The role of dietary habits of patients with laryngopharyngeal reflux (LPR) is comparatively underexplored. The aim of the study is to examine dietary habits, onset and course of the disease as well ...as the quality of life of patients with LPR.
The results of the modified food frequency questionnaire (FFQ-m) and laryngopharyngeal reflux health-related quality of life (LPR-HRQL) questionnaires were compared between subjects with and without LPR. There were a total of 100 subjects with LPR and 65 subjects in the control group. The group of subjects with LPR was further randomly divided into two subgroups; the first subgroup was treated with esomeprazole at a dose of 20 mg twice daily combined with the instructions for dietary and general lifestyle changes, and the other with pantoprazole at a dose of 20 mg twice daily combined with the instructions for dietary and general lifestyle changes. Participants were instructed to fill out FFQ-m and LPR-HRQL questionnaires immediately after the initial examination and then after control examinations 30 and 60 days after the initial examination.
Patients with LPR consume more food with high reflux potential, drink more carbonated drinks and juices and have a worse quality of life than the control group (p<0.001). Taking proton pump inhibitors at a dose of 20 mg twice daily in combination with a change in dietary habits such as substituting acidic, spicy, fermented, sweet, fried foods and other foods with a high reflux potential as well as carbonated drinks and juices with the food with a low reflux potential and water significantly reduced the symptoms of LPR and increased the quality of life of the patients (p<0.001).
This is the first study showing the correlation between dietary habits and the quality of life of patients with LPR. The contribution of this research is an objective assessment of the follow-up of patients with LPR that could be used in their regular assessment.
Available studies report conflicting results on the association of body mass index (BMI) and pathohistological features of thyroid cancer. This study aimed to investigate the relationship between BMI ...and the pathohistological features of different thyroid cancer types. We analyzed the following data from 95 patients with thyroid cancer: age, gender, BMI, pathohistological characteristics of cancer (tumor size, multifocality, lymphovascular invasion, extrathyroidal invasion) and the presence of regional metastases. The BMI of all patients with thyroid cancer was 27.1 ± 4.2. Significantly more patients with obesity class I had cancer size less than 2 cm (p = 0.02). There is a significant association between BMI and extrathyroid invasion (p = 0.03; OR, 1.18), but not with lymphovascular invasion, tumor size, and multifocality. We can conclude that although obesity is a risk factor for the development of thyroid cancer, higher BMI is only partially associated with more aggressive pathohistological features of thyroid cancer.
The current study was performed to determine the presence of pepsin in saliva and laryngeal tissue among participants with benign and malignant laryngeal neoplasms.
Case-control study included three ...groups of patients with: (1) benign laryngeal neoplasms, (2) malignant laryngeal neoplasms and (3) control subjects without symptoms or signs of laryngopharyngeal reflux (LPR).
Eighty-one voluntary participants were included into study. They were recruited from a group of patients with histologically proven benign and malignant laryngeal neoplasms and in case of control subjects among patients with nasal septum deformation without symptoms of LPR. Morning saliva samples were collected preoperatively. Tumor biopsies were collected by directoscopy of larynx and the control samples from interarytenoid unit of larynx. All samples were analyzed by Enzyme-Linked Immunosorbent Assay (ELISA) and Immunohistochemistry.
Pepsin was found in all samples of saliva and tissue biopsies in groups with malignant and benign neoplasms. The highest concentration of pepsin was found in a group of patients with malignant laryngeal neoplasms. Patients with benign laryngeal neoplasms had lower concentrations and the control subjects presented with the lowest concentration of pepsin measured from their saliva. Differences were not statistically significant. Immunohistochemical (IHC) analysis showed the largest number of high positive samples in the group of malignant lesions.
These results suggest that pepsin and LPR can contribute to the development of benign and malignant laryngeal neoplasms. Further prospective studies, with far more patients, are necessary to prove the role of pepsin in multifactorial etiology of laryngeal neoplasms.
Due to cannabidiol's health benefits and absence of serious side effects, its use is constantly growing. This is a survey-based cross-sectional study that was conducted to determine Croatian ...pharmacists', physicians', and students' knowledge and attitudes about cannabidiol (CBD). Two questionnaires were created, one for students and the other for physicians and pharmacists. Our participants (in total 874: 473 students and 401 physicians and pharmacists) generally had positive attitudes towards CBD therapy as approximately 60% of them believe that CBD treatment is generally efficacious. Participants had positive attitudes toward the therapeutic value of CBD, especially pharmacists and pharmacy students (63.8% and 72.2%, respectively). Pharmacists were significantly more convinced that CBD could reduce the use of opioids prescribed for chronic pain (
< 0.05). Only 17.5% of students had read scientific papers about CBD, compared to a significantly higher percentage of physicians and pharmacists (43.0% and 47.8%, respectively) (
< 0.05). This study revealed a gap in knowledge regarding CBD, since 89.3% of pharmacists and physicians, as well as 84.8% of students, believe they need more education about CBD. We conclude that it is important to improve the educational curricula so that medical professionals can recommend CBD use to their patients when needed.
This report aimed to investigate the relationship after successful left-sided stapedotomy and postoperative benign paroxysmal positional vertigo (BPPV) due to vitamin D deficiency. A 56-year-old ...woman presented with a complaint of progressive hearing loss and tinnitus in the left ear without dizziness. A successful left-sided stapedotomy was performed, confirming the diagnosis of otosclerosis and closing the air-bone gap to less than 10 dB. Seven days after the stapedotomy, the patient reported dizziness, usually when turning to her left side in the bed. An electrophysiological assessment was performed to investigate vestibular function. Dix Hallpike maneuver showed a typical response, about 5 seconds after repositioning the head, and geotropic, torsional rotary nystagmus of about 30 seconds was registered. Vitamin D deficiency in serum was found. Complete symptom remission was achieved after 7-day-treatment with Epley's maneuver. As a postoperative vertigo complication, BPPV often remains unrecognized after stapes surgery. Canalith repositioning maneuver is treatment for BPPV. Determining serum levels of total calcium and vitamin D may play a significant role in monitoring and reducing the recurrence of dizziness.
In recent years, the prevalence of laryngopharyngeal reflux has risen, especially among pediatric patients. The diagnosis of laryngopharyngeal reflux relies on patient history and clinical assessment ...using the Reflux Finding Score and Reflux Symptom Index as crucial diagnostic tools. Some studies have proposed a link between pepsin and laryngopharyngeal reflux, potentially triggering palatine tonsil hypertrophy. Our study aimed to investigate the correlation between laryngeal and pharyngeal manifestations of laryngopharyngeal reflux through two questionnaires and the presence of pepsin in saliva and palatine tonsils in a pediatric population. Pepsin in saliva was detected using a Western blot method, while immunohistochemistry assessed its presence in palatine tonsils. Although no statistically significant differences in Reflux Finding Score and Reflux Symptom Index were found between the immunohistochemistry-positive (IHC-positive) and immunohistochemistry-negative (IHC-negative) groups, median reflux symptom index and Reflux Finding Score values consistently trended higher in the IHC-positive group. This suggests a potential connection between elevated index values and pepsin presence in tonsillar tissue. Further investigations are essential to fully comprehend the clinical implications of these findings.
Previous studies suggest the effectiveness of hyperbaric oxygen treatment (HBOT) in idiopathic sudden sensorineural hearing loss (ISSNHL) but it is mostly used as an adjuvant and salvage treatment. ...This study evaluated the effect of primary HBOT according to pretreatment hearing grades and hearing recovery outcomes using modified Siegel's criteria in patients with ISSNHL.
Fifty-nine ISSNHL patients treated with only HBOT were included. A pure-tone audiogram was recorded before and after a course of HBOT (90 min at 203 kPa daily for 20 days). Using the modified Siegel's criteria, patients were divided into groups according to hearing threshold before and after treatment.
Hearing thresholds were significantly lower after HBOT compared to pre-treatment values across all patients (P < 0.001) with a median value of recovery of 22.5 dB (interquartile range 12.5-33.7 dB). Significantly lower hearing threshold values were recorded at 500, 1,000, 2,000, and 4,000 Hz after treatment (P < 0.001). The greatest recovery was at 1,000 Hz, (change in median threshold = 32 dB) but without a significant difference compared to other frequencies (P = 0.10).
HBOT is a legitimate choice as the primary treatment for ISSNHL, especially if it is readily accessible, and if there are contraindications for corticosteroid therapy.
This study aimed to investigate the association between type 2 diabetes mellitus (T2DM), antidiabetic therapy, hypothyroidism, and thyroid cancer. We analyzed data from 320 patients who underwent ...thyroid surgery for suspicion of cancer. The diagnosis of thyroid cancer was confirmed by histopathological analysis in 95 patients. No significant difference was found in the diagnosis of T2DM and hypothyroidism concerning the presence of thyroid cancer (p=0.13; p=0.85), nor in the gender of patients with T2DM and hypothyroidism with respect to the type of thyroid cancer (p=0.19; p=0.25). Patients with T2DM (Odds ratio OR 1.89; 95% CI, 0.856-4.163) and patients with hypothyroidism (OR, 1.05; 95% CI, 0.530-2.164) had higher prevalence of thyroid cancer, as did those who had both diagnoses combined (p=0.37; OR, 2.39; 95% CI, 0.333-17.278), compared with the patients who did not have those diagnoses. Men with T2DM (OR, 6.19; 95% CI, 1.180-32.513) had higher prevalence of thyroid cancer than women. Patients who were on oral antidiabetics (OR, 1.91; 95% CI, 0.804-4.512) had higher prevalence of thyroid cancer than those receiving insulin. According to the results of this study, we can conclude that there is an association between T2DM, hypothyroidism, oral antidiabetics, and thyroid cancer.
Papillary thyroid cancer accounts for 80-85% of diagnosed thyroid cancers, while follicular, medullary, and anaplastic cancers are diagnosed significantly less frequently. This study aimed to show ...the characteristics of malignant thyroid tumors. In this retrospective study, we analyzed data from 320 patients who underwent thyroid surgery from January 2018 to December 2019. We recorded and statistically analyzed basic demographic data, data of the cytological and pathohistological findings, and tumor characteristics (size, multifocality, extrathyroidal and lymphovascular invasion). Thyroid cancer was diagnosed in 95 patients. The incidence of thyroid cancer was higher in women than in men, but without a significant difference (p=0.46). There was a significant difference between preoperative cytological findings and definitive pathohistological diagnosis (p=0.001). There was no significant difference between genders in tumor size, extrathyroidal and lymphovascular invasion, and multifocality. There were significantly more thyroid cancers with a lymphovascular invasion that were less than 2 cm in size (p=0.04). In our opinion, it is important to emphasize the value of early diagnostics and analysis of the malignant tumor characteristics that are major prognostic factors for survival in patients with thyroid cancer.
Ocular vestibular evoked myogenic potentials (oVEMP) and cervical VEMP (cVEMP) are newer diagnostic methods, which allow an insight into the otolith senses. Our aim was to determine changes in ...certain parameters of the VEMP wave complex after successfully performed repositioning procedure, as an indicator of the state of recovery in patients with benign paroxysmal positional vertigo (BPPV). This may confirm the theory of otolith returning into the area of otolithic senses. The study included 48 patients with unilateral posterior semicircular canal BPPV. On their first arrival, otoneurological examinations, oVEMP and cVEMP tests were performed. The same were included in follow up check-ups scheduled at seven days and six months after successful implementation of Epley maneuvers. The initial measurement revealed a significantly reduced amplitude of oVEMP on the affected side. On the 7-day measurement, the amplitude increase was observed on the affected side, with significant reduction in the amplitude ratio (p=0.693), which reached statistical significance on the last measurement at 6 months (p=0.006). These findings confirmed the hypothesis of the return of otoconia into the utricular area.
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