The most common tool for the diagnosis of laryngopharyngeal reflux (LPR) is still 24-hours esophageal pH monitoring; there is lack of non-invasive, less expensive and accurate diagnostic tools for this frequent disease. To evaluate the accuracy of immunoserologic pepsin detection in the saliva for the diagnosis of LPR. Cross-sectional study. A two channeled 24-hour esophageal pH monitoring catheter was placed in patients with a suspicion of LPR. During the 24-hour period, each patient gave one sample of sputum for the immunoserologic pepsin detection test. Pathologic gastroesophageal reflux (GER) findings, LPR findings, pH score in the proximal and distal probes when the sputum sample was given were recorded. The sensitivity, specificity, positive and negative predictive values of the pepsin detection test were analyzed and compared to pH monitoring scores. The study group consisted of 20 patients who met the criteria. A positive pepsin detection test was elicited from 6 patients. The sensitivity and specificity of the pepsin detection test was 33% and 100%, respectively. A positive predictive value of 100% was recorded. When the pH results of the pepsin positive patients (PPP) and the rest of the study group in the proximal probe at the sample time were compared, the PPP had an apparent acidic pH value compared to the pepsin negative patients (pH: 3.26 for the PPP, pH: 6.81 for the pepsin negative patients). Pepsin detection in the saliva is a recent method and becoming increasingly popular. Because of the benefits and ease of application, a positive salivary pepsin test in a patient suspected of having LPR can be a cost effective, accurate and alternative diagnostic method. Increasing the daily number of sputum samples may increase the sensitivity of the test.
The etiology and underlying pathogenetic mechanisms in autism spectrum disorder (ASD) are still largely unknown. In this manuscript, a comprehensive review of the studies which are relevant to ASD and CAPD is conducted and the relationship of ASD and central auditory processing disorders (CAPD) is discussed in the light of recent studies on this subject that may provide new paths in the therapeutical perspective. Many studies confirm that most of the individuals with ASD have some degree of sensory dysfunction related to disorders of processing auditory, visual, vestibular and/or tactile stimuli. Among these, some recent studies addressed CAPD. There is an increasing amount of effort for researches about the link between ASD and CAPD. Most of the studies investigating CAPD in patients with ASD use electrophysiological measurements such as mismatch negativity or P300 event related potentials. Besides these, many publications reported deterioration in speech perception and expression in ASD patients which may also be related with CAPD in this unique group of individuals.
20 July 2016 in Brazilian Journal of Otorhinolaryngology
The adherence to medical treatment in allergic rhinitis is poorly evaluated in clinical practice. To evaluate adherence to intranasal corticosteroids in the treatment of allergic rhinitis patients. This prospective study was conducted on adult patients who were admitted to the outpatient clinic of the otolaryngology department tertiary hospital. Patients diagnosed with moderate to severe persistent AR and who had not used any nasal sprays were enrolled in the study. The patients were provided with mometasone furoate nasal sprays. On the 30th day, all participants filled out a questionnaire regarding the factors that may have influenced their adherence to the treatment. Afterwards, each patient filled out the Turkish-language-validated Morisky Medical Adherence Scale (MMAS-8) form. Each factor that may have affected adherence to the prescribed medication was evaluated according to the MMAS-8 score and all variables were analyzed statistically. Fifty-nine adult patients with a mean age of 32.5 years (range 21-52 years) were included in the study. The mean overall MMAS-8 score was 3.64. Two factors were significantly related to low adherence: number of dependent children (p=0.001) and benefit from the medication (p=0.001). In addition, patients with higher education levels seemed to be more adherent than the rest of the group. Clinicians must keep in mind the factors related to non-adherence in order to achieve better treatment outcomes. Therefore, based on our results, patients must be informed that medications should be taken properly regardless of the benefit, and the treatment should be scheduled with respect to daily activities, particularly for patients caring for more than two children.
28 February 2016 in Brazilian Journal of Otorhinolaryngology
A considerable high number of SNHL patients also suffer from dizziness and related vestibular symptoms. To evaluate the association of vestibular dysfunction and sensorineural hearing loss (SNHL) in adult patients. Prospective, double-blinded, controlled studies composed by 63 adult patients without any vestibular symptoms or diagnosed vestibular diseases. Audiological status was measured with pure tone audiometry and the vestibular system was tested with vestibular evoked myogenic potential (VEMP). Patients were divided into two groups: a study group (patients with SNHL) and a control group (patients without SNHL). VEMP results of the groups were calculated and compared. Mean P1 (23.54) and N1 (30.70) latencies were prolonged in the study group (p<0.001) and the amplitudes of the study group were significantly reduced (p<0.001). Both parameters of the VEMP test were abnormal in the study group when compared to the control group. These findings suggest that age-related SNHL may be accompanied by vestibular weakness without any possible predisposing factors for vestibulopathy.
1 December 2014 in International Journal of Pediatric Otorhinolaryngology
Recent advancements in stem cell therapy have led to an increased interest within the auditory community in exploring the potential of mesenchymal stem cells (MSCs) in the treatment of inner ear disorders. However, the biocompatibility of MSCs with the inner ear, especially when delivered non-surgically and in the immunocompetent cochlea, is not completely understood. In this study, we determined the effect of intratympanic administration of rodent bone marrow MSCs (BM-MSCs) on the inner ear in an immunocompetent rat model. The administration of MSCs did not lead to the generation of any oxidative stress in the rat inner ear. There was no significant production of proinflammatory cytokines, tumor necrosis factor (TNF)-α, interleukin (IL)-1β, IL-6 and IL-12, due to BM-MSCs administration into the rat cochlea. BM-MSCs do not activate caspase 3 pathway, which plays a central role in sensory cell damage. Additionally, transferase dUTP nick end labeling (TUNEL) staining determined that there was no significant cell death associated with the administration of BM-MSCs. The results of the present study suggest that trans-tympanic administration of BM-MSCs does not result in oxidative stress or inflammatory response in the immunocompetent rat cochlea.