Distribution Characteristics of Juvenile-Onset Recurrent Respiratory Papillomatosis at First-Time Surgery

2021 ◽  
pp. 014556132110498
Author(s):  
Xiaoli Qu ◽  
Yang Xiao ◽  
Lijing Ma ◽  
Jun Wang
Keyword(s):  
Vocal Cord ◽  
Disease Severity ◽  
Recurrent Respiratory Papillomatosis ◽  
Age At Diagnosis ◽  
Juvenile Onset ◽  
Vocal Cords ◽  
Younger Age ◽  
False Vocal ◽  
The Impact ◽  
First Time

Objectives The lesion distribution of juvenile-onset recurrent respiratory papillomatosis (JORRP) during first-time surgery has been rarely reported. The purpose of this study was to describe the anatomical distribution of papilloma across 25 Derkay sites during initial surgery and to assess the impact of the lesion distribution on disease severity. Methods Surgical videos and medical records of 106 patients with JORRP (27 aggressive and 79 nonaggressive cases) were retrospectively reviewed. Lesion locations were recorded using Derkay anatomical sites. Logistic regression was used to analyze the effect of the lesion distribution on disease severity. Results Among the 106 patients, the true vocal cords (90.6% left, 84.0% right) were the most frequently involved site, followed by the false vocal cords (39.6% left, 35.8% right) and the anterior commissure (26.4%). Two patients (1.9%) had tracheal involvement. Patients with false vocal cord involvement (odds ratio [OR] = 3.425, 95% confidence interval [CI] [1.285, 9.132], P = .014) and a younger age at diagnosis (OR = .698, 95% CI [.539, .905], P = .007) were more likely to require more than 4 procedures in the year following first-time surgery. Conclusions Lesions were most common on the true vocal cords. False vocal cord involvement and a younger age at diagnosis were risk factors for disease severity.

scholarly journals HPV Strain Predicts Severity of Juvenile-Onset Recurrent Respiratory Papillomatosis with Implications for Disease Screening

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2556
Author(s):  
Mary C. Bedard ◽  
Alessandro de Alarcon ◽  
Yann-Fuu Kou ◽  
David Lee ◽  
Alexandra Sestito ◽  
...  
Keyword(s):  
Gene Expression ◽  
Disease Severity ◽  
Disease Onset ◽  
Tissue Bank ◽  
Benign Neoplasm ◽  
Recurrent Respiratory Papillomatosis ◽  
Clinical Severity ◽  
Viral Gene ◽  
Juvenile Onset ◽  
Severity Scores

Juvenile-onset recurrent respiratory papillomatosis (JoRRP) is the most common benign neoplasm of the larynx in children, presenting with significant variation in clinical course and potential for progression to malignancy. Since JoRRP is driven by human papillomavirus (HPV), we evaluated viral factors in a prospective cohort to identify predictive factors of disease severity. Twenty children with JoRRP undergoing routine debridement of papillomas were recruited and followed for ≥1 year. Demographical features, clinical severity scores, and surgeries over time were tabulated. Biopsies were used to establish a tissue bank and primary cell cultures for HPV6 vs. HPV11 genotyping and evaluation of viral gene expression. We found that patients with HPV11+ disease had an earlier age at disease onset, higher frequency of surgeries, increased number of lifetime surgeries, and were more likely to progress to malignancy. However, the amplitude of viral E6/E7 gene expression did not account for increased disease severity in HPV11+ patients. Determination of HPV strain is not routinely performed in the standard of care for JoRRP patients; we demonstrate the utility and feasibility of HPV genotyping using RNA-ISH for screening of HPV11+ disease as a biomarker for disease severity and progression in JoRRP patients.

Younger Age at Diagnosis Predicts Disease Severity in Ulcerative Colitis

2007 ◽  
Vol 102 ◽  
pp. S474-S475
Author(s):  
Lee Roth ◽  
Nilesh Chande ◽  
Agatha Lau ◽  
Maya Roth ◽  
Terry Ponich ◽  
...  
Keyword(s):  
Ulcerative Colitis ◽  
Disease Severity ◽  
Age At Diagnosis ◽  
Younger Age

Estimating the prevalence of and treatment patterns for juvenile onset recurrent respiratory papillomatosis in Australia pre-vaccination: a pilot study

Sexual Health ◽  
2010 ◽  
Vol 7 (3) ◽  
pp. 253 ◽  
Author(s):  
Daniel Novakovic ◽  
Alan T. L. Cheng ◽  
Daron H. Cope ◽  
Julia M. L. Brotherton
Keyword(s):  
Disease Burden ◽  
Online Survey ◽  
Chart Review ◽  
Retrospective Chart Review ◽  
Tertiary Hospital ◽  
Recurrent Respiratory Papillomatosis ◽  
Juvenile Onset ◽  
Hpv Types ◽  
The Impact ◽  
Near Future

Background: Recurrent respiratory papillomatosis (RRP) causes serious morbidity. RRP in Australia may be eliminated in the near future following the implementation of a national vaccination program using a human papillomavirus (HPV) vaccine that protects against infection with HPV types 6 and 11, those responsible for RRP. Baseline data on RRP prevalence and disease burden in Australia are lacking. Methods: Three study methods were used to estimate the burden of juvenile onset RRP in Australia. We conducted a retrospective chart review of RRP cases treated at The Children’s Hospital at Westmead over 10 years, examined the coding of these cases, and then calculated and applied the positive predictive value of the codes to national data to estimate the prevalence of RRP in Australia. We also conducted an online survey of otolaryngologists in Australia who manage RRP. Results: Nineteen patients were treated at the hospital over 10 years, involving 359 admissions. We estimate that between 33 and 56 RRP cases aged <20 are being treated nationally per year (0.6–1.1 per 100 000 persons), with children 5–9 years having a higher estimated rate of 1.2–1.8 per 100 000. Among 39 otolaryngologists treating juvenile onset RRP, the majority (73%) treated RRP in a paediatric tertiary hospital, and used the microdebrider for ablation of lesions. Conclusions: Our estimates of RRP disease burden agree with international estimates. As a small number of clinicians treat RRP nationally, we believe that establishment of a national RRP register is both feasible and necessary to monitor the impact of vaccination.

scholarly journals Vitamin D-related polymorphisms and vitamin D levels as risk biomarkers of COVID-19 disease severity

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Ana Teresa Freitas ◽  
Conceição Calhau ◽  
Gonçalo Antunes ◽  
Beatriz Araújo ◽  
Matilde Bandeira ◽  
...  
Keyword(s):  
Vitamin D ◽  
Serum Concentration ◽  
Disease Severity ◽  
European Population ◽  
Polygenic Risk Score ◽  
Portuguese Population ◽  
Vitamin D Levels ◽  
Risk Biomarkers ◽  
The Impact ◽  
First Time

AbstractVitamin D is a fundamental regulator of host defences by activating genes related to innate and adaptive immunity. Previous research shows a correlation between the levels of vitamin D in patients infected with SARS-CoV-2 and the degree of disease severity. This work investigates the impact of the genetic background related to vitamin D pathways on COVID-19 severity. For the first time, the Portuguese population was characterized regarding the prevalence of high impact variants in genes associated with the vitamin D pathways. This study enrolled 517 patients admitted to two tertiary Portuguese hospitals. The serum concentration of 25 (OH)D, was measured in the hospital at the time of patient admission. Genetic variants, 18 variants, in the genes AMDHD1, CYP2R1, CYP24A1, DHCR7, GC, SEC23A, and VDR were analysed. The results show that polymorphisms in the vitamin D binding protein encoded by the GC gene are related to the infection severity (p = 0.005). There is an association between vitamin D polygenic risk score and the serum concentration of 25 (OH)D (p = 0.04). There is an association between 25 (OH)D levels and the survival and fatal outcomes (p = 1.5e−4). The Portuguese population has a higher prevalence of the DHCR7 RS12785878 variant when compared with its prevalence in the European population (19% versus 10%). This study shows a genetic susceptibility for vitamin D deficiency that might explain higher severity degrees in COVID-19 patients. These results reinforce the relevance of personalized strategies in the context of viral diseases.Trial registration: NCT04370808.

scholarly journals 483. Disease Severity and Clinical Manifestations of SARS-CoV-2 Infection Among Infants Over the First Year of the Pandemic in Canada

2021 ◽  
Vol 8 (Supplement_1) ◽  
pp. S342-S343
Author(s):  
Pierre-Philippe Piché-Renaud ◽  
Luc Panetta ◽  
Daniel Farrar ◽  
Charlotte Moore Hepburn ◽  
Olivier Drouin ◽  
...  
Keyword(s):  
Risk Factors ◽  
Disease Severity ◽  
Disease Risk ◽  
Severe Disease ◽  
Clinical Manifestations ◽  
Significant Risk ◽  
Age Group ◽  
Younger Age ◽  
The Impact ◽  
Research Grant

Abstract Background There is limited data on outcomes of SARS-CoV-2 infection among infants (&lt; 1 year of age). In the absence of any approved vaccines for infants, understanding the risk factors for hospitalization and severe disease from COVID-19 in this age group will help inform clinical management and targeted public health interventions. The objective of this study was to describe the clinical manifestations, disease severity, and risk factors for hospitalization among infants with SARS-CoV-2 infection in Canada. Methods This is a nationwide prospective observational study using the infrastructure of the Canadian Paediatric Surveillance Program. All cases of infants aged &lt; 1 year of age with microbiologically confirmed SARS-CoV-2 infection were reported from April 8th 2020 to May 11th 2021, and classified by disease severity, and primary cause of hospitalization. Logistic regression was performed to identify risk factors for hospitalization and severe disease. Results A total of 393 cases were reported, including 229 (58.3%) non-hospitalized and 164 (41.7%) hospitalized infants. The most common symptoms included fever (63.4%), runny nose (45.0%), cough (35.1%) and decreased oral intake (24.9%). Significant risk factors for hospitalization included younger age and presence of comorbid conditions (excluding prematurity), as shown in the Table. Among hospitalized infants, 108 (65.9%) were admitted because of COVID-19-related illness, and 52 (31.7%) were admitted for reasons other than COVID-19. A total of 31 (7.9%) infants developed severe or critical disease. Risk factors for severe disease included prematurity and younger age (Table). Conclusion We describe one of the largest cohort of infants with SARS-CoV-2 infection. Severe disease in this age group is uncommon, with younger age and prematurity being significant risk factors for severe COVID-19. Disclosures Pierre-Philippe Piché-Renaud, MD, Pfizer Global Medical Grants (Competitive grant program) (Research Grant or Support, Investigator-led project on the impact of COVID-19 on routine childhood immunizations) Olivier Drouin, MDCM MsC MPH, Covis Pharma (Research Grant or Support) Shaun Morris, MD, MPH, DTM&H, FRCPC, FAAP, GSK (Speaker’s Bureau)Pfizer (Advisor or Review Panel member)Pfizer (Grant/Research Support)

scholarly journals Vocal cord surgery and pharmacological treatment of a patient with HPV and recurrent respiratory papillomatosis

2019 ◽  
Vol 12 (11) ◽  
pp. e231117 ◽  
Author(s):  
Francesco Galletti ◽  
Francesco Freni ◽  
Francesco Gazia ◽  
Andrea Gallo
Keyword(s):  
Human Papillomavirus ◽  
Surgical Technique ◽  
Vocal Cord ◽  
Anterior Commissure ◽  
Free Edge ◽  
Respiratory Epithelium ◽  
Recurrent Respiratory Papillomatosis ◽  
Vocal Cords ◽  
The Voice

Recurrent respiratory papillomatosis (RRP) is caused by persistent infection of the respiratory epithelium by human papillomavirus (HPV), especially HPV 6 and 11. We present a case of surgically treated RRP. The main purpose of our protocol is to remove the lesions with a non-aggressive surgical technique and prevent recurrences with the use of cidofovir for local infiltrations in multiple sessions. We use low-power energy CO2 laser, directed towards the upper part of the vocal cord, to determine a retraction of the mucosa with consequent coverage of the epithelium of the free edge. The aim of this technique is to treat and stop the formation of synechia of the anterior commissure and the free margin of the vocal cords in the anterior commissure. After 8 years follow-up, there are no signs of recurrence of the disease. The voice had a net improvement confirming the effectiveness of the protocol.

Tracheotomy in Children with Juvenile-Onset Recurrent Respiratory Papillomatosis: The Children's Hospital of Pittsburgh Experience

1996 ◽  
Vol 105 (1) ◽  
pp. 1-5 ◽  
Author(s):  
Andrew M. Shapiro ◽  
Frank L. Rimell ◽  
Anna Pou ◽  
David Shoemaker ◽  
Sylvan E. Stool
Keyword(s):  
Airway Obstruction ◽  
Recurrent Respiratory Papillomatosis ◽  
Airway Compromise ◽  
Juvenile Onset ◽  
Children's Hospital ◽  
Aggressive Disease ◽  
Distal Airway ◽  
Younger Age ◽  
Children’S Hospital ◽  
Progression Of Disease

Despite the risk of airway obstruction, tracheotomy has been viewed with trepidation in the management of recurrent respiratory papillomatosis (RRP). The literature suggests that the injury associated with the tracheotomy site may initiate the progression of disease to the distal airway. Alternatively, patients who require tracheotomy for RRP may be predisposed to distal spread because of more aggressive disease. In an effort to clarify this issue, we reviewed the Children's Hospital of Pittsburgh experience with 35 patients with RRP between 1984 and 1994; 13 patients received tracheotomies. Tracheotomy patients presented at a younger age with more widespread disease, often involving the distal airway prior to tracheotomy. Although distal spread occurred in 50% of patients, it was generally limited to the tracheotomy site. Overall, outcome in the tracheotomy group was satisfactory. Complications related to the tracheotomy were rare. We conclude that tracheotomy is an appropriate option for significant airway compromise in patients with RRP.

scholarly journals Heterotopic Salivary Gland Tissue in the Larynx

2018 ◽  
Vol 4 (3) ◽  
pp. 1-3
Author(s):  
Rohan Bidaye ◽  
Ashraf Mahmood ◽  
Sam Arman ◽  
Huw Griffiths
Keyword(s):  
Salivary Gland ◽  
Vocal Cord ◽  
Male Patient ◽  
Clinical Presentation ◽  
English Literature ◽  
Vocal Cords ◽  
Subglottic Region ◽  
Salivary Gland Tissue ◽  
Gland Tissue ◽  
False Vocal

Heterotopic Salivary Gland Tissue (HSGT) of the larynx is an extremely rare pathology, with only 8 cases reported in English literature. We are reporting 2 cases of HSGT in the larynx which we encountered in our practice. The first one is a unique presentation of a 45 year old female with HSGT in bilateral false vocal cords. While the second case is 50-year-old male patient with HSGT in the left false vocal cord and subglottic region. With these 2 cases, we would be discussing about the clinical presentation of this rare anomaly and add to the literature.

scholarly journals OSTEOARTHRITIS AND DEPRESSION IN A MALE VA POPULATION

2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S165-S166
Author(s):  
Christopher J Burant ◽  
Gregory Graham ◽  
Denise M Kresevic ◽  
Gary Deimling ◽  
Said Ibrahim ◽  
...  
Keyword(s):  
Disease Severity ◽  
Structural Equation ◽  
Functional Decline ◽  
Equation Model ◽  
Chronic Illnesses ◽  
Male Veterans ◽  
Younger Age ◽  
Confirmatory Factor ◽  
And Function ◽  
The Impact

Abstract Osteoarthritis (OA) is a leading cause of disability among older adults. By 2050, approximately 60 million will suffer from arthritis adding up to a total societal cost of $65 billion. Chronic illnesses resulting in pain, and functional decline have been associated with depression in previous studies. The primary goal of this study is to investigate whether OA severity, as measured by the Western Ontario McMasters Arthritis Composite (WOMAC), impacts reported levels of depression and to what degree clinical and sociodemographic variables play a part. A causal model was developed and tested examining the antecedents of OA disease severity and depression. Information on clinical, demographic, socioeconomic, and psychosocial variables was collected on 596 male Veterans with moderate to severe symptomatic OA of the knee\hip. A Confirmatory Factor Analysis was conducted to determine the factor structure of the WOMAC. A 2nd order three factor solution (pain, stiffness, and function) fit the data well (TLI of .94, a CFI of .94 and a RMSEA of .058). The results of the Structural Equation Model reveal a final model that fit the data well (TLI of .95, a CFI of .97 and a RMSEA of .047). Depression was predicted by higher WOMAC scores (beta=.37 , p&lt;.01); higher levels of comorbidity (beta= .11, p&lt;.05); younger age (beta= -.29, p&lt;.01); being white (beta=-.11, p&lt;.05); lower levels of income (beta= -.12, p&lt;.05); lower levels of religiosity (beta= 11, p&lt;.05). Clinicians should be aware of the impact of disease severity when treating OA patients with depression.

scholarly journals A Rare Benign Tumor of Vocal Cord: Myxofibrolipoma

2014 ◽  
Vol 4 (2) ◽  
pp. 67-68
Author(s):  
Surendra Kumar Kanaujia ◽  
Annanya Soni
Keyword(s):  
Vocal Cord ◽  
Benign Tumor ◽  
Relevant Literature ◽  
Vocal Cords ◽  
True Vocal Cord ◽  
Present Case Report ◽  
Rare Benign Tumor ◽  
Giant Tumor ◽  
Myxomatous Degeneration ◽  
False Vocal

ABSTRACT Laryngeal lipomas are rare. Most of these arise from the aryepiglottic folds of which intrinsic tumors most frequently originate from the false vocal cords. The present case report describes a giant tumor arising from true vocal cord, and that too with a rare histopathology which revealed lipoma with myxomatous degeneration and fibrous changes. Clinical features, management and relevant literature are discussed. How to cite this article Kanaujia SK, Soni A. A Rare Benign Tumor of Vocal Cord: Myxofibrolipoma. Int J Phonosurg Laryngol 2014;4(2):67-68.

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