A Case of Unilateral Otologic Symptoms as Initial Manifestations of Granulomatosis With Polyangiitis.

Granulomatosis with polyangiitis (GPA) is a chronic and systematic autoimmune condition characterized by granuloma formation and necrotizing vasculitis of small to medium-sized vessels. GPA initially presents itself as respiratory and renal symptoms. Although temporal bone involvement is not uncommon, an otologic disorder is rarely the initial symptom. We present a case of a 36-year-old man who presented with unilateral ear pain, hearing loss, and facial palsy. After a series of diagnostics and temporal bone and chest imaging, he was diagnosed with GPA with multiorgan involvement. Cyclophosphamide and methylprednisolone relieved the patient's ear pain and partially improved his hearing, facial palsy, and overall clinical condition. Although uncommon, systemic GPA may cause initial otologic symptoms and should not be dismissed as a possible cause of an otologic disease resistant to standard therapy.

Feather foreign body caused periparotid and peritonsillar abscess in a 9-month-old girl.

Migratory foreign body appeared to be bird feather, caused peritonsillar and periparotid abscess in a nine-month-old infant. Patient presented painful, tender and fluctuating red neck mass on the left neck region II, and refusal of oral intake, with no fever. Azithromycin was introduced four days before presentation for suspected urinary tract infection. ENT examination revealed left peritonsillar abscess; ultrasound confirmed periparotid abscess, MSCT verified both diagnoses. Under general anaesthesia, we performed abscess incision, after pus drainage, small foreign body spontaneously came through the wound. After washing it with saline, it appeared like a bird feather. Subsequently, peritonsillar abscess was incised and drained. After 24-hour postoperative care on pediatric intensive care unit, the patient continued three-day parenteral antibiotic treatment on the otolaryngology department; it was discharged with a recommendation to continue seven days of oral antibiotic therapy. Suggested mechanism was ingestion of bird feather from stuffed bedding, that got trapped in the tonsillar crypt. Afterwards, it started to migrate through the neck tissue. Households with children younger than three years should not have feather stuffed clothes or beddings.

Nasopharyngeal Perforation After Blunt Neck Trauma During Epileptic Seizure.

Pharyngeal perforation after blunt neck trauma is a rarity. We present a case of nasopharyngeal perforation after blunt neck trauma in a 29-year-old female patient. She presented with anterior neck tenderness and dysphagia after falling during an epileptic seizure. The head and neck assessment and fiberoptic pharyngolaryngeal examination did not show any injury. A computed tomography scan showed a parapharyngeal emphysema due to a nasopharyngeal perforation. The patient was successfully treated with a broad-spectrum antibiotic, analgesic, and 1 day of fasting. Adequate imaging (radiographs or computed tomography scans) should be conducted in patients with blunt neck trauma. The treatment modality depends on the location and size of the pharyngeal perforation.

Unusual Mechanism of Facial Nerve Palsy Caused by Penetrating Neck Trauma.

We present a case of a low energy penetrating neck injury with only facial nerve (FN) palsy in the clinical finding. A 32-year-old male patient was admitted to the emergency department with a penetrating injury on the right side of the neck just behind the right ear, accompanied by evident right (FN) palsy, evaluated as House Brackmann grade IV. Computed tomography demonstrated an isolated soft tissue injury in the right retroauricular region without bone fracture, parotid gland lesion, or vascular structure involvement. The FN palsy was treated with corticosteroids (CS), and the patient had an uneventful and complete recovery. This case report presents an unusual mechanism of isolated, extratemporal, blunt injury of the FN after a penetrating neck injury followed by complete recovery.

IMPACT Observatory: tracking the evolution of clinical trial data sharing and research integrity.

INTRODUCTION: The opening of research data is emerging thanks to the increasing possibilities of digital technology. The opening of clinical trial (CT) data is a part of this process, expected to have positive scientific, ethical, health, and economic impacts thus contributing to research integrity. The January 2016 proposal by the International Council of Medical Journal Editors triggered ample discussion about CT data sharing and reconfirmed the need for an ongoing assessment of its dynamics. The IMProving Access to Clinical Trials data (IMPACT) Observatory aims to play such a role, and assess the data sharing culture, policies, and practices of key players, the impact of their interventions on CTs, and contribute to a transformation of research. The objective of this paper is to present the IMPACT Observatory as well as share some of its preliminary findings. MATERIALS AND METHODS: Methods include a scoping study of research, surveys, interviews, and an environmental scan of research data repositories. RESULTS: Our preliminary findings indicate that although opening of CT data has not yet been achieved, its evolution is encouraging. Initiatives by key players contribute to increasing of CT data sharing, and many barriers are shrinking or disappearing. CONCLUSIONS: The major barrier is the lack of data sharing standards, from preparing data for public sharing to its curatorship, findability and access. However, experiences accumulated by sharing CT data according to "upon request" or "open" mechanisms could inform the development of such standards. The Vivli, CORBEL-ECRIN and Open Trials projects are currently working in this direction.