or AH) based on their size and evaluated for ER stress pathway and apoptosis pathway markers by Real-time PCR and Western blot analysis. Results: ER stress pathway markers significantly differed between the CA and AH groups. Children with CA had higher ER stress marker levels than the AH group (p < .001 for ATF-4, ATF-6, and GRP78, and p < .05 for EDEM1, CHOP, EIF2AK3, ERNI, and GRP94). Apoptosis pathway marker levels (BAX and BCL-2) were not different between groups. Conclusions: ER stress contributes to the etiopathogenesis of adenoid tissue diseases and the pathogenesis of adenoid tissue disorders, which are part of the immune response. These results may guide the development of new and alternative treatments for immune system disorders.

Detection of tongue edema caused by endotracheal intubation tube in ICU patients by ultrasonography: a prospective, observational, clinical study.

PURPOSE: We aimed to determine the tongue edema that may develop due to the pressure exerted by the endotracheal intubation (ETI) tube on the tongue during the follow-up period of mechanical ventilation in patients intubated in the intensive care unit (ICU) by submental ultrasonography (USG). Also, we aimed to investigate the effect of tongue edema on the oxygen saturation values (SpO2) measured two h after extubation. METHODS: One hundred patients aged 18-65 years, who were followed up with mechanical ventilation in the ICU from the 0th day of intubation, were included. Patients (n = 57) who were followed up on mechanical ventilation for four days or longer after ETI were included in the study group. Those who were followed up on mechanical ventilation for three days or less after endotracheal intubation and were extubated during this period were included in the control group (n = 43). The tongue cross-sectional areas (TSAs) of patients in both groups were measured twice with submental USG. The first measurement (TSA1) was performed on the 0th day of ETI in all patients in both groups. The second measurement (TSA2) was performed on the 4th day of ETI in the study group and just before extubation in the control group. The difference between TSA2 and TSA1 was defined as tongue edema. Also, the effect of tongue edema on the oxygen saturation levels measured at the 2nd h after extubation of the patients in the control group was investigated. RESULTS: The tongue edema was more prevalent in the study group (p < 0.01). A significant negative correlation was found between the SpO2 levels two hours after extubation and the increase in the mean TSA values indicating tongue edema (p < 0.01). The oxygen saturations of the patients with tongue edema were 4% lower than those without tongue edema. CONCLUSIONS: Tongue edema may develop due to the long-term application of pressure of the ETI tube on the tongue and may impair oxygenation after extubation. GOV IDENTIFIER: NCT05249738.

Correlation between nystagmus intensity and vestibular-ocular reflex gain in benign paroxysmal positional vertigo: A prospective, clinical study.

BACKGROUND: Video head impulse test (vHIT) and videonystagmography (VNG) provide significant benefits in evaluating benign paroxysmal positional vertigo (BPPV) and determining the semicircular canal localization of the otoconia. OBJECTIVE: This study aimed to investigate the relationship between vestibular-ocular reflex (VOR) gains measured via vHIT and the slow-phase velocity (SPV) of nystagmus in patients with the posterior semicircular canal (PSCC)-BPPV. METHODS: Sixty-two patients were included in this study and divided into the study (n = 32, patients with isolated PSCC-BPPV) and control (n = 30, age- and sex-matched healthy individuals) groups. While VOR gains were measured with vHIT in both groups and compared between groups, the SPV values of nystagmus observed during the Dix-Hallpike maneuver in the study group were recorded using VNG and compared with the VOR gains of the study group. RESULTS: There were significant differences in posterior canal VOR gains between the study and control groups (p < 0.001 and p < 0.01, respectively). Although the affected PSCC had decreased VOR gains versus the control group, it was still within the normal range. However, there was no significant relationship between the VOR gains of the affected PSCC and the SPV of the nystagmus. CONCLUSIONS: vHIT can help detect semicircular canal dysfunction in patients with PSCC-BPPV. The SPV values of nystagmus on VNG during the Dix-Hallpike maneuver do not correlate with the level of VOR gain.

New validation of a well-known marker in cochlear implant infections: A retrospective, case-controlled, observational study.

Objectives: Cochlear implant (CI) infection is the most common complication after CI surgery. We investigated whether the preoperative neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) values could predict the CI infection and the NLR and PLR values obtained at the first admission to the hospital with an CI infection could help the clinician in the diagnosis. Methods: This retrospective case-controlled study included 26 patients with postsurgical CI infection. To prevent age-related incompatibility in the blood analysis of the infected group, the patients were divided into three age groups: 0-4 years, 5-18 years, and over 18 years old. To compare the infected group, 29 patients who did not have implant infection after CI surgery and whose age ranges were compatible with the infected group were randomly selected from the hospital records as the control group. The infected group preimplantation (PREs) and postinfection (POSTi) NLR and PLR values were compared with each other and the control group values. The area under the curve, sensitivity, specificity, and cutoff values were calculated by ROC analysis. Results: The POSTi NLR values of the infected group patients aged 0-4 years and over 18 years were significantly greater than the PREs NLR values (p = .038 and p = .008, respectively). Significant differences were found between the POSTi NLR values of the infected group patients aged 0-4 years and over 18 years and those of PREs in the control group (p = .011 and p = .015, respectively). Conclusions: Preoperative NLR and PLR values cannot predict postoperative CI infection. However, NLR and PLR values increased significantly after CI infection, even if systemic symptoms did not occur. At the first admission to the hospital, NLR values can guide the clinician in diagnosing the CI infection in patients between 0 and 4 years and over 18 years.Trial Registration Clinical Trials.gov Identifier: NCT04120181.