scholarly journals Clinical-Cytological-Grading and phenotyping in patients with chronic rhinosinusitis with nasal polyps: the relevance in clinical practice

2020 ◽  
Vol 90 (2) ◽  
Author(s):  
Matteo Gelardi ◽  
Giuseppe Porro ◽  
Vitaliano Quaranta ◽  
Nicola Quaranta ◽  
Michele Cassano ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Total Population ◽  
Cross Sectional Study ◽  
Low Grade ◽  
High Grade ◽  
Cross Sectional ◽  
Aspirin Intolerance ◽  
Careful Management

Chronic rhinosinusitis (CRS) includes two main phenotypes: without nasal polyps (CRSsNP) and with nasal polyps (CRSwNP). CRSwNP may be associated with comorbidity, mainly concerning asthma, aspirin intolerance, and allergy. CRSwNP patients may also be evaluated by clinical-cytological grading (CCG). The current study investigated the prevalence and characteristics of the different CCG and phenotypes in CRSwNP outpatients examined in clinical practice. This retrospective cross-sectional study enrolled 791 consecutive CRSwNP outpatients (424 males, mean age 48.8 years). In the total population, asthma was a common comorbidity (30.8%) as well as aspirin intolerance (24.8%), and allergy (50.8%). As concerns CCG-grading, 210 (26.5%) outpatients had low-grade, 366 (46.3%) medium, and 215 (27.2%) high. As regards cytological phenotypes, 87 (11%) had neutrophilic type, 371 (46.3%) eosinophilic, 112 (14.2%) mast cell, and 221 (27.9%) mixed. High-grade CCG was significantly associated with more frequent asthma, aspirin intolerance, allergy, recurrent surgery, and mixed cytological phenotype. Low-grade CCG was characterized by fewer comorbidities and operations, and neutrophilic phenotype. Therefore, the present study confirmed that CCG is a useful tool in the management of outpatients with CRSwNP. CRSwNP is frequently associated with asthma, aspirin intolerance, and allergy comorbidity. High-grade CCG is frequently characterized by a mixed cytological phenotype, thus, by more severe progress. These real-world outcomes underline that CRSwNP deserves adequate attention for careful management and optimal identification of the best-tailored therapy; CCG and cytological phenotyping could be fruitful tools in clinical practice. Asthma and aspirin intolerance should be adequately investigated in all CRS patients.

Occupational exposure influences control of disease in patients with chronic rhinosinusitis

2021 ◽  
Vol 59 (4) ◽  
pp. 380-386
Author(s):  
D.A.E. Dietz de Loos ◽  
S. Ronsmans ◽  
M.E. Cornet ◽  
P.W. Hellings ◽  
V. Hox ◽  
...  
Keyword(s):  
Occupational Exposure ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Conservative Therapy ◽  
Cross Sectional Study ◽  
Sinus Surgery ◽  
Sectional Study ◽  
Cross Sectional ◽  
Independent Variables ◽  
The Relationship

Background: Chronic rhinosinusitis (CRS) is a frequent condition that is treated by endoscopic sinus surgery (ESS) when medical treatment fails. Irritating or sensitizing airborne agents can contribute to uncontrolled CRS. A prior study showed a linear correlation between occupational exposure and the number of ESS. Methods: In this cross-sectional study we tested the hypothesis that occupational exposure is a risk for undergoing ESS. We sent questionnaires enquiring occupational exposure in patients with CRS with nasal polyps (CRSwNP) or CRS without nasal polyps (CRSsNP). An expert assessed blindly the reported work exposures to inhaled agents. The relationship between occupational exposure on undergoing ESS was analysed. Results: Among all patients who underwent ESS (n=343), 30% reported a relevant occupational exposure, which is significantly higher than the 4.8% found among CRS patients that underwent no prior sinus surgery (n=21). Besides occupational exposure, self-reported doctor-diagnosed asthma were independent variables contributing to the chance of undergoing ESS. Conclusion: In our study we confirm occupational exposure as a risk factor for uncontrolled CRS, if defined by undergoing ESS. In CRS patients with uncontrolled symptoms, despite maximal conservative therapy, the clinician should explore the possible contribution of occupational exposure.

scholarly journals HER2 / neu Overexpression in Urothelial Carcinoma and Its Association with Tumour Grading - A Cross Sectional Study from a Tertiary Care Hospital in Kerala

2021 ◽  
Vol 8 (9) ◽  
pp. 497-501
Author(s):  
Sebina Asmi A.T ◽  
Suma Madathiveetil
Keyword(s):  
Urothelial Carcinoma ◽  
Growth Factor Receptor ◽  
Cross Sectional Study ◽  
Low Grade ◽  
High Grade ◽  
Sectional Study ◽  
Tumour Grade ◽  
Cross Sectional ◽  
Epidermal Growth ◽  
Papillary Urothelial Carcinoma

BACKGROUND Human epidermal growth factor receptor-2 HER2 / neu, is a trans membrane tyrosine kinase receptor of epidermal growth factor receptor (EGFR) family and is involved in the pathogenesis of urinary bladder cancer. In this study we attempted to evaluate the HER2 / neu expression in urothelial carcinoma of bladder and its association with tumour grading. METHODS This was a cross sectional study with a sample size of 75. Routine 4 micrometre thick sections of formalin fixed paraffin embedded tissue blocks stained with haematoxylin & eosin were reviewed. Tumour grade was determined by using the World Health Organization (WHO) / International Society of Urological Pathologist criteria (ISUP). Immunohistochemistry was done by using HER2 / neu monoclonal antibody and its expression were observed. The membrane staining intensity and pattern were studied and scored. RESULTS In our study 75 cases of urothelial carcinoma were studied, of which 49 cases were papillary urothelial carcinoma low grade, 26 cases were papillary urothelial carcinoma high grade. Among these, 19 cases were infiltrating urothelial carcinoma. HER2 / neu positivity were observed in 27 (36 %) cases and overexpression in 8 (10 %) cases. Low grade urothelial carcinoma showed HER2 / neu positivity in 11 (22 %) cases and overexpression in 1 (2 %) case. High grade urothelial carcinoma showed HER2 / neu positivity in 16 (64 %) cases, among which 7 (28 %) cases showed overexpression. HER2 / neu positivity was seen in 13 (68 %) cases of infiltrating urothelial carcinoma with 4 (21 %) cases showing overexpression. A statistically significant difference in HER2 / neu expression was noted in high grade and invasive urothelial carcinoma compared to low grade and non-invasive urothelial carcinoma. CONCLUSIONS Urothelial carcinomas show overexpression of HER2 / neu and this over expression increases with increasing grade of tumour and muscle invasiveness. KEYWORDS Urothelial Carcinoma, HER2 / neu, Overexpression, Tumour Grade, Trastuzumab

scholarly journals Prognostic Role of Matrix Metalloproteinase Expression in Meningioma: A Cross-Sectional Study.

2020 ◽  
Author(s):  
Maryam Ahmad Sharifuddin ◽  
Sharifah Emilia Tuan Sharif ◽  
Hasnan Jaafar
Keyword(s):  
Cross Sectional Study ◽  
Low Grade ◽  
High Grade ◽  
Sectional Study ◽  
Cross Sectional ◽  
Who Grade ◽  
Exact Test ◽  
Immunohistochemical Markers ◽  
Chi Squared ◽  
The Difference

Abstract Background: Meningioma is the most common intracranial tumor in adults. In addition to the extent of tumor surgical resection and WHO grade, angiogenesis is a prognostic factor that is influenced by MMP-2. Our study examined the association of these prognostic factors with MMP-2 expression in meningioma. Methods: A cross-sectional study of patients diagnosed with meningioma between January 2008 and December 2017 was conducted. All samples were re-reviewed and subjected to immunohistochemical staining for Ki67, MMP-2, and CD34. Pearson’s chi-squared test and Fisher’s exact test were used to examine the association of MMP-2 expression with the WHO grade and microvascular density (MVD). Results: The study included 99 patients aged 23–75. Most patients were female (73.7%). This study included 85 cases of low-grade meningioma (grade I) and 14 cases of high-grade meningioma (grade II, 11; grade III, 3). The most common subtypes were meningothelial, transitional, and fibroblastic. In total, 62 of 85 patients with low-grade meningioma and 10 of 14 patients with high-grade meningioma exhibited high MMP-2 expression, and the difference in the rates between the groups was not significant. Most patients in this study displayed MVD scores of 1+ (54/99) and 2+ (33/99). Of the 54 patients with an MVD score of 1+, 42 exhibited high MMP-2 expression. MMP-2 was expressed by all patients with meningioma. Conclusion: In the future, more samples are required, in high-grade tumors, to prevent bias, and more specific immunohistochemical markers should be used to evaluate angiogenesis.

scholarly journals Satisfação com a Especialidade entre os Internos da Formação Específica em Portugal

2015 ◽  
Vol 28 (2) ◽  
pp. 209 ◽  
Author(s):  
Maria João Martins ◽  
Inês Laíns ◽  
Bruno Brochado ◽  
Manuel Oliveira-Santos ◽  
Pedro Pinto Teixeira ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Total Population ◽  
Medical Profession ◽  
Cross Sectional Study ◽  
Study Data ◽  
Medical Residents ◽  
Cross Sectional ◽  
High Satisfaction ◽  
Degree Of Satisfaction

<strong>Introduction:</strong> The satisfaction with the medical profession has been identified as an essential factor for the quality of care, the wellbeing of patients and the healthcare systems’ stability. Recent studies have emphasized a growing discontent of physicians, mainly as a result of changes in labor relations.<br /><strong>Objectives: </strong>To assess the perception of Portuguese medical residents about: correspondence of residency with previous expectations; degree of satisfaction with the specialty, profession and place of training; reasons for dissatisfaction; opinion regarding clinical practice in Portugal and emigration intents.<br /><strong>Material and Methods:</strong> Cross-sectional study. Data collection was conducted through the “Satisfaction with Specialization Survey”, created in an online platform, designed for this purpose, between May and August 2014.<br /><strong>Results: </strong>From a total population of 5788 medical residents, 804 (12.25 %) responses were obtained. From this sample, 77% of the responses were from residents in the first three years. Results showed that 90% of the residents are satisfied with their specialty, 85% with the medical profession and 86% with their place of training. Nevertheless, results showed a decrease in satisfaction over the final years of residency. The overall assessment of the clinical practice scenario in Portugal was negative and 65% of residents have plans to emigrate after completing their residency.<br /><strong>Conclusion:</strong> Portuguese residents revealed high satisfaction levels regarding their profession. However, their views on Portuguese clinical practice and the results concerning the intent to emigrate highlight the need to take steps to reverse this scenario.

scholarly journals IS SUPERFICIAL COLORECTAL LESIONS WITH LOW AND HIGH GRADES INTRAEPITHELIAL NEOPLASMS MORE PREVALENT IN OLDER ABOVE 65 YEARS?

2019 ◽  
Vol 32 (4) ◽  
Author(s):  
Nildete Rodrigues DIGER ◽  
Luiz Fernando KUBRUSLY ◽  
Paulo Afonso Nunes NASSIF ◽  
Artur Adolfo PARADA ◽  
Giovana Tonello BOLSI ◽  
...  
Keyword(s):  
Age Groups ◽  
Intraepithelial Neoplasia ◽  
Cross Sectional Study ◽  
Colorectal Carcinogenesis ◽  
Low Grade ◽  
High Grade ◽  
Cross Sectional ◽  
Intraepithelial Neoplasms ◽  
Colon And Rectum ◽  
The Right

ABSTRACT Background: Colorectal cancer has a higher incidence in the rectum and sigmoid. However, with the expansion of the diagnosis of superficial lesions interest in the diagnosis and in the role they play in colorectal carcinogenesis has increased. Aim: To verify the behavior of superficial lesions of the colon and rectum, comparing the pathological and endoscopic findings, below and above 65 years. Methods: Cross-sectional study with prospective evaluation of standard protocol, where 200 patients with colorectal superficial lesions were evaluated; they were submitted to colonoscopy and mucosectomy of these lesions. They were divided in two age groups, below and above 65 years. Results: One hundred-and-eight were women (54%) and 92 men (46%). Most colon lesions were localized in the right colon (95%) and the remaining (5%) in the rectum. In endoscopy, 77.20% were granular lesions in patients under 65 years and 77.90% above. Colon histology showed low grade intraepithelial neoplasia, being 69.79% in patients under and 73.70% in above 65 years. In rectum, above 65 years the incidence of high-grade intraepithelial neoplasia was higher (66.70%). Conclusion: The superficial colorectal lesions have been more endoscopically diagnosed today, and the highest incidence is the granular type, both in the colon and rectum, regardless of age. Regardless the age, histologically colon lesions were more as low grade intraepithelial neoplasia. In rectum, there was distinction for both age groups, being more frequent high grade intraepithelial neoplasia in patients over 65 years.

Obstructive sleep apnea in patients with chronic rhinosinusitis with nasal polyps: a cross-sectional study

2019 ◽  
Vol 64 ◽  
pp. 43-47 ◽  
Author(s):  
D.P. Migueis ◽  
G.C.B. Lacerda ◽  
M.C. Lopes ◽  
L.M.S.F. Azevedo-Soster ◽  
L.C.S. Thuler ◽  
...  
Keyword(s):  
Obstructive Sleep Apnea ◽  
Sleep Apnea ◽  
Chronic Rhinosinusitis ◽  
Nasal Polyps ◽  
Cross Sectional Study ◽  
Sectional Study ◽  
Cross Sectional ◽  
Obstructive Sleep
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