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The nasopharynx is the initial site of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, and neutrophils play a critical role in preventing viral transmission into the lower airways or lungs during the early phases of infection. However, neutrophil dynamics, functional signatures, and predictive roles in the nasopharynx of coronavirus disease 2019 (COVID-19) patients have not yet been elucidated. In this study, we carried out RNA sequencing of nasopharyngeal swabs from a cohort of COVID-19 patients with mild, moderate, severe outcomes and healthy donors as controls. Over 32.7% of the differentially expressed genes associated with COVID-19 severity were neutrophil-related, including those involved in migration, neutrophil extracellular traps formation, and inflammasome activation. Multicohort single-cell RNA sequencing analysis further confirmed these findings and identified a population of neutrophils expressing Vacuolar-type ATPase (V-ATPase) and the chemokine receptor CXCR4 in the nasopharynx. This population of neutrophils preferentially expressed pro-inflammatory genes relevant to phagosomal maturation as well as local reactive oxygen species and reactive nitrogen species production in the nasopharynx of patients with severe outcomes. A four-gene panel defined as a neutrophil signature associated with COVID-19 progression (NSAP) was identified as an early diagnostic predictor of severe COVID-19, which potentially distinguished severe patients from mild cases with influenza, respiratory syncytial virus, dengue virus, or hepatitis B virus infection. NSAP is mainly expressed on CXCR4high neutrophils and exhibits a significant association with the cell fraction of this neutrophil population. This study highlights novel potential therapeutic targets or diagnostic tools for predicting patients at a higher risk of severe outcomes.
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COVID-19 , Humanos , COVID-19/diagnóstico , SARS-CoV-2/genética , Neutrófilos , Nasofaringe , Progressão da Doença , Adenosina TrifosfatasesRESUMO
PURPOSE: To use data from the Global Burden of Disease (GBD) Study 2019 to report the global, regional and national rates and trends of deaths incidence, prevalence, disability-adjusted life years (DALYs) for Nasopharynx cancer (NPC) in adolescents and young adults (AYAs). METHODS: Data from the GBD 2019 were used to analyze deaths incidence, prevalence and DALYs due to NPC at global, regional, and national levels. Joinpoint regression analysis was used to calculate the average annual percentage changes (AAPC). The association between incidence, prevalence and DALYs and socioeconomic development was analyzed using the GBD Socio-demographic Index (SDI). Finally, projections were made until 2030 and calculated in Nordpred. RESULTS: The incidence, prevalence, death and DALYs rates (95%UI) due to NPC 0.96 (0.85-1.09, 6.31 (5.54-7.20),0.20 (0.19-0.22), and 12.23(11.27-13.29) in 2019, respectively. From 1990 to 2019, the incidence and prevalence rates increased by 1.79 (95% CI 1.03 to 2.55) and 2.97(95% CI 2.13 to 3.82) respectively while the deaths and DALYs rates declined by 1.64(95%CI 1.78 to 1.49) and 1.6(95%CI 1.75 to 1.4) respectively. Deaths and DALYs rates in South Asia, East Asia, North Africa and Middle East decreased with SDI. Incidence and prevalence rates in East Asia increased with SDI. At the national level, the incidence and prevalence rates are high in China, Taiwan(China), Singapore, Malaysia, Brunel Darussalam, Algeria, Tunisia, Libya and Malta. Meanwhile, the deaths and DALYs rates are still high in Malaysia, Brunel Darussalam, Greenland and Taiwan(Province of China). The deaths and DALYs rates are low in Honduras, Finland and Norway. From the 2020 to 2030, ASIRãASPR and ASDR in most regions are predicted to stable, but DALYs tends to decline. CONCLUSION: NPC in AYAs is a significant global public problem. The incidence, prevalence, and DALYs rates vary widely by region and country. Therefore different regions and countries should be targeted to improve the disease burden of NPC.
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Anos de Vida Ajustados por Deficiência , Carga Global da Doença , Saúde Global , Neoplasias Nasofaríngeas , Humanos , Adolescente , Adulto Jovem , Incidência , Masculino , Feminino , Prevalência , Neoplasias Nasofaríngeas/epidemiologia , Neoplasias Nasofaríngeas/mortalidade , Carga Global da Doença/tendências , Saúde Global/estatística & dados numéricos , Adulto , Anos de Vida Ajustados por Qualidade de VidaRESUMO
BACKGROUND: Pituitary adenoma (PA), though rare, has seen increased incidence with widespread MRI use, enabling incidental diagnosis. Prevalence is approximately 1 case per 1000 in the general population. PAs are benign neoplasms, constituting 10 to 20% of intracranial tumours. Ectopic pituitary adenoma developed outside the sella turcica is exceptional. It may be hormonally active or not. These are called nonfunctional pituitary adenomas. METHODS: Here is reported a case of a man in his eighties with a nasopharyngeal ectopic pituitary adenoma treated by robot-assisted excision using a combined route. CARE guidelines have been respected. RESULTS: A man in his eighties, asymptomatic, underwent an MRI for dizziness, revealing a nasopharyngeal mass. Despite being asymptomatic, nasofibroscopy revealed a reddish oval-shaped tissue mass attached to the roof of the nasopharynx. Biopsy identified a neuroendocrine tumor G1/G2. Imaging showed no local invasion or distant metastases. A multidisciplinary team decided on a robot-assisted surgical excision through the mouth, coupled with nasal endoscopy. The procedure achieved complete excision with clear margins and no adverse event has occurred. CONCLUSIONS: This unique case involved the successful transoral robot-assisted excision of a nasopharyngeal ectopic pituitary adenoma, highlighting an innovative surgical approach.
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BACKGROUND: The delineation of clinical target volumes (CTVs) for radiotherapy for nasopharyngeal cancer is complex and varies based on the location and extent of disease. PURPOSE: The current study aimed to develop an auto-contouring solution following one protocol guidelines (NRG-HN001) that can be adjusted to meet other guidelines, such as RTOG-0225 and the 2018 International guidelines. METHODS: The study used 2-channel 3-dimensional U-Net and nnU-Net framework to auto-contour 27 normal structures in the head and neck (H&N) region that are used to define CTVs in the protocol. To define the CTV-Expansion (CTV1 and CTV2) and CTV-Overall (the outer envelope of all the CTV contours), we used adjustable morphological geometric landmarks and mimicked physician interpretation of the protocol rules by partially or fully including select anatomic structures. The results were evaluated quantitatively using the dice similarity coefficient (DSC) and mean surface distance (MSD) and qualitatively by independent reviews by two H&N radiation oncologists. RESULTS: The auto-contouring tool showed high accuracy for nasopharyngeal CTVs. Comparison between auto-contours and clinical contours for 19 patients with cancers of various stages showed a DSC of 0.94 ± 0.02 and MSD of 0.4 ± 0.4 mm for CTV-Expansion and a DSC of 0.83 ± 0.02 and MSD of 2.4 ± 0.5 mm for CTV-Overall. Upon independent review, two H&N physicians found the auto-contours to be usable without edits in 85% and 75% of cases. In 15% of cases, minor edits were required by both physicians. Thus, one physician rated 100% of the auto-contours as usable (use as is, or after minor edits), while the other physician rated 90% as usable. The second physician required major edits in 10% of cases. CONCLUSIONS: The study demonstrates the ability of an auto-contouring tool to reliably delineate nasopharyngeal CTVs based on protocol guidelines. The tool was found to be clinically acceptable by two H&N radiation oncology physicians in at least 90% of the cases.
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OBJECTIVE: Craniofacial anomalies are widely discussed as predisposing factors of breathing disorders. Since many more cofactors exist, this study investigated the association between maxillary micrognathia and morphological changes of posterior airway space and adenoids in these patients. MATERIAL AND METHODS: Cephalometric radiographs of n = 73 patients were used for data acquisition. The patients were divided into two groups according to certain skeletal characteristics: maxillary micrognathia (n = 34, 16 female, 18 male; mean age 10.55 ± 3.03 years; defined by a SNA angle < 79°) and maxillary eugnathia (n = 39, 19 female, 20 male; mean age 10.93 ± 3.26 years; defined by a SNA angle > 79°). The evaluation included established procedures for measurements of the maxilla, posterior airway space and adenoids. Statistics included Kolmogorov-Smirnov-, T- and Mann-Whitney-U-Tests for the radiographs. The level of significance was set at p < 0.05. RESULTS: The cephalometric analysis showed differences in the superior posterior face height and the depth of the posterior airway space at palatal level among the two groups. The depth of the posterior airway space at mandibular level was the same for both groups, just as the size of the area taken by adenoids in the nasopharynx. CONCLUSIONS: Skeletal anomalies affect the dimension of the posterior airway space. There were differences among the subjects with maxillary micrognathia and these with a normal maxilla. However, the maxilla was only assessed in the sagittal direction, not in the transverse. This study showed that the morphology of the maxilla relates to the posterior airway space whereas the adenoids seem not to be affected. CLINICAL RELEVANCE: Maxillary micrognathia is significantly associated with a smaller depth of the posterior airway space at the palatal level compared to patients with maxillary eugnathia.
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Tonsila Faríngea , Micrognatismo , Humanos , Masculino , Feminino , Criança , Adolescente , Micrognatismo/diagnóstico por imagem , Nasofaringe , Maxila/diagnóstico por imagem , Sistema Respiratório , Cefalometria/métodosRESUMO
Stertor, a clinical sign associated with obstructive airway syndrome, is often observed in non-brachycephalic dogs. This prospective, case-control study aimed to compare soft palate dimensions, nasopharyngeal cross-sectional area (CSA), and nasopharyngeal collapsibility at various locations in non-brachycephalic dogs with and without stertor. A total of 50 dogs were recruited and stratified into control (n = 34) and stertor (n = 13) groups. Static and dynamic computed tomography was conducted without tracheal intubation, and the following variables were calculated: normalized soft palate length and thickness, normalized maximum and minimum nasopharyngeal CSAs (rCSAmax and rCSAmin), and nasopharyngeal collapsibility at the level of the cranial end of the soft palate, pterygoid hamulus, foramen lacerum, bony labyrinth, and caudal end of the soft palate. The stertor group demonstrated significantly lower rCSAmax and rCSAmin, as well as higher nasopharyngeal collapsibility compared with the control group, while no significant differences were noted in the soft palate dimension. Evaluating nasopharyngeal collapse at the foramen lacerum level was recommended due to the clear presence of identifiable bony landmarks and lower overlap in the nasopharyngeal collapsibility between dogs with and without stertor. Physical dimensions of the soft palate may not be the primary contributing factor to nasopharyngeal collapse and clinical signs in non-brachycephalic dogs.
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Doenças do Cão , Nasofaringe , Palato Mole , Tomografia Computadorizada por Raios X , Animais , Cães , Estudos de Casos e Controles , Nasofaringe/diagnóstico por imagem , Nasofaringe/anatomia & histologia , Doenças do Cão/diagnóstico por imagem , Estudos Prospectivos , Palato Mole/diagnóstico por imagem , Feminino , Tomografia Computadorizada por Raios X/veterinária , Masculino , Obstrução das Vias Respiratórias/veterinária , Obstrução das Vias Respiratórias/diagnóstico por imagem , Doenças Nasofaríngeas/veterinária , Doenças Nasofaríngeas/diagnóstico por imagemRESUMO
The nasopharynx is a rare anatomical location where a foreign body may become lodged after being ingested or inhaled. We are presenting a rare case of nasopharyngeal foreign body impaction in a two-and-a-half-year-old child that had been missed for almost a year. The child presented with a history of right-sided foul-smelling nasal discharge, snoring and mouth breathing. An X-Ray soft tissue lateral view of the post-nasal space showed an irregular partially radiopaque nasopharyngeal foreign body. The removal of the foreign body was performed under general anaesthesia successfully. Foreign body impaction in the nasopharynx can easily be missed and it is important to keep this region in mind when dealing with missing inhaled or ingested foreign bodies.
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Corpos Estranhos , Nasofaringe , Humanos , Corpos Estranhos/cirurgia , Corpos Estranhos/diagnóstico por imagem , Nasofaringe/diagnóstico por imagem , Pré-Escolar , Masculino , Radiografia/métodosRESUMO
Advances in treatment deintensification for human papillomavirus-associated oropharyngeal cancer include use of transoral surgery to permit reduction in pathologic risk-based postoperative therapy after transoral resection. The E3311 cooperative group trial demonstrated 3-year progression-free survival (PFS) of 95% for intermediate risk patients treated with 50 Gy radiation alone, with no decrement for those with a smoking history. Favorable risk patients could be observed, with a 3-year PFS of 93%. Reduction in radiation dose is also feasible for favorable risk patients (low or no smoking history and low stage) treated with chemoradiation on the NRG HN002 trial, where 2-year PFS was 90.7%. For those favorable risk patients treated with radiation alone, 2-year PFS was 87.7% and this arm did not meet criteria for further testing. Important phase 3 trials of immunotherapy in first-line treatment of recurrent and/or metastatic head and neck cancer were also reported in 2022. For patients with nonnasopharyngeal sites of disease, the combination of the programmed death-1-directed antibody nivolumab plus the anti-CTLA-4 agent ipilimumab was not superior to chemotherapy plus cetuximab in the Checkmate 651 trial. However, in an important breakthrough for patients with nasopharyngeal cancer, the JUPITER-02 trial, conducted in China, Singapore, and Taiwan among patients with predominantly Epstein-Barr virus-related cancers, demonstrated a significant improvement in PFS (hazard ratio, 0.52) when toripalimab was added to gemcitabine/cisplatin chemotherapy. Immature survival data indicate overall survival will likely also be impacted.
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Infecções por Vírus Epstein-Barr , Neoplasias de Cabeça e Pescoço , Neoplasias Nasofaríngeas , Humanos , Resultado do Tratamento , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Herpesvirus Humano 4 , Neoplasias de Cabeça e Pescoço/terapia , Neoplasias de Cabeça e Pescoço/etiologiaRESUMO
BACKGROUND: Indoor dust particles are an everyday source of human exposure to microorganisms and their inhalation may directly affect the microbiota of the respiratory tract. We aimed to characterize the changes in human nasopharyngeal bacteriome after short-term exposure to indoor (workplace) environments. METHODS: In this pilot study, nasopharyngeal swabs were taken from 22 participants in the morning and after 8 h of their presence at the workplace. At the same time points, indoor dust samples were collected from the participants' households (16 from flats and 6 from houses) and workplaces (8 from a maternity hospital - NEO, 6 from a pediatric hospital - ENT, and 8 from a research center - RCX). 16S rRNA sequencing analysis was performed on these human and environmental matrices. RESULTS: Staphylococcus and Corynebacterium were the most abundant genera in both indoor dust and nasopharyngeal samples. The analysis indicated lower bacterial diversity in indoor dust samples from flats compared to houses, NEO, ENT, and RCX (p < 0.05). Participants working in the NEO had the highest nasopharyngeal bacterial diversity of all groups (p < 0.05). After 8 h of exposure to the workplace environment, enrichment of the nasopharynx with several new bacterial genera present in the indoor dust was observed in 76% of study participants; however, no significant changes were observed at the level of the nasopharyngeal bacterial diversity (p > 0.05, Shannon index). These "enriching" bacterial genera overlapped between the hospital workplaces - NEO and ENT but differed from those in the research center - RCX. CONCLUSIONS: The results suggest that although the composition of nasopharyngeal bacteriome is relatively stable during the day. Short-term exposure to the indoor environment can result in the enrichment of the nasopharynx with bacterial DNA from indoor dust; the bacterial composition, however, varies by the indoor workplace environment.
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Poluição do Ar em Ambientes Fechados , Poeira , Gravidez , Criança , Humanos , Feminino , Poeira/análise , Projetos Piloto , RNA Ribossômico 16S/genética , RNA Ribossômico 16S/análise , Bactérias/genética , Nasofaringe , Poluição do Ar em Ambientes Fechados/análiseRESUMO
BACKGROUND: The auditory tube (AT), an osteocartilaginous channel, connects the nasopharynx to the middle ear cavity. At the nasopharyngeal opening of the AT, there are dense collections of submucosal glands. In a recent article, Valstar et al. proposed these nasopharyngeal tubal glands conglomerate as salivary glands, which starkly contrasts with their previously known anatomy for being a component of the respiratory tract. This study examines the contesting views regarding the taxonomical categorization of the nasopharyngeal tubal glands. MATERIALS AND METHODS: The AT glands in context were examined in human cadavers grossly, and microscopically using routine and special (Hematoxylin and Eosin [H&E] and Periodic acid-Schiff [PAS] respectively), as well as immunohistochemical (for alpha-SMA and salivary amylase) staining methods and compared with the major and minor salivary glands and the submucosal glands in the trachea. Further, a biochemical analysis was performed to detect the presence of salivary amylase in the oral and nasopharyngeal secretions of the four living human subjects, representing major salivary glands and tubal glands, respectively. RESULTS: The submucosal seromucous glands with a surface lining of respiratory epithelium were observed at the nasopharyngeal end of AT. The cells in the tubal glands showed cytoplasmic positivity for alpha-SMA, which indicated the presence of the myoepithelial cells; however, this expression was significantly lower than in the seromucous submucosal glands within the trachea. Salivary alpha-amylase was undetectable in the cadaveric tissue samples. Moreover, the amylase level in the nasopharyngeal swabs was negligible compared to the oral swabs. CONCLUSION: The anatomical location along the respiratory tract, the presence of respiratory epithelium in the overlying mucosa, their morpho-functional resemblance to the seromucous glands in the trachea, and the absence of salivary amylase strongly indicate that the tubal glands are taxonomically different from the salivary glands. Given the available evidence, their existing recognition as a part of the respiratory tract and an integral component of the AT seems more appropriate.
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Tuba Auditiva , Humanos , Glândulas Salivares , Nasofaringe , Células Epiteliais , AmilasesRESUMO
Pharyngeal collapsibility is a major determinant of obstructive sleep apnea (OSA) pathophysiology, but its anatomical predictors in children are largely unknown. We hypothesised that anatomical (tonsillar hypertrophy, narrow palate, nasal obstruction, dental/skeletal malocclusion, obesity) and OSA-related (apnea-hypopnea index, AHI) parameters could be related to a measure of awake pharyngeal collapsibility. We performed acoustic pharyngometry in children evaluated for suspected OSA, allowing us to measure the reduction of oropharyngeal volume in supine versus sitting position normalised for the volume in supine position (ΔV%), a measure of pharyngeal collapsibility. In addition to polysomnography and a clinical examination (anatomical parameters), acoustic rhinometry was used to assess nasal obstruction. A total of 188 snoring children were included, 118 (63%) of whom were obese and 74 (39%) of whom had moderate to severe OSA (AHI ≥5/h). The median (25th-75th percentiles) ΔV% in the whole population was 20.1% (4.7; 43.3). ΔV% was independently and positively associated with AHI (p = 0.023), z-score of BMI (p = 0.001), tonsillar hypertrophy (p = 0.007), narrow palate (p = 0.035), and African (p < 0.001) ancestry. By contrast, ΔV% was not modified by dental or skeletal malocclusion, Friedman palate position class or nasopharyngeal obstruction. Tonsillar hypertrophy, obesity, narrow palate and African ancestry are independently associated with an increase in pharyngeal collapsibility in snoring children, thus increasing the risk of OSA. Increased pharyngeal compliance in African children may explain the increased risk of residual OSA after adenotonsillectomy observed in this population.
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Má Oclusão , Obstrução Nasal , Apneia Obstrutiva do Sono , Humanos , Criança , Ronco/complicações , Postura Sentada , Decúbito Dorsal , Vigília , Hipertrofia/complicações , Obesidade/complicações , Má Oclusão/complicaçõesRESUMO
OBJECTIVES: Optical Coherence Tomograph (OCT) imaging technology can be used to examine, in vivo, the human ET. At present, it is impossible to achieve the OCT scanning vivo and ex vivo in the same individual human body, or study the consistency between OCT images and histological images of the eustachian tube nasopharyngeal region and adjacent structures. The aim of this study was to determine the consistency between OCT images and histological sections in vivo and ex vivo in miniature pigs. METHODS: OCT imaging was performed on five adult miniature pigs in vivo and ex vivo. The images of the eustachian tube OCT (ET-OCT), nasopharynx OCT (NP-OCT) and histological cross sections were further studied. RESULTS: All five miniature pigs achieved the OCT scan successfully, acquiring ET-OCT and NP-OCT images in vivo and ex vivo on both sides. The acquired ET OCT images closely matched the histological images, revealing details of the cartilage, submucosa, glands, and mucosa. The lower segment of the ET wall mucosa had an abundance of glands and submucosal tissues, with more low-signal areas appearing in the ex vivo images. The NP-OCT images of the nasopharynx matched the details of the mucosa and submucosal tissues. The ex-vivo OCT images showed thicker mucosa and more scattered slightly lower signal areas compared to the vivo OCT images. CONCLUSIONS: ET-OCT images and NP-OCT images matched the histological structure of eustachian tube nasopharyngeal region structures in miniature pigs both in vivo and ex vivo. OCT images may be sensitive to changes in edema and ischemia status. There is a great potential for morphological assessment of inflammation, edema, injure, mucus gland status.
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Tuba Auditiva , Adulto , Suínos , Humanos , Animais , Tuba Auditiva/diagnóstico por imagem , Porco Miniatura , Tomografia de Coerência Óptica/métodos , Inflamação , Nasofaringe/diagnóstico por imagemRESUMO
PROBLEM: Artificial intelligence has been widely investigated for diagnosis and treatment strategy design, with some models proposed for detecting oral pharyngeal, nasopharyngeal, or laryngeal carcinoma. However, no comprehensive model has been established for these regions. AIM: Our hypothesis was that a common pattern in the cancerous appearance of these regions could be recognized and integrated into a single model, thus improving the efficacy of deep learning models. METHODS: We utilized a point-wise spatial attention network model to perform semantic segmentation in these regions. RESULTS: Our study demonstrated an excellent outcome, with an average mIoU of 86.3%, and an average pixel accuracy of 96.3%. CONCLUSION: The research confirmed that the mucosa of oral pharyngeal, nasopharyngeal, and laryngeal regions may share a common appearance, including the appearance of tumors, which can be recognized by a single artificial intelligence model. Therefore, a deep learning model could be constructed to effectively recognize these tumors.
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Inteligência Artificial , Carcinoma , Humanos , Sistema Respiratório , SemânticaRESUMO
INTRODUCTION: In Saudi Arabia, head and neck cancers represent 6 % of all malignancies. 33 % of these are nasopharyngeal. Thus, we aimed to distinguish patterns of treatment failure and salvage treatment outcomes among patients with nasopharyngeal carcinoma (NPC). METHODS: A retrospective review of patients treated for NPC in a tertiary care hospital. From May 2012 to January 2020, we retrospectively reviewed 175 patients that fit our inclusion criteria. Those who did not complete their treatment, started treatment in another institution, or did not complete a 3-year follow-up were excluded. In addition, the primary treatment outcome and the salvage treatment for those who failed initial treatment were collected and analyzed. RESULTS: Patients were predominantly stage 4 disease. 67 % of the patients were alive without evidence of disease during their last follow-up. However, 75 % of failure occurs in the first 20 months of completing the treatment regimen. Neoadjuvant therapy and delays in referral play a significant role in treatment failure. For failed cases, concurrent salvage chemoradiotherapy showed the best survival. CONCLUSION: Advanced stage 4A and T4 nasopharyngeal carcinoma should receive the maximum treatment, with a close follow-up, particularly during the first 2 years after treatment. Furthermore, the excellent outcome from salvage chemoradiotherapy and radiotherapy alone would make physicians aware of the importance of aggressive primary treatment.
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Neoplasias Nasofaríngeas , Terapia de Salvação , Humanos , Carcinoma Nasofaríngeo/terapia , Carcinoma Nasofaríngeo/patologia , Estudos Retrospectivos , Neoplasias Nasofaríngeas/patologia , Estadiamento de Neoplasias , Seguimentos , Resultado do Tratamento , Quimiorradioterapia/efeitos adversos , Falha de TratamentoRESUMO
Nasopharyngeal depth (ND) prediction is clinically relevant in performing medical procedures, and in enhancing technique accuracy and patient safety. Nonetheless, clinical predictive variables and normative data in adults remain limited. This study aimed to determine normative data on ND and its correlation to external facial measurements. A multicenter cross-sectional study obtained data from adults presenting to otolaryngology clinics at five sites in Canada, Italy, and Spain. Investigators compared endoscopically measured depth from the nasal sill (soft tissue between the nasal ala and columella) to nasopharynx along the nasal floor to the "curved distance from the alar-facial groove along the face to the tragus" and "distance from the tragus to a plane perpendicular to the philtrum." When sinus computed tomography images were available, the distance from the nasopharynx to the nasal sill was also collected. 371 patients participated in the study (41% women; 51 years old, SD 18). Average ND was 9.4 cm (SD 0.86) and 10.1 cm (SD 0.9) for women and men, respectively (p < 0.001; 95% CI 0.46-0.86). Perpendicular distance was strongly correlated to ND (r = 0.775; p < 0.001), with an average underestimation of 0.1 cm (SD 0.65; 95% CI 0.06-0.2). The equation: ND (cm) = perpendicular distance*0.773 + 2.344, generated from 271 randomly selected participants, and validated on 100 participants, resulted in a 0.03 cm prediction error (SD 0.61; 95% CI -0.08-0.16). Nasopharyngeal depth can be approximated by the distance from the tragus to a plane perpendicular to the philtrum.
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Nasofaringe , Nariz , Adulto , Masculino , Humanos , Feminino , Pessoa de Meia-Idade , Estudos Transversais , Nasofaringe/diagnóstico por imagem , Lábio , Tomografia Computadorizada por Raios XRESUMO
BACKGROUND: The risk factors determining short- and long-term morbidity following acute respiratory infection (ARI) due to respiratory syncytial virus (RSV) in infancy remain poorly understood. OBJECTIVES: Our aim was to examine the associations of the upper respiratory tract (URT) microbiome during RSV ARI in infancy with the acute local immune response and short- and long-term clinical outcomes. METHODS: We characterized the URT microbiome by 16S ribosomal RNA sequencing and assessed the acute local immune response by measuring 53 immune mediators with high-throughput immunoassays in 357 RSV-infected infants. Our short- and long-term clinical outcomes included several markers of disease severity and the number of wheezing episodes in the fourth year of life, respectively. RESULTS: We found several specific URT bacterial-immune mediator associations. In addition, the Shannon âº-diversity index of the URT microbiome was associated with a higher respiratory severity score (ß =.50 [95% CI = 0.13-0.86]), greater odds of a lower ARI (odds ratio = 1.63 [95% CI = 1.10-2.43]), and higher number of wheezing episodes in the fourth year of life (ß = 0.89 [95% CI = 0.37-1.40]). The Jaccard ß-diversity index of the URT microbiome differed by level of care required (P = .04). Furthermore, we found an interaction between the Shannon âº-diversity index of the URT microbiome and the first principal component of the acute local immune response on the respiratory severity score (P = .048). CONCLUSIONS: The URT microbiome during RSV ARI in infancy is associated with the acute local immune response, disease severity, and number of wheezing episodes in the fourth year of life. Our results also suggest complex URT bacterial-immune interactions that can affect the severity of the RSV ARI.
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Microbiota , Infecções por Vírus Respiratório Sincicial , Vírus Sincicial Respiratório Humano , Infecções Respiratórias , Humanos , Lactente , Sons Respiratórios/etiologia , Sistema Respiratório , Infecções Respiratórias/complicaçõesRESUMO
Chihuahuas and Pomeranians are often afflicted with obstructive upper respiratory tract disease. Previous computed tomographic (CT) studies have described the dimensions and abnormalities of different parts of the upper respiratory tract in brachycephalic dogs. However, Chihuahuas and Pomeranians were not included. The objective of this study was to determine the transverse-sectional (TSA) dimensions of the nasopharynx, cricoid, and trachea of Chihuahuas and Pomeranians, and investigate whether or not Chihuahuas and Pomeranians had smaller airway dimensions than another non-brachycephalic breed (Dachshund). A retrospective, descriptive, single-center cross-sectional cohort study was performed. CT studies of 88 dogs were included (42 Chihuahuas, 29 Dachshunds, and 17 Pomeranians). The TSA of the rostral, mid, and caudal aspect of the nasopharynx, the cricoid and trachea at the level of C4 were determined. For all these locations, TSA/weight, nasopharynx/cricoid, nasopharynx/trachea, and cricoid/trachea ratios were determined. The rostral nasopharynx was the smallest part of the upper airways in Chihuahuas and Pomeranians. Chihuahuas had significantly smaller rostral nasopharynx TSA/weight ratios compared to Dachshunds (P < 0.0001). The rostral nasopharynx TSA/cricoid ratio and the rostral nasoharynx/trachea ratio for Chihuahuas were significantly smaller than both that of Pomeranians (P < 0.0001 and P = 0.00027) and Dachshunds (P < 0.0001 and P = 0.00084). Pomeranians had significantly smaller cricoid TSA/weight ratios compared to Chihuahuas (P = 0.0014) and Dachshunds (P = 0.00028). This study demonstrated that the nasopharynx is narrow in Chihuahuas and Pomeranians, with the smallest dimensions located at the rostral part of the nasopharynx.
Assuntos
Craniossinostoses , Doenças do Cão , Laringe , Animais , Cães , Estudos Retrospectivos , Estudos Transversais , Nasofaringe/diagnóstico por imagem , Tomografia Computadorizada por Raios X/veterinária , Tomografia Computadorizada por Raios X/métodos , Craniossinostoses/veterinária , Doenças do Cão/diagnóstico por imagemRESUMO
BACKGROUND: The primary objective of the study was to evaluate the effects of SEC III (Splints, Class III Elastics, and Chin cup) protocol on the upper airway dimensions using lateral cephalometric radiographs. The secondary objectives were to evaluate the skeletal and dental effects of the SEC III protocol using lateral cephalometric radiographs. METHODS: The pre- and post-treatment lateral cephalometric radiographs of 24 patients treated using the SEC III protocol were used to address the aim of the study. Children in the pre-pubertal (CS-1 or CS-2) or circumpubertal (CS-3 or CS-4) skeletal maturation stage and having class III dentoskeletal malocclusion were included in the study. Patients with a history of previous orthodontic treatment, maxillofacial surgery or trauma, tonsillectomy, adenoidectomy, or craniofacial malformations were excluded. The pre-treatment and post-treatment lateral cephalometric radiographs were traced, then airway measurements, skeletal measurements, and dental measurements were performed. The results were analysed using paired samples t-test or Wilcoxon signed rank test according to the data normality. RESULTS: Data of 6 males and 18 females were analysed (Mean age = 11.21 ± 1.02 years). Duration of active treatment was 5.75 ± 1.03 months. Treatment using SEC III protocol resulted in a significant increase in ANB angle (2.92 ± 1.50 degrees, p < 0.001) and Wits appraisal (3.31 ± 1.99 mm) (p < 0.001). The increase in the mandibular plane angle (0.75 ± 1.42 degrees, p = 0.02) and the maxillary length (2.29 ± 2.69 mm, p < 0.001) was statistically significant. Contrarily, the mandibular length did not change significantly (p = 0.10). The maxillary incisors were significantly proclined (4.38 ± 4.28 degrees; p < 0.001), while the mandibular incisors were significantly retroclined (-5.79 ± 6.21 degrees; p < 0.001) following treatment. The change in the nasopharyngeal airway and the retropalatal airway was not statistically significant. The middle and inferior pharyngeal space (retroglossal airway) significantly decreased by 1.33 ± 1.97 mm (p = 0.003) and 1.96 ± 2.48 mm (p = 0.001), respectively. CONCLUSIONS: Early class III correction using SEC III protocol reduced the retroglossal airway dimensions but did not affect the nasopharyngeal and retropalatal airway dimensions. Correction of the class III dentoskeletal relationship was obtained through both skeletal and dental changes.
Assuntos
Má Oclusão Classe III de Angle , Nariz , Masculino , Criança , Feminino , Humanos , Estudos Retrospectivos , Má Oclusão Classe III de Angle/diagnóstico por imagem , Má Oclusão Classe III de Angle/cirurgia , Maxila/diagnóstico por imagem , Faringe , Cefalometria/métodos , Mandíbula/diagnóstico por imagemRESUMO
Objectives: To evaluate the role of cancer stem cell biomarkers in diagnosis and prognosis of OSCC patients. METHODS: The search strategy was entered into PubMed NLM, EBSCO CINAHL, EBSCO Dentistry & Oral Sciences Source, Wiley Cochrane Library, and Scopus. The full text eligible studies (n=7) were assessed for their quality using the JBI Critical Appraisal Checklist to evaluates the methodological quality of the studies based on possibility of bias in its design, conduct, and analysis. Selected studies were further analysed based on different parameters such as publication year, sample size, and outcomes. RESULTS: A total of 432 studies were identified through the search strategy. A total of 306 records were removed before screening either because of duplication or marked ineligible by the automation tools. The screened records were 126 out of which 104 were removed as they were not conducted on OSCC. Twenty-two reports were sought for retrieval, however, we could not find the full text of 3 studies and12 studies were excluded because the biomarkers were not associated with cancer stem cells. The most common cancer stem cell biomarkers associated with OSCC were MCT1,VEGF-A, GD15, HIF1 α, Ki67, Hsp 70, Cyclin D1, and CD44. CONCLUSIONS: Various stem cell biomarkers have been found to have diagnostic and prognostic role in oral squamous cell carcinoma such as Cyclin D1, VEGF-A, GD15, and CD44. They can be used to predict the overall survival rate, local progression-free survival rate, and distant metastasis-free survival rate in Head and Neck cancer patients.
Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Humanos , Carcinoma de Células Escamosas/patologia , Carcinoma de Células Escamosas de Cabeça e Pescoço , Neoplasias Bucais/diagnóstico , Neoplasias Bucais/patologia , Ciclina D1/análise , Prognóstico , Fator A de Crescimento do Endotélio Vascular , Biomarcadores Tumorais , Células-Tronco Neoplásicas/química , Células-Tronco Neoplásicas/patologiaRESUMO
BACKGROUND: No studies have explored the association between pneumococcal nasopharyngeal density and severe pneumonia using the World Health Organization (WHO) 2013 definition. In Lao People's Democratic Republic (Lao PDR), we determine the association between nasopharyngeal pneumococcal density and severe pneumonia in children. METHODS: A prospective observational study was undertaken at Mahosot Hospital, Vientiane, from 2014 to mid-2018. Children <5 years admitted with acute respiratory infections (ARIs) were included. Clinical and demographic data were collected alongside nasopharyngeal swabs for pneumococcal quantification by lytA real-time quantitative polymerase chain reaction. Severe pneumonia was defined using the 2013 WHO definition. For pneumococcal carriers, a logistic regression model examined the association between pneumococcal density and severe pneumonia, after adjusting for potential confounders including demographic and household factors, 13-valent pneumococcal conjugate vaccine status, respiratory syncytial virus co-detection, and preadmission antibiotics. RESULTS: Of 1268 participants with ARI, 32.3% (nâ =â 410) had severe pneumonia and 36.9% (nâ =â 468) had pneumococcal carriage. For pneumococcal carriers, pneumococcal density was positively associated with severe pneumonia (adjusted odds ratio, 1.4 [95% confidence interval, 1.1-1.8]; Pâ =â .020). CONCLUSIONS: Among children with ARIs and pneumococcal carriage, pneumococcal carriage density was positively associated with severe pneumonia in Lao PDR. Further studies may determine if pneumococcal density is a useful marker for pneumococcal conjugate vaccine impact on childhood pneumonia.