Medicine by Alexandros G. Sfakianakis,Anapafseos 5 Agios Nikolaos 72100 Crete Greece,00306932607174

Τετάρτη 1 Νοεμβρίου 2017

Risk factors of pediatric tinnitus: Systematic review and meta-analysis

Objectives/Hypothesis

Medications for pediatric tinnitus are not widely used due to a lack of evidence-based information. The modification of risk factors is essential in pediatric tinnitus; however, there is a lack of systematic reviews despite several reports on risk factors. This study performed a systematic review and meta-analysis of available literature to evaluate risk factors of pediatric tinnitus.

Methods

Studies reporting the risk factors of pediatric tinnitus were systematically reviewed by searching the MEDLINE, PubMed, and Embase databases for studies published from database inception to 2016. The selected articles included clinical or epidemiological studies conducted with at least 50 subjects and at least one risk factor, including age, gender, hearing loss, noise exposure, or smoking.

Results

Eleven studies involving a total of 28,358 individuals were identified. Increased age was not a significant risk factor with a standardized median difference of 0.16 (95% confidence interval [CI]: −0.01 to 0.33). However, there was a significant correlation between increased age and tinnitus in the adolescent population. The odds ratio (OR) was 1.37 for female gender (95% CI: 1.17 to 1.60), 2.39 for hearing loss (95% CI: 1.48 to 3.87), and 11.35 for noise exposure (95% CI: 1.87 to 68.77). Two studies in adolescents showed statistical significance for smoking as a risk factor in developing tinnitus (OR: 6.05, 95% CI: 1.81 to 20.21).

Conclusions

Older-aged adolescents, as well as those who are females and those with hearing loss may have a higher risk of tinnitus. Noise exposure in the general pediatric population and smoking in adolescents may represent especially important risk factors in pediatric tinnitus. Laryngoscope, 2017

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Adult normative data for phonatory aerodynamics in connected speech

Objectives/Hypothesis

To establish normative values for phonatory aerodynamic measurements in connected speech across adult ages and gender.

Study Design

Prospective data collection across group design.

Methods

One hundred fifty adults aged >18 years without voice complaints were stratified into three equal-age groups (group 1 [ages 18–39 years]; group 2 [ages 40–59 years], and group 3 [ages 60 + years]) and two equal-gender groups (male and female) resulting in 25 participants in each category. Participants read the first four sentences of the Rainbow Passage at comfortable pitch and loudness to obtain a connected speech sample. The following dependent variables were analyzed: breath number, reading passage duration, mean phonatory airflow, inspiratory airflow duration, and expiratory airflow duration.

Results

A gender effect was found for mean phonatory airflow, with males showing significantly greater phonatory airflow than females during connected speech (P < .001). Number of breaths was significantly greater for group 3 than group 2 (P < .001) and group 1 (P < .001). Duration, and inspiratory and expiratory airflow durations were all significantly greater for group 3 (P < .001) than group 2 (P < .001) than group 1 (P < .001).

Conclusions

This study provides normative data for phonatory aerodynamics in adult connected speech. Significant age and gender effects were observed. Laryngoscope, 2017

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Dentist Office Donates Halloween Candy To Troops

The day after Halloween, Laura Muchnick's children won't trade Halloween candy with their friends. They'll trade it with their dentist.

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Response to Letter to the Editor Regarding “Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis”

Otolaryngology-Head and Neck Surgery, Volume 157, Issue 5, Page 911-911, November 2017.

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Response to “In Reference to ‘The Effect of Montelukast on Mild Persistent OSA after Adenotonsillectomy in Children: A Preliminary Study’”

Otolaryngology-Head and Neck Surgery, Volume 157, Issue 5, Page 909-910, November 2017.

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In Reference to “The Effect of Montelukast on Mild Persistent OSA after Adenotonsillectomy in Children: A Preliminary Study”

Otolaryngology-Head and Neck Surgery, Volume 157, Issue 5, Page 909-909, November 2017.

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Regarding “Accuracy of Ultrasonography and Computed Tomography in the Evaluation of Patients Undergoing Sialendoscopy for Sialolithiasis”

Otolaryngology-Head and Neck Surgery, Volume 157, Issue 5, Page 910-911, November 2017.

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Highlights from the Current Issue: November 2017

Otolaryngology-Head and Neck Surgery, Volume 157, Issue 5, Page 743-744, November 2017.

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Additive naftopidil treatment synergizes docetaxel-induced apoptosis in human prostate cancer cells

Abstract

Purpose

Docetaxel (DTX) is a standard chemotherapeutic drug for castration-resistant prostate cancer (CRPC), although adverse events are common. To overcome this problem, researchers have evaluated the efficacy of DTX treatment in combination with other drugs. Naftopidil is a tubulin-binding drug with fewer adverse events, implying the usefulness of this drug in clinical applications when combined with DTX. Here, we investigated the efficacy of additive naftopidil treatment in combination with DTX on prostate cancer (PCa) cells.

Methods

The effects of combination treatment with DTX plus naftopidil were analyzed using two animal models of LNCaP cells plus PrSC xenografts (sub-renal capsule grafting) and PC-3 xenografts (intratibial injection).

Results

Combination treatment with DTX plus naftopidil significantly inhibited cell growth in LNCaP cells compared with DTX alone. Analysis of the cooperativity index (CI) showed that combination treatment exhibited additive effects on DTX-induced growth inhibition in LNCaP cells. In contrast, combination treatment showed more than an additive (synergistic) effect on DTX-induced apoptosis in LNCaP and PC-3 cells. In LNCaP cells plus PrSC xenografts, combination treatment showed synergistic effects on DTX-induced apoptosis. The synergistic effects of naftopidil on DTX-induced apoptosis were also observed in PC-3 xenografts.

Conclusions

Our results demonstrated that additive naftopidil treatment in combination with DTX increased the efficacy of DTX for the treatment of LNCaP and PC-3 tumors in vivo. Thus, additive naftopidil treatment showed a synergistic effect on DTX-induced apoptosis in PCa cells in vitro and in vivo, suggesting that this treatment approach may yield improved clinical benefits compared with DTX alone.

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Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway

OBJECTIVE: Interleukin (IL)-33 promotes T helper (Th2) immune response and may be involved in the pathogenesis of chronic rhinosinusitis with nasal polyps (CRSwNP). Using murine and human specimens, we evaluated the role of IL-33 in CRSwNP.

MATERIALS AND METHODS: To establish CRSwNP, Balb/c mice were sensitized with house dust mite, followed up by intranasal exposure to Staphylococcus aureus to stimulate the inflammatory response of nasal mucosa. The hematoxylin-eosin staining and total serum IgE were used to the successful construction of CRSwNP model. For mechanistic studies, we blocked mice with IL-33 and the Th2 cells counts in tissue were detected. Th2 cytokine expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control group, CRSwNP group and IL-33 blockade group at 12 weeks after CRSwNP model establishment, were analyzed by qRT-PCR. Meanwhile, the relative mRNA and protein expression levels of NF-κB, MyD88 and TLR7 were detected after IL-33 blockade. To document the inflammatory response in patients with CRSwNP, The relative mRNA expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 in control individuals and patients with CRSwNP (chronic rhinosinusitis with nasal polyps) were analyzed by qRT-PCR.

RESULTS: The CRSwNP model was successfully constructed. After IL-33 blocked, the relative expression of IL-33 and Th2 cells counts were reduced significantly. CRSwNP mice showed overproduction of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24 and IL-33 blockade inhibited the expression of IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24. Furthermore, IL-33 blockade decreased the mRNA levels of NF-κB, MyD88 and TLR7, and also restrained the protein expression of them. On the other hand, patients' specimens with CRSwNP showed high levels of Th2 cytokines including IL-33, IL-4, IL-5, IL-13, IL-22, CCL-11, and CCL-24.

CONCLUSIONS: CRSwNP is associated with overexpression of IL-33, with subsequent activation of Th2 immune response by NF-κB signaling pathway.

L'articolo Interleukin-33 promotes the inflammatory reaction in chronic rhinosinusitis with nasal polyps by NF-κB signaling pathway sembra essere il primo su European Review.

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Rescue therapy with bismuth quadruple regimen in patients with Helicobacter pylori -resistant strains

Abstract

Background

Bismuth quadruple therapy (BQT) is the recommended rescue therapy for Helicobacter pylori (H. pylori) infection. This study aimed to assess the efficacy and safety of a 10-day BQT regimen in patients who failed previous therapies and were infected with multiresistant H. pylori strains

Materials and methods

Helicobacter pylori-infected patients underwent endoscopy, culture, and susceptibility test for clarithromycin, metronidazole, and levofloxacin. Treatment with three-in-one capsule (Pylera®) four times daily and esomeprazole 20 mg twice daily for 10 days was administered. Treatment-emergent adverse events (TEAEs) were registered.

Results

A total of 116 patients with persistent H. pylori infection following at least one eradication therapy attempt were treated. Overall, resistance toward clarithromycin was detected in 80% of strains, toward metronidazole in 70%, and levofloxacin in 47.5%, with dual or triple resistance in 72.5% of cases. An eradication rate of 81.0% (95% CI: 73.0-87.1) and 87.0% (95% CI: 79.4-92.1) at ITT and PP analyses, respectively, was achieved. The cure rate remained high until it was used as fourth-line regimen, while it dropped to low values (<67%) in those patients with more than 4 therapy failures. A total of 65.7% (95% CI: 56.4-74.0) patients complained of TEAEs.

Conclusions

Our data found that bismuth-based quadruple regimen is effective as rescue therapy for curing patients infected with multiresistant H. pylori strains.

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