A “Terrible” Headache in a HIV Patient Stavrakas, Marios; Koskinas, Ioannis; Constantinidis, Jannis ...
Ear, nose, & throat journal,
07/2023, Letnik:
102, Številka:
7
Journal Article
Recenzirano
Odprti dostop
Mucormycosis is a type of fungal infection more prevalent among immunosuppressed patients, requires prompt identification and surgical treatment, as it can is associated with local and distant ...spread. This case is aiming to highlight the importance of early identification of subtle symptoms in immunocompromised patients. The clinician should be aware of fungal sinusitis, consider it in the differential diagnosis, and seek for an ear, nose, and throat opinion.
The development of smart immune evasion mechanisms is crucial for the establishment of acute and chronic viral hepatitis. Hepatitis is a major health problem worldwide arising from different causes, ...such as pathogens, metabolic disorders, and xenotoxins, with the five hepatitis viruses A, B, C, D, and E (HAV, HBV, HCV, HDV, and HEV) representing the majority of the cases. Most of the hepatitis viruses are considered enveloped. Recently, it was reported that the non-enveloped HAV and HEV are, in reality, quasi-enveloped viruses exploiting exosomal-like biogenesis mechanisms for budding. Regardless, all hepatitis viruses use exosomes to egress, regulate, and eventually escape from the host immune system, revealing another key function of exosomes apart from their recognised role in intercellular communication. This review will discuss how the hepatitis viruses exploit exosome biogenesis and transport capacity to establish successful infection and spread. Then, we will outline the contribution of exosomes in viral persistence and liver disease progression.
In this special issue of the Ear Nose and Throat (ENT) journal entitled Lasers in Otolaryngology, we attempted to cover and accommodate different experiences from around the globe on both established ...and some not so well-known techniques and indications for Lasers in most ENT subspecialties. Despite the COVID 19 pandemic, authors from all over the world have expressed their interest in publishing their Laser experiences with ENT journal and for this we are very grateful.
Lasers have been used in otolaryngology for more than 40 years and are widely considered an established way of addressing laryngeal pathology, benign and malignant. Carbon dioxide (CO2) laser is ...considered a gold standard, but over the last 2 decades, a new technology has been developed and established in other medical specialties, not so much in Ear Nose and Throat (ENT), the diode laser. It consists of a flexible fiber that passes through a hollow guidance system and is capable of reaching certain angled spots easier than straight beam systems. Portability, lower cost, easier setup, and improved photocoagulation are just some of the many features rendering it an excellent choice for the surgeon and the patient. The few studies published worldwide for the usage and efficacy of this system show no major differences related to the oncologic outcome and survival rate of patients having an early glottic tumor between diode laser microsurgery and CO2 laser cordectomy. Nevertheless, the advantages offered by fiber-optic laser surgery render it a worthy and perhaps equal alternative for treating this kind of pathology.
Background:
To demonstrate the efficacy of a new laser surgical technique for bilateral vocal fold immobility (BVFI) on postoperative quality of voice and swallowing.
Methods:
Prospective study in a ...tertiary university hospital and a private hospital. Patients with iatrogenic BVFI were included. Outcome measures were Voice Handicap Index 10, 10-item Eating Assessment Tool, flexible laryngoscopy, and success of decannulation.
Results:
Forty patients with post thyroidectomy BVFI were initially enrolled in our study; only 12 patients returned questionnaires and kept their follow-ups and were included in the study. All patients were successfully decannulated and remain decannulated up to 24-month follow-up. There was a statistically significant improvement in quality of swallowing and no significant deterioration in quality of voice. There was no need for revision up to 24-month follow up.
Conclusions:
The “Π” technique using diode laser technology is a new and safe technique for BVFI with excellent long-term decannulation rates and improvement in quality of life and swallowing without significant changes in voice quality.
Unlocking flexibility on the demand side is a prerequisite for balancing supply and demand in distribution networks with high penetration levels of renewable energy sources that lead to high ...volatility in energy prices. The main means of fully gaining access to the untapped flexibility is the application of demand response (DR) schemes through aggregation. Notwithstanding, to extract the utmost of this potential, a combination of performance-, financial-, and technical-related parameters should be considered, a balance rarely identified in the state of the art. The contribution of this work lies in the introduction of a holistic DR framework that refines the DR-related strategies of the aggregator towards optimum flexibility dispatch, while facilitating its cooperation with the distribution system operator (DSO). The backbone of the proposed DR framework is a novel constrained-objective optimisation function which minimises the aggregator’s costs through optimal segmentation of customer groups based on fairness and reliability aspects, while maintaining the distribution balance of the grid. The proposed DR framework is evaluated on a modified IEEE 33-Bus radial distribution system where a real DR event is successfully executed. The flexibility of the most fair, reliable and profitable sources, identified by the developed optimisation function, is dispatched in an interoperable and secure manner without interrupting the normal operation of the distribution grid.
Tracheal metastasis from papillary thyroid carcinoma (PTC) is an unprecedented and rare entity. We present the case of a 65 year-old lady who suffered from dyspnea and a thyroid goiter that turned ...out to be PTC. A magnetic resonance imaging (MRI) scan of the lungs revealed a huge tracheal mass causing obstruction of the tracheal lumen. She underwent a surgical tracheostomy and diode laser debulking of the tumor. Following this, she had a total thyroidectomy and postoperative radioiodine ablation and radiotherapy. She remains well under close and regular follow-up. A secondary tracheal tumor usually comes from a lymphatic spread of the primary tumor, whereas the vascular route is rarely reported. Endoscopic minimally invasive laser tracheal surgery with adjuvant radiotherapy appears to be equally effective to more aggressive tracheal resections.
Defective interfering (DI) RNAs have been detected in several human viruses. HCV in-frame deletions mutants (IFDMs), missing mainly the envelope proteins, have been found in patient sera and liver ...tissues. IFDMs replicate independently and can be
-packaged into infectious virions in the presence of full length viral genome. So far, their biological role is unclear. In this study, we have isolated and cloned IFDMs from sera samples and liver tissues of patients infected with HCV genotypes 1b, 2a, and 3a. IFDMs were present in up to 26% of samples tested. Using the
HCV cell culture system, co-expression of the wild type (wt) HCV replicon with HCV IFDMs RNA resulted in increased HCV replication. Additionally, co-transfection of the HCV full length genome RNA and a defective mutant missing the envelope region led to increased viral release, collectively suggesting an important biological role for IFDMs in the virus life cycle. Recently, exosomes, masters of intercellular communication, have been implicated in the transport of HCV viral genomes. We report for the first time that exosomal RNA isolated from HCV sera samples contains HCV defective genomes. We also demonstrate that inhibition of exosomal biogenesis and release influences HCV viral replication. Overall, we provide evidence that the presence of HCV IFDMs affects both viral replication and release. IFDMs exploit exosomes as means of transport, a way to evade the immune system, to spread more efficiently and possibly maintain persistent infection.
BACKGROUND The first gastric resection for stomach cancer was performed in 1879, and the first gastric resection for gastric ulcer disease was performed in 1882. During the 1990s, the first ...laparoscopic gastrostomies were reported. During the past decade, laparoscopic techniques have developed rapidly, gaining wide clinical acceptance. Minimally invasive surgery is now shifting the balance away from traditional open methods. We report 2 cases of endoscopically assisted laparoscopic local gastric resections for both gastric cancer and gastric ulcer disease. CASE REPORT The first case involves a 67-year-old male patient who suffered from recurrent bleeding from a gastric ulcer located 4-5 cm from the gastroesophageal junction. The patient was subjected to endoscopically assisted laparoscopic wedge resection of the affected part of the stomach, had an uneventful recovery and was discharged on the third postoperative day. The second case involves a 60-year-old female patient who was diagnosed with intramucosal gastric adenocarcinoma and was also subjected to endoscopically assisted laparoscopic wedge gastrectomy. This patient also had an uneventful recovery and was discharged on the second postoperative day. CONCLUSIONS Endoscopically assisted laparoscopic local gastric resection is a minimally invasive procedure which allows the surgeon to operate under direct visualization of the internal part of the stomach. Thus, it enables the surgeon to safely remove the affected part within healthy margins, providing the patient with all the advantages of laparoscopic surgery.
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