scholarly journals Differences in Expression of Inflammatory Mediator in Mucosal and Polyp Tissue between Chronic Rhinosinusitis and Recurrent Chronic Rhinosinusitis

2019 ◽  
Vol 7 (11) ◽  
pp. 1733-1738 ◽  
Author(s):  
Effy Huriyati ◽  
Eryati Darwin ◽  
Yanwirasti Yanwirasti ◽  
Irza Wahid

BACKGROUND: Chronic rhinosinusitis with nasal polyps (CRSwNP) remains a challenging clinical entity with its propensity for recurrence. This disease decreases the patients’ quality of life and creates a high economic burden. An effort to investigate the aetiology of recurrent polyps have to be more alert. AIM: This study aims to prove the differences in expression of IL-5, IL-8, IL-17A and TGF-β1 in mucosal and polyp tissue between CRSwNP and recurrent CRSwNP and also to determine which expression of cytokines that have the main role in mucosal and polyp tissue in recurrent CRSwNP. MATERIAL AND METHODS: An observational study was conducted with a comparative cross-sectional design of CRS patients with 15 recurrent CRSwNP and CRSwNP who had never undergone surgery for as many as 15 polyps. Mucosal specimens of nasal polyps are taken by brushing, and polyp tissue specimens are taken during surgical removal of nasal polyps. Specimens from the polyp mucosa were examined by ELISA while the polyp tissue specimens were carried out immunohistochemistry (IHC). RESULTS: The result showed that there is a significant difference in IL-5 expression in the polyp mucosal between CRSwNP with recurrent CRSwNP, where expression is higher in recurrent CRSwNP. The expression of IL-8, IL-17 and TGF-β1 were lower in recurrent CRSwNP, but the difference was not significant. In nasal polyp tissue, there is a significant difference in TGF-β1 and IL-8 expression between CRSwNP and recurrent CRSwNP, where the expression of both cytokines is lower in recurrent CRSwNP. Interleukin-5 expression was higher in recurrent CRSwNP than CRSwNP, but the difference was not significant. In the polyps mucosal, IL-5 has the main role in recurrent CRSwNP polyp, whereas TGF-β has the main role in polyp tissue. CONCLUSION: This study concluded that the expression of IL-5 in the mucosa could be examined with simple techniques like brushing before polypectomy or FESS was performed to determine the possibility of polyps recurrencies.

2020 ◽  
Vol 77 (2) ◽  
pp. 182-188
Author(s):  
Marija Stupar ◽  
Djordje Spreng ◽  
Aleksandar Peric

Background/Aim. Diagnosis of chronic rhinosinusitis (CRS) is based on clinical symptoms, and confirmed with endoscopic findings and computed tomography (CT) scans of paranasal sinuses. However, the results of numerous studies have shown that the symptoms that patients report are not in correlation with the degree of the disease spread obtained by radiological findings. The aim of our study was to examine is there a correlation between the degree of symptoms intensity of the non-polypous and polypous form of CRS and the degree of the disease spread, obtained on the basis of radiological diagnostics. Methods. A total of 60 patients, of which 30 patients with CRS without nasal polyps (CRSsNP) and 30 with CRS with nasal polyps (CRSwNP), were included in this cross-sectional study. Symptoms were evaluated using two questionnaires: Sino-Nasal Outcome Test 22 (SNOT-22) and Visual Analogue Score (VAS). The Lund Mackay CT score was used as a radiological parameter of the disease expansion. In addition, each of the subjects was examined for sensitivity to standard inhalation allergens. Results. In patients with CRSsNP, there were statistically significant positive correlations between the Lund Mackay CT score and the SNOT-22 score (r = 0.578, p = 0.001) and between the Lund Mackay CT score and the VAS (r = 0.408, p = 0.025). We found no correlation between the both questionnaire scores and the Lund Mackay score in CRSwNP patients. In patients with CRSwNP, a statistically significant difference was found in the values of SNOT-22 between patients with and without sensitivity to inhalation allergens, with higher values of the score in patients with allergy (p = 0.039). Conclusion. There is a positive correlation between the severity of the symptoms and the radiological findings only in patients with CRSsNP, which suggests that application of these questionnaires would be possible only in the case of this clinical entity.


2018 ◽  
Vol 1 (2) ◽  
pp. 114
Author(s):  
Wahdaniah Wahdaniah ◽  
Sri Tumpuk

Abstract: Routine blood examination is the earliest blood test or screening test to determine the diagnosis of an abnormality. Blood easily froze if it is outside the body and can be prevented by the addition of anticoagulants, one of which Ethylene Diamine Tetra Acetate (EDTA). Currently available vacuum tubes containing EDTA anticoagulants in the form of K2EDTA and K3EDTA. K3EDTA is usually a salt that has better stability than other EDTA salts because it shows a pH approaching a blood pH of about 6.4. The purpose of this research is to know the difference of erythrocyte index results include MCH, MCV and MCHC using K3EDTA anticoagulant with K2EDTA. This research is a cross sectional design. This study used venous blood samples mixed with K2EDTA anticoagulant and venous blood mixed with K3EDTA anticoagulants, each of 30 samples. Data were collected and analyzed using paired different test. Based on data analysis that has been done on MCH examination, p value <0,05 then there is a significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value. Then on the examination of MCV and MCHC obtained p value <0.05 then there is no significant difference between samples with K3EDTA anticoagulant with K2EDTA to erythrocyte index value.Abstrak: Pemeriksaan darah rutin merupakan pemeriksaan darah yang paling awal atau screening test untuk mengetahui diagnosis suatu kelainan. Darah mudah membeku jika berada diluar tubuh dan bisa dicegah dengan penambahan antikoagulan, salah satunya Ethylene Diamine Tetra Acetate (EDTA). Dewasa ini telah tersedia tabung vakum yang sudah berisi antikoagulan EDTA dalam bentuk  K2EDTA dan  K3EDTA. K3EDTA  biasanya berupa garam yang mempunyai stabilitas yang lebih baik dari garam EDTA yang lain karena menunjukkan pH yang mendekati pH darah yaitu sekitar 6,4. Tujuan dari penelitian ini adalah untuk mengetahui perbedaan hasil indeks eritrosit meliputi MCH, MCV dan MCHC menggunakan antikoagulan K3EDTA dengan K2EDTA. Penelitian ini merupakan penelitian dengan desain cross sectional. Penelitian ini menggunakan sampel darah vena yang dicampur dengan antikoagulan K2EDTA dan darah vena yang dicampur dengan antikoagulan K3EDTA, masing-masing sebanyak 30 sampel. Data dikumpulkan dan dianalisis menggunakan uji beda berpasangan. Berdasarkan analisis data yang telah dilakukan pada pemeriksaan MCH didapatkan nilai p < 0,05 maka ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit. Kemudian pada pemeriksaan MCV dan MCHC didapatkan nilai p < 0,05 maka tidak ada perbedaan yang signifikan antara sampel dengan antikoagulan K3EDTA dengan K2EDTA terhadap nilai indeks eritrosit.


BMJ Open ◽  
2021 ◽  
Vol 11 (5) ◽  
pp. e047230
Author(s):  
Jae-Sung Nam ◽  
Yun Ho Roh ◽  
Wasan Almazouq Fahad ◽  
Hae-Eun Noh ◽  
Jong-Gyun Ha ◽  
...  

ObjectivesWe performed a cross-sectional analysis of data from the nationwide Korea National Health and Nutrition Examination Survey to evaluate the association between obesity and chronic rhinosinusitis with nasal polyps (CRSwNP) or without nasal polyp (CRSsNP).DesignRetrospective cross-sectional analysis of health survey data.SettingVoluntary survey of representative South Korean populations.ParticipantsIn total, 32 384 individuals aged 19 years or older with available data on CRS and obesity were included.Primary and secondary outcome measuresDiagnosis of CRSwNP or CRSsNP was performed by trained otolaryngologists through sinus endoscopy and surveys of medical history. General and central obesity was diagnosed using body mass index (BMI) and waist circumference (WC), respectively.MethodsA multivariate logistic regression analysis was used to clarify the association between CRSwNP or CRSsNP and obesity according to BMI and WC. Non-obese individuals were recruited as controls.ResultsThe prevalence of CRSwNP was higher in the general (OR, 1.438; 95% CI, 1.170 to 1.768; p<0.001) and central (OR, 1.251; 95% CI, 1.031 to 1.520; p=0.033) obesity groups than in the control group. Prevalence of CRSsNP was not correlated with obesity. In a logistic regression analysis, olfactory dysfunction (OR, 1.329; 95% CI, 1.137 to 1.553; p<0.001) and purulent discharge (OR, 1.383; 95% CI, 1.193 to 1.603; p<0.001) showed a higher incidence in the central obesity group than in the control group.ConclusionsWe demonstrated an association between CRSwNP and general and central obesity. Further investigations on the mechanism underlying this correlation are necessary for an improved understanding of the pathogenesis of CRSwNP.


Author(s):  
Wagner Vargas Souza Lino ◽  
André Luis Lacerda Bachi ◽  
José Arruda Mendes Neto ◽  
Gabriel Caetani ◽  
Jônatas Bussador do Amaral ◽  
...  

Abstract Introduction Combination of chronic inflammation and an altered tissue remodeling process are involved in the development of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Studies demonstrated that mesenchymal stem cells expressing the progenitor gene CD133 were involved in a significant reduction of the chronic inflammatory process in the polypoid tissue. Objective To evaluate the levels of CD133 (Prominin-1) in nasal polypoid tissue and its correlation with interleukin-8 (IL-8) and transforming growth factor β1 (TGF-β1). Methods A total of 74 subjects were divided in the following groups: control group (n = 35); chronic rhinosinusitis with nasal polyps nonpresenting comorbid asthma and aspirin intolerance (CRSwNPnonAI) group (n = 27); and chronic rhinosinusitis with nasal polyps presenting comorbid asthma and aspirin intolerance (CRSwNPAI) group (n = 12). Histologic analysis and also evaluation of the concentration of CD133, IL-8, and TGF-β1 by enzyme-linked immunosorbent assay (ELISA) kits were performed in nasal tissue obtained from nasal polypectomy or from middle turbinate tissue. Results Higher eosinophilic infiltration was found in both CRSwNP groups by histologic analysis. Lower levels of TGF-β1 and IL-8 were observed in both CRSwNP groups when compared with the control group, whereas the CD133 levels were significantly reduced only in the CRSwNPnonAI group compared with the control group. Conclusion It was demonstrated that the nasal mucosa presenting polyposis showed a significant reduction of CD133 levels, and also that this reduction was significantly correlated with the reduction of TGF-β1 levels, but not with IL-8 levels. Therefore, these findings may be involved in the altered inflammatory and remodeling processes observed in the nasal polyposis.


2021 ◽  
Vol 31 (1) ◽  
pp. 7-19
Author(s):  
O. M. Kurbacheva ◽  
M. E. Dyneva ◽  
I. P. Shilovskiy ◽  
E. L. Savlevich ◽  
V. I. Kovchina ◽  
...  

The combination of bronchial asthma (BA) and chronic rhinosinusitis with nasal polyps (CRSwNP) is currently considered a separate phenotype wit1 dysregulation of pro- and anti-inflammatory cytokines as one of t1e leading causes of inflammation. The aim of this study was to investigate the local and systemic inflammatory process in patients with BA associated with CRSwNP. Methods. The study enrolled 96 volunteers divided into 4 groups: the 1st was healthy control (Normal); the 2nd had allergic BA associated with CRSwNP; the 3rd had nonallergic BA associated with CRSwNP; the 4th had CRSwNP without BA. All participants of the study underwent clinical, laboratory, instrumental, and histological examinations. The expression of il-1β, il-4, il-,5 il-6, il-13, il-37, il-17f, ifn-γ, tnf-α and tgf-β genes was assessed in the peripheral blood mononuclear cells - PBMC and in the polyp tissue using RT-PCR. We also estimated the expression of tslp, il-25 and il-33 in the polyp tissue and expression of GATA3 and RORgt transcription factors in PBMC. Results. The pathogenesis of BA associated with CRSwNP is characterized by the dys-regulation of the local pro- and anti-inflammatory cytokines of the Th1-, Th2-, Th17- immune response. Moreover, the high expression of il-37 gene in patients with BA associated with CRSwNP, and especially in patients with not-allergic BA associated with CRSwNP, probably indicates the «inclusion» of the compensatory mechanism. In addition, BA associated with CRSwNP is characterized by severe course of both diseases. A nonallergic BA associated with CRSwNP is characterized by more pronounced eosinophilic inflammation, which is an unfavorable prognostic factor. Conclusion. Thus, a comparison of the levels of local and systemic cytokine expression in patients with BA associated with CRSwNP led to the conclusion that CRSwNP affects the local immunity more than systemic immunity. However, the latter is affected to some extent in the long-term as well.


2021 ◽  
Vol 6 (14) ◽  
pp. 1-7
Author(s):  
Emine Serap ÇAĞAN ◽  
Birsen KARACA SAYDAM ◽  
Sinem GÜLÜMSER ATEŞ ◽  
Rabia EKTİ GENÇ ◽  
Esin ÇEBER TURFAN

Introduction: The primary attachment figure is mostly defined as the mother, and studies focus on the mother. However, in many babies, basic attachment is just as good with the father as with the mother. It is seen that there are very few studies in the literature investigating the correlations of father-infant attachment relationships.. The aim of this study is to determine the father-infant attachment status and to determine the factors affecting attachment. Method: The population of the cross-sectional study consisted of the spouses of all puerperant women hospitalized in the Gynecology and Obstetrics Clinic between September 1, 2018 and October 1, 2018. The sample size consisted of 156 fathers who agreed to participate in the study. Father identification form and father-infant attachment scale were used to collect the study data. The analysis of the data obtained from the research was carried out on the computer using the SPSS 16.0 package program. Results: 156 fathers participated in the study. The mean age of the fathers is 33.64±6.49, and 38.5% of them have a bachelor's degree. 91.0% of fathers stated that they felt ready for fatherhood. The fathers' Father-Infant Attachment Scale mean score was 82.60±7.72 In the analysis, the difference between the variables and the total score of the scale was found to be statistically insignificant (p>0.05). Discussion and Conclusion: At the end of the study, the bonding process of fathers participating in the study with their babies and the factors affecting this process were evaluated and it was seen that the father-infant attachment scale mean scores of the fathers participating in the study were high and were similar to other studies. In addition, when the basic factors affecting father-infant attachment were compared with the attachment scale mean score, it was found that there was no statistically significant difference.


Hand ◽  
2016 ◽  
Vol 12 (5) ◽  
pp. 439-445 ◽  
Author(s):  
Paul W. L. ten Berg ◽  
Tessa Drijkoningen ◽  
Thierry G. Guitton ◽  
David Ring

Background: Radiological grading of wrist osteoarthritis associated with scaphoid nonunion advanced collapse (SNAC) can be difficult. A comparison radiograph of the contralateral healthy wrist and an educational training in the various SNAC stages may improve reliability. Our purposes were to evaluate the difference in the reliability: (1) between observers who rate SNAC wrists with and without a comparison radiograph; and (2) between observers who receive training prior to ratings and those who do not. Methods: In this cross-sectional survey study, 82 fully trained orthopedic or hand surgeons rated anteroposterior radiographs of 19 patient wrists following a scaphoid nonunion based on SNAC stages 0 to 4. Observers were randomized online in 4 groups: one group rated unilateral views without training, a second group unilateral views with training, a third group bilateral views without training, and a fourth group bilateral views with training. Training included a 1-page clarification of the SNAC stages. Interobserver agreement was calculated using kappa statistics. Results: There was no significant difference between agreement between observers who rated unilateral radiographs (κ = 0.55) and who rated bilateral radiographs (κ = 0.58) ( P = .14), nor between agreement between observers who received training (κ = 0.59) and who did not (κ = 0.54) ( P = .058). Conclusions: The use of an additional comparison view and/or training does not seem to be clinically relevant in SNAC staging. There is room for improvement in the way we assess patients with SNAC wrists.


2020 ◽  
Vol 5 (2) ◽  
pp. 1027-1030
Author(s):  
Shanti Sunuwar Subedi ◽  
Rakina Bhansakarya ◽  
Sajjan Kumar Sharma

Introduction: To evaluate the maternal and perinatal outcome in booked and unbooked cases. Objectives: To assess the maternal and fetal outcomes in unbooked and booked patients. Methodology: This was a cross-sectional comparative study conducted in the Department of Obstetrics and Gynecology from Augustti2019 to January 2020. Using a convenient sampling technique, 204 samples were taken and cross-sectional study was done. Results: There were total 204 cases in this study;102were booked and 102 were unbooked. In this study, 85(83%) of booked cases were educated up to secondary level as compared toti65 (64%) of unbooked cases. There was no significant difference in Apgar score in 1 and 5 minute between booked and unbooked cases. More babies in the unbooked group were transferred to NICU as compared to the booked group and the difference was significant (9.8%vs 1.9%). Greater proportion of booked cases had spontaneous vaginal delivery (81.3% vs 59.8%) and complications like preterm delivery, anemia, preeclampsia/ eclampsia, complicated labor and puerperal sepsis was also less in the booked group. Conclusions: The study showed that unbooked mothers and their newborns had higher chance of having complications.


e-CliniC ◽  
2016 ◽  
Vol 4 (1) ◽  
Author(s):  
Marianne C. Jacobus ◽  
Max F.J Mantik ◽  
Adrian . Umboh

Abstract: Haemoglobin is the main component of red blood cells that serves as a transporter of oxygen and carbon dioxide in the blood. The normal range of haemoglobin values can be used to determine the degree of anemia according to age and gender. Geographical condition such as altitude influences the haemoglobin value. This study aimed to obtain the difference of haemoglobin levels between teenagers with good nutrition status who live at the highland and those at the seaside. This was an observational analytical study with a cross sectional design. Samples were students with good nutrition status of SMPN 3 Tomohon (living at the highland) and those of SMP Kristen Nazaret Tuminting (living at the seaside). There were 60 students who met the inclusion criteria as follows: adolescent, good nutrition status, healthy, aged 13-15 years, lived at the highland or at the seaside ≥ 6 month, and willing to be performed blood examinations, and had been approved by their parents. The Mann-Whitney test for the difference between haemoglobin levels of the two groups showed a p value < 0,001. Conclusion: There was a very significant difference between haemoglobin levels of good nutrition teenagers who lived at the highland and at the seaside. Keywords: haemoglobin levels, good nutrition, teenagers, highland, seaside  Abstrak: Hemoglobin merupakan komponen utama sel darah merah dan berfungsi sebagai transporter oksigen dan karbon dioksida dalam darah. Batas normal nilai hemoglobin dapat digunakan untuk menetapkan derajat anemia, dengan distribusi usia dan jenis kelamin spesifik didasarkan pada sampel referensi sehat. Kondisi geografis, seperti ketinggian tempat dari permukaan laut menjadi faktor pertimbangan dalam distribusi nilai normal hemoglobin. Penelitian ini bertujuan untuk mendapatkan perbedaan kadar hemoglobin antara remaja gizi baik yang tinggal di pegunungan dengan yang tinggal di tepi pantai. Jenis penelitian ini analitik-observasional dengan desain potong lintang. Sampel penelitian yaitu remaja gizi baik yang tinggal di pegunungan yaitu siswa SMPN 3 Tomohon dan yang di tepi pantai yaitu siswa SMP Kristen Nazaret Tuminting. Subjek penelitian berjumlah 60 remaja yang memenuhi kriteria inklusi yaitu gizi baik, sehat, berumur 13-15 tahun, berdomisili di pegunungan atau tepi pantai ≥6 bulan, bersedia dilakukan pemeriksaan darah, dan telah disetujui oleh orang tua. Data yang diperoleh dianalisis menggunakan uji Mann-Whitney dengan bantuan program SPSS. Hasil uji Mann-Whitney mengenai perbedaan kadar hemoglobin antara kedua kelompok menunjukkan nila p <0,001. Simpulan: Terdapat perbedaan yang sangat bermakna kadar hemoglobin remaja gizi baik yang tinggal di pegunungan dengan di tepi pantai.Kata kunci: kadar hemoglobin, remaja gizi baik, pegunungan, tepi pantai


2020 ◽  
Vol 19 (2) ◽  
pp. 1-5
Author(s):  
Aso Sabir Saeed ◽  
◽  
Osama MohammadAmin Shukr

Background: Several studies have demonstrated an association between obesity and migraine. It’s still unclear whether migraine is the cause or it's the result of obesity. Objective: We investigated the prevalence of migraine among obese and non-obese individuals and analyzed the relationship between migraine prevalence and obesity. Patients and Methods: This is cross-sectional observational study was carried out at the neurology outpatients’ department of the Rizgary Teaching Hospital in Erbil, Iraq, from July 1st , 2018 to September 30, 2019. We interviewed and examined 300 persons, both obese (n=154) and non-obese (n=146), and of both gender. All of them were adults (>18 years old). Each person's weight, height, body mass index (BMI), and waist circumference were measured.The diagnosis of migraine was made according to the International Headache Society’s criteria. Obesity was present if the individual’s BMI is ≥30 and/or waist-to-hip ratio is >0.9 in females and >1.0 in males. Results: Out of the 300 persons, 14 males (8.5%) got migraines while migraine was found in 37 females (27.4%), irrespective of their weight. Out of the 300 persons, the prevalence of migraine among obese individuals was 21.4% (n=33) and while in non-obese individuals was 12.3% (n=18). There was a statistically significant difference between the groups (p-value=0.045). The overall prevalence of migraine was 16.9% of the persons interviewed. Conclusion: The results showed that migraine is more prevalent among obese persons than non-obese persons and the difference was statistically significant. Keywords: Migraine, obesity, BMI, headache


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