Staphylococcus aureus secretes numerous exotoxins which may exhibit superantigenic properties. Whereas the virulence of several of them is well documented, their exact biological effects are not ...fully understood. Exotoxins may influence the immune and inflammatory state of various organs, including the sinonasal mucosa: their possible involvement in chronic rhinosinusitis has been suggested and is one of the main trends in current research. The aim of this study was to investigate whether the presence of any of the 22 currently known staphylococcal exotoxin genes could be correlated with chronic rhinosinusitis.
We conducted a prospective, multi-centred European study, analysing 93 Staphylococcus aureus positive swabs taken from the middle meatus of patients suffering from chronic rhinosinusitis, with or without nasal polyposis, and controls. Strains were systematically tested for the presence of the 22 currently known exotoxin genes and genotyped according to their agr groups. No direct correlation was observed between chronic rhinosinusitis, with or without nasal polyposis, and either agr groups or the presence of the most studied exotoxins genes (egc, sea, seb, pvl, exfoliatins or tsst-1). However, genes for enterotoxins P and Q were frequently observed in nasal polyposis for the first time, but absent in the control group. The number of exotoxin genes detected was not statistically different among the 3 patient groups.
Unlike many previous studies have been suggesting, we did not find any evident correlation between staphylococcal exotoxin genes and the presence or severity of chronic rhinosinusitis with or without nasal polyposis.
Acute promyelocytic leukaemia is a very aggressive form of leukaemia related to a characteristic acquired somatic mutation; it is highly curable when proper chemotherapy is associated to all-trans ...retinoic acid early in the course of the disease.
Abstract Introduction Submandibular gland sarcoidosis is rare and little is known about its clinical presentation besides the usual neck swelling. The aim of the study was to extract clinical ...knowledge on submandibular sarcoidosis from the literature. Methods A systematic review was performed using a search in Medline with the key-words “sarcoidosis,” “submandibular,” “submaxillary.” Results Forty-six articles fitting the search criteria were found, whereas 31 had to be excluded because they did not report submandibular gland sarcoidosis. Twenty cases of submandibular gland sarcoidosis were considered suitable for analysis. Almost all reported cases concerned female patients. In some cases submandibular gland's swelling is the first and only manifestation of the disease. Conclusion Sarcoidosis should be considered in the differential diagnosis of all progressive and painless swellings of the submandibular gland, especially in women. Rarely, it may be the first manifestation of the disease.
Learning points Patients reporting unilateral nasal symptoms (epistaxis, new-onset discharge and progressive obstruction), unexplained maxillary pain or hypoaesthesia should be referred to an ...otolaryngologist for nasal endoscopy.
An adult patient presented to the emergency department with pharyngeal discomfort on swallowing, persisting several hours after lunch. Transnasal fibre-optic endoscopy performed by an ...otolaryngologist identified a hypopharyngeal foreign body, and the stalk of a dry leaf partially penetrating the mucosa was easily removed under general anaesthesia. Symptoms regressed completely and the patient was discharged. Two days later he presented again, reporting slight dysphagia without odynophagia or other associated symptoms. Meticulous physical examination by the same otolaryngologist revealed this time a slight asymmetry of the posterior pharyngeal wall. A history of recent pharyngeal trauma and findings on clinical examination raised clinical suspicion of retropharyngeal abscess which was supported by CT scan findings. The diagnosis was confirmed in the operating theatre where a purulent collection was drained under new general anaesthesia.
Learning points The mandibular nerve carries motor and sensory fibres, the latter distributed to part of the face and the mouth (temporal region, part of the pinna, cheek, chin, lower lip, cheek ...mucosa, floor of the mouth and anterior 2/3 of the tongue). ...the lingual nerve's connection to the corda tympani transfers taste fibres from the mobile tongue and parasympathetic fibres to the submandibular ganglion.
HPV associated head and neck cancers Vourexakis, Zacharias; Dulguerov, Pavel
Revue médicale suisse,
2011-Oct-05, Volume:
7, Issue:
311
Journal Article
Peer reviewed
The incidence of oropharyngeal squamous cell carcinoma is rising and this increase is linked to sexual behaviors. Viral and epidemiological studies have linked tonsillar and base of tongue carcinoma ...with a human papilloma virus (HPV) infection. The patients involved are usually younger and do not exhibit other risk factors such as smoking and alcohol abuse. HPV positive squamous cell carcinoma are associated with a better prognosis than other head and neck carcinoma. Differences in the carcinogenesis mechanisms open options for different and specific oncologic treatments and the potential for prevention of these HPV-related carcinoma by vaccination.
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