Risk factors for cholesterol polyp formation in the gallbladder are closely related to lipid metabolism

Background The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Methods This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients who underwent cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with a diagnosis of pathologically confirmed cholesterol polyps larger than 10 mm. Population characteristics and medical data were collected within 24 h of admission before surgery. The non-polyp group included participants from the hospital physical examination center database. They had at least two ultrasound examinations with an interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4714 participants were recruited, including 376 cholesterol polyp patients and 4338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyps were age, male sex, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), and higher aspartate aminotransferase (AST) and alanine aminotransferase (ALT) levels. In multivariate logistic analysis, independent risk factors were age > 50 years (odds ratio [OR] = 3.02, 95% confidence interval [CI] 2.33–3.91, P < 0.001], LDL > 2.89 mmol/L (OR = 1.38, 95% CI 1.08–1.78, P = 0.011), lower HDL (OR = 1.78 95% CI 1.32–2.44, P < 0.001), AST > 40 IU/L (OR = 3.55, 95% CI 2.07–6.07, P < 0.001), and BMI > 25 kg/m 2 (OR = 1.32, 95% CI 1.01–1.72, P = 0.037). Conclusions Age, LDL, HDL, AST, and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk for cholesterol polyps.

Risk Factors for Cholesterol Polyp Formation In The Gallbladder - Closely Related to Lipid Metabolism

Objective The purpose of this study was to assess the risk factors for cholesterol polyp formation in the gallbladder. Method This was a multicenter retrospective study based on pathology. From January 2016 to December 2019, patients receiving cholecystectomy and non-polyp participants confirmed by continuous ultrasound follow-ups were reviewed. Patients in the cholesterol polyp group were recruited from three high-volume centers with diagnosis of pathologically confirmed cholesterol polyps larger than 10mm. Population characteristics and medical data were collected within 24 hours of admission before surgery. The non-polyp group included participants from hospital physical examination center database. They had at least two ultrasound examinations with the interval longer than 180 days. Data from the final follow-up of the non-polyp group were analyzed. The risk factors for cholesterol polyp formation were analyzed by comparing the two groups. Results A total of 4 714 participants were recruited, including 376 cholesterol polyp patients and 4 338 non-polyp participants. In univariate analysis, clinical risk factors for cholesterol polyp were age, male gender, higher body mass index (BMI), higher low-density lipoprotein (LDL), lower high-density lipoprotein (HDL), higher aspartate aminotransferase (AST), and alanine aminotransferase (ALT). In multivariate logistic analysis, independent risk factors were age>50 years (OR=3.41, 95% CI 2.61-4.47, p<0.001), LDL>2.89mmol/L (OR=1.45, 95% CI 1.13-1.87, p=0.003), AST>40IU/L (OR=3.58, 95% CI 2.03-6.31, p<0.001) and BMI>25kg/m² (OR=1.62, 95% CI 1.23-2.13, p<0.001). Conclusion Age, LDL, AST and BMI are strong risk factors for cholesterol polyp formation. Older overweight patients with polyps, accompanied by abnormal lipid levels, are at high risk of cholesterol polyps.

Effect of lipopolysaccharide and polyinosinic:polycytidylic acid in a murine model of nasal polyp

Several factors, including bacterial and viral infections, have been associated with rhinosinusitis and nasal tissue remodelling that may result in nasal polyp formation. However, the potential role of bacterial or viral stimuli triggering polyp development is unclear. Here, we used lipopolysaccharide (LPS) and polyinosinic:polycytidylic acid [poly(I:C)] in a murine model of allergic rhinosinusitis to compare different effects of bacterial- and virus-derived stimuli in the pathogenesis of nasal polyp formation. Briefly, BALB/c mice were sensitised and challenged with ovalbumin and staphylococcal enterotoxin, with or without LPS or poly(I:C), and the consequent histopathological profiles, cytokines, and systemic humoral responses were studied. While no significant differences in polyp formations and epithelial disruptions were observed among the experimental groups, the local cell recruitment patterns slightly differed in animals that received either LPS or poly(I:C). Additionally, the local immune environments generated by LPS or poly(I:C) stimulation varied. LPS stimulation induced a marked Th1/Th17 response and predominantly neutrophilic nasal polyp formations, whereas poly(I:C) induced a Th2-skewed environment in neutrophilic nasal polyp development. Overall, our findings show that both cell recruitment patterns and local immune environments induced by these two stimuli differ, which may have implications in the physiopathology of rhinosinusitis with nasal polyp.

Recurrent polyp formation with Candida tropicalis infection and otitis in a dog

ZusammenfassungFallbericht einer wiederkehrenden Otitis externa, media und interna durch Candida tropicalis bei einem Hund mit einem Ohrpolypen. Ein 9-jähriger Irischer Setter wies im Abstand von 7 Monaten jeweils linksseitig eine Otitis, ein Vestibulärsyndrom sowie ein Horner-Syndrom auf. Bei der ersten Episode wurde ein gutartiger Ohrpolyp extrahiert und Candida tropicalis aus dem Mittelohr kultiviert. Die neurologischen Symptome sistierten innerhalb von 7 Tagen, die Candida-Infektion war schwieriger zu behandeln. Nach 7 Monaten wurde erneut ein Polyp im Ohr festgestellt und der zytologische Befund war wieder kompatibel mit Candida tropicalis. Eine vollständige Ablation des linken Gehörgangs mit lateraler Bullaosteotomie wurde durchgeführt und eine Kultur aus dem Mittelohr bestätigte Candida tropicalis. Die Behandlung führte zur klinischen Remission. Candida tropicalis, ein zunehmend häufiger auftretendes Pathogen, sollte in Fällen rezidivierender Otitis durch Hefen in Betracht gezogen werden. Die Behandlung kann sich schwierig gestalten.

A rare case report of laryngopharyngeal polyp formation following anterior cervical discectomy and fusion (ACDF)

Background Anterior Cervical Discectomy and Fusion (ACDF) has been regarded as the “gold standard” treatment of cervical spondylosis. Though it has good outcomes, many complications still exist, such as loss of fixation, degeneration of adjacent segments, dysphagia and pharyngeal perforation. In view of current literature, this study is the first to report a case of laryngopharyngeal polyp following ACDF. Case presentation A 63 year old male patient suffered from cervical spine hyperextension after trauma accompanied by numbness of the hands and decreased muscle strength in both upper limbs. Anterior cervical fusion surgery was performed in our hospital, after which the patient’s upper limb numbness disappeared and muscle strength returned to normal. In the fifth month after surgery, the patient developed a sore throat and dysphagia. Symptoms gradually worsened, and the patient was hospitalized four times, subsequently undergoing tracheotomy, internal fixation removal, and polypectomy. The patient’s pronunciation, breathing, and swallowing functions returned to normal, and the incision healed. After a one-year follow-up, the polyp did not recur. Conclusions Laryngopharyngeal polyp formation following ACDF has yet to be reported in literature. By excluding esophageal fistula as soon as possible, removing internal fixation and polypectomy serves as the best treatment in relieving patient symptoms.

Comparison of Bioabsorbable Steroid-Eluting Sinus Stents Versus Nasopore After Endoscopic Sinus Surgery: A Multicenter, Randomized, Controlled, Single-Blinded Clinical Trial

Objectives: The aim of this study was to compare the efficacy of bioabsorbable steroid-eluting sinus stents versus absorbable Nasopore packs after endoscopic sinus surgery (ESS) for the treatment of chronic rhinosinusitis (CRS). Methods: One hundred eighty-one patients with CRS who underwent ESS were randomly assigned to receive a steroid-eluting sinus stent in one ethmoid sinus cavity, whereas the contralateral control side received a Nasopore pack. Endoscopic evaluations were performed 14, 30, and 90 days after the ESS. Postoperative intervention, polyp formation, adhesions, and middle turbinate (MT) position were assessed as efficacy outcomes. Results: The stents were successfully deployed in all 181 sinuses. Thirty days after the ESS, the stents significantly reduced the need for surgical intervention compared to the Nasopore ( P < .0001). The percentage of cases with polyp formation was significantly lower on the stent sides compared with the Nasopore sides ( P < .0001) at 14, 30, and 90 days after ESS. The percentage of severe adhesion was significantly lower on the stents sides than on the Nasopore sides at postoperative day 90 ( P = .0003), whereas they were not significantly lower at postoperative days 14 and 30. There were no significant differences between the stent sides and the Nasopore sides regarding the frequency of MT lateralization at all end points. No device-related adverse events occurred. Conclusions: Our study demonstrated significant improvement in the early postoperative outcomes by reducing the need for postoperative surgical intervention and polyp formation using steroid-eluting stents when compared with absorbable Nasopore packs. The steroid-eluting sinus stents and the Nasopore packs were each effective in preserving the ethmoid sinus patency and in preventing MT lateralization. A further prospective cohort study with long-term postoperative outcomes is warranted.