Search Results (43)

Background: Adenotonsillectomy (AT) is a common surgical procedure among pediatrics, usually performed to treat obstructive sleep apnea (OSA), recurrent tonsillitis, and chronic adenoid hypertrophy. The aim of our systematic review is to evaluate the relationship between AT and postoperative weight gain in children to guide clinicians in optimizing surgical outcomes. Methods: A systematic search was conducted following the PRISMA guidelines in PubMed, MEDLINE, and Web of Science databases. Studies evaluating weight, BMI, and growth parameters before and after AT were included. Data were collaboratively extracted, including patient demographics, baseline weight status, comorbidities, and long-term outcomes. Results: Underweight children (less than the 3rd percentile on the growth chart) who underwent AT often experienced “catch-up growth” in weight, while obese children (above the 95th percentile on the growth chart) had postoperative weight gain that exacerbated pre-existing obesity. These outcomes were affected by factors such as baseline weight, age, and comorbid conditions. Conclusions: AT can improve the quality of life in underweight children, while overweight or obese children need careful monitoring and nutrition counseling postoperatively to mitigate excessive weight gain. More randomized trials are needed to better understand the metabolic and growth implications of AT and to refine clinical guidelines. Full article

Background and Objectives: Actinomycosis is a rare chronic contagion caused by Actinomyces spp. known for its ability to mimic malignant processes across various anatomical locations. Its clinical presentation can often resemble malignancies, Mycobacterium tuberculosis infections, nocardiosis, fungal infections, or other granulomatous diseases. This case series presents three patients diagnosed with Actinomyces spp., highlighting the diagnostic challenges and diverse clinical manifestations of the disease. Materials and Methods: We reviewed the clinical course, diagnostic procedures, and treatment outcomes of three patients with confirmed Actinomyces spp. The first case involved a 51-year-old male with a history of rhabdomyosarcoma in remission who presented with dysphagia. Magnetic resonance imaging identified an irregularly enhancing mass in the tonsil, and subsequent tonsillectomy confirmed Actinomyces spp. The second patient, an 80-year-old female, presented with dysphagia and a sublingual mass initially suspected to be diffuse large B-cell non-Hodgkin lymphoma; however, a histopathological analysis confirmed Actinomyces spp. The third case involved a 72-year-old male with abdominal pain and an ulcerated gastric lesion, where subtotal gastrectomy and histopathological examination confirmed the diagnosis of Actinomyces spp. Results: These three cases highlight the ability of Actinomyces spp. to closely mimic malignant lesions, which significantly complicates the diagnostic process. Although personalized interventions were required for each patient, diagnoses were ultimately confirmed through histopathology. Despite these challenges, timely recognition and appropriate treatment were achieved, underscoring the need to consider Actinomyces spp. in the differential diagnosis of similar presentations. Conclusions:Actinomyces spp. remains a diagnostic challenge due to its ability to mimic a variety of malignant and contagion conditions. This case series emphasizes the need for a thorough histopathological examination and a high index of suspicion when encountering lesions with atypical presentations. Given the potential for misdiagnosis, awareness and consideration of Actinomyces spp. are crucial in the differential diagnosis of chronic contagion and mass lesions. Further studies are warranted to refine diagnostic and therapeutic approaches. Full article

Background: HIV-1 infection, even with effective antiretroviral therapy (ART), is associated with chronic inflammation and immune dysfunction, contributing to long-term health complications. Nicotine use, prevalent among people with HIV (PWH), is known to exacerbate immune activation and disease progression, but the precise biological mechanisms remain to be fully understood. This study sought to uncover the synergistic effects of HIV-1 infection and nicotine on immune cell function, focusing on beneficial insights into NLRP3 inflammasome activation, oxidative stress, and mitochondrial pathways. Methods: Human tonsil explants were infected with HIV-1 and exposed to nicotine. Single-cell RNA sequencing was used to profile immune cell populations and gene expression linked to inflammasome activation, oxidative stress, and mitochondrial function. Gene set enrichment analysis (GSEA) and synergy assessments were conducted to investigate how nicotine modulates immune responses in the context of HIV. Results: The combination of HIV infection and nicotine exposure significantly increased NLRP3 inflammasome activation, thioredoxin, and components of oxidative phosphorylation. Conclusions: This study highlights how the combined effects of HIV-1 and nicotine offer valuable insights into immune modulation, opening doors for future therapeutic strategies. Targeting the NLRP3 inflammasome and addressing nicotine use may contribute to improved outcomes for PWH. Full article

Trollius chinensis Bunge (TCB) is a perennial plant of the Ranunculaceae family with medicinal and edible values. It is widely distributed and commonly used in various regions, including Asia, Europe, and North America. The main chemical components of TCB include alkaloids, flavonoids, phenolic acids, and volatile oil compounds. TCB is renowned for its anti-inflammatory, heat-clearing, detoxifying, and eyesight-improving properties. Its dried flowers are commonly used as a traditional Chinese medicine indicated for the treatment of upper respiratory tract infections, chronic tonsillitis, pharyngitis, influenza, and bronchitis. Modern pharmacology has demonstrated the anti-cancer, anti-inflammatory, antihypertensive, and antioxidant effects of TCB. This study presents a comprehensive overview of various aspects of TCB, including herbal textual research, botany, phytochemistry, pharmacology, traditional uses, clinical application, and quality control, aiming to provide new ideas on the scientific application of TCB as well as the integration of modern research with traditional medicinal uses. Full article

Tonsillectomy with steroid pulse therapy (SPT) has been established as an effective treatment for immunoglobulin A nephropathy (IgAN) in Japan. However, the underlying mechanisms supporting tonsillectomy remain unclear. This study assessed palatine tonsils from 77 patients with IgAN, including 14 and 63 who received SPT before and after tonsillectomy, respectively. Tonsils from 21 patients with chronic tonsillitis were analyzed as controls. Specific tonsillar lesions were confirmed in patients with IgAN, correlating with active or chronic renal glomerular lesions and SPT. T-nodule and involution of lymphoepithelial symbiosis scores in tonsils correlated with the incidence of active crescents and segmental sclerosis in the glomeruli, respectively. The study revealed an essential role of the tonsil–glomerular axis in early active and late chronic phases. Moreover, the SPT-preceding group demonstrated no changes in the T-nodule score, which correlated with active crescent formation, but exhibited a considerable shrinkage of lymphatic follicles that produced aberrant IgA1. The study underscores the involvement of innate and cellular immunity in IgAN and advocates for tonsillectomy as a necessary treatment alongside SPT for IgAN, based on a stepwise process. Full article

Background/Objectives: Patients with rheumatoid arthritis (RA) are prone to develop infections. Methods: Accordingly, 195 untreated early (e)RA patients and 398 healthy controls were selected from women in Tatarstan’s cohort to study infectious history in the anamnesis (four criteria) and in the previous year (16 criteria). Information about annual infections was collected face-to-face from year to year by a qualified rheumatologist/general practitioner and included the active use of information from medical records. Results: In the anamnesis, tuberculosis, and pneumonia, and in the previous year, respiratory tract infections, skin infections, and herpes simplex virus reactivation incidence were reported to be increased in eRA patients, as well as the event number and duration of acute and chronic tonsillitis. Moreover, more bacterial-suspected upper respiratory infections and urinary tract infections were retrieved in sporadic eRA patients as compared to familial eRA patients. An elevated immunization against CCP prevented respiratory tract infection in those with HSV exacerbation. Finally, associations were retrieved between infection (event number/delay) and RA indices: (i) chronic tonsillitis exacerbations with disease activity and health assessment (HAQ) in familial eRA; (ii) bacterial-suspected upper respiratory infections with the number of swollen and tender joints in sporadic eRA; and (iii) HSV exacerbation with inflammation in eRA patients with negative/low response against CCP. Here, we demonstrate the complex nature of the interplay of RA with specific infections. Conclusions: For the first time, differences in the patterns of annual trivial infections and their links with RA indices were found in cohorts of familial and sporadic cases of the disease. Additionally, for the first time, we identified a remarkable relationship between early RA and exacerbations of chronic tonsillitis, as well as tuberculosis in the patient’s history. Altogether, this study supports the existence of a complex interplay between infections and RA at onset driven by familial status and the presence of anti-CCP Ab at elevated levels. Full article

Oridonin is the primary active component in the traditional Chinese medicine Rabdosia rubescens, displaying anti-inflammatory, anti-tumor, and antibacterial effects. It is widely employed in clinical therapy for acute and chronic pharyngitis, tonsillitis, as well as bronchitis. Nevertheless, the clinical application of oridonin is significantly restricted due to its reproductive toxicity, with the exact mechanism remaining unclear. The aim of this study was to investigate the mechanism of oridonin-induced damage to HTR-8/SVneo cells. Through the integration of epigenetics, proteomics, and metabolomics methodologies, the mechanisms of oridonin-induced reproductive toxicity were discovered and confirmed through fluorescence imaging, RT-qPCR, and Western blotting. Experimental findings indicated that oridonin altered m6A levels, gene and protein expression levels, along with metabolite levels within the cells. Additionally, oridonin triggered oxidative stress and mitochondrial damage, leading to a notable decrease in WNT6, β-catenin, CLDN1, CCND1, and ZO-1 protein levels. This implied that the inhibition of the Wnt/β-catenin signaling pathway and disruption of tight junction might be attributed to the cytotoxicity induced by oridonin and mitochondrial dysfunction, ultimately resulting in damage to HTR-8/SVneo cells. Full article

Transoral Robotic Surgery (TORS) is utilized for treating various malignancies, such as early-stage oropharyngeal cancer and lymph node metastasis of an unknown primary tumor (CUP), and also benign conditions, like obstructive sleep apnea (OSA) and chronic lingual tonsillitis. However, the success and failure of TORS have not been analyzed to date. In this retrospective observational multicenter cohort study, we evaluated patients treated with TORS using the da Vinci surgical system. Success criteria were defined as identification of the primary tumor for CUP, >2 mm resection margin for malignant conditions, and improvement on respiratory polygraphy and tonsillitis complaints for benign conditions. A total of 220 interventions in 211 patients were included. We identified predictors of success, such as low comorbidity status ACE-27, positive P16 status, and lower age for CUP, and female gender and OSA severity for benign conditions. For other malignancies, no predictors for success were found. Predictors of failure based on postoperative complications included high comorbidity scores (ASA) and anticoagulant use, and for postoperative pain, younger age and female gender were identified. This study provides valuable insights into the outcomes and predictors of success and failure in TORS procedures across various conditions and may also help in patient selection and counseling. Full article

Acute recurrent tonsillitis is a chronic, biofilm-related infection that is a significant burden to patients and healthcare systems. It is often treated with repeated courses of antibiotics, which contributes to antimicrobial resistance. Studying biofilms is key to understanding this disease. In vitro modelling using 3D bioprinted hydrogels is a promising approach to achieve this. A novel gelatin-PEGDA pseudomonas fluorescens-laden bioink was developed and bioprinted in a 3D hydrogel construct fabricated using computer-aided design to mimic the tonsillar biofilm environment. The bioprinted constructs were cultured at 37 °C in lysogeny broth for 12 days. Bacterial growth was assessed by spectrophotometry. Cellular viability analysis was conducted using optical fluorescence microscopy (FDA/PI staining). A biocompatible 3D-printed bacteria-laden hydrogel construct was successfully fabricated. Bacterial growth was observed using optical fluorescence microscopy. A live/dead cellular-staining protocol demonstrated bacterial viability. Results obtained after the 12-day culture period showed higher bacterial growth in the 1% gelatin concentration construct compared to the 0% control. This study demonstrates the first use of a bacteria-laden gelatin-PEGDA hydrogel for biofabrication of a 3D-printed construct designed to model acute recurrent tonsillitis. Initiating a study with clinically relevant ex vivo tonsil bacteria will be an important next step in improving treatment of this impactful but understudied disease. Full article

In livestock, brucellosis is mainly an asymptomatic disease except when abortion occurs; therefore, two serological tests are used for diagnosis as no single test is suitable. Abattoir samples enable a combination of culture, molecular, and serological tests to detect brucellosis. This study assessed Brucella-specific PCR (ITS-PCR) to detect brucellosis and to conduct a molecular characterization of Brucella spp. isolated from PCR-positive livestock (n = 565) slaughtered at abattoirs and the appropriate sample tissue(s). ITS-PCR detected Brucella DNA in 33.6% of cattle, 14.5% of sheep, and 4.7% of pig tissues. Impure Brucella cultures from PCR-positive tissues were 43.6% (44/94) of cattle, 51.7% (15/29) of sheep, and 50% (2/4) of pigs with predominantly B. abortus identification with AMOS-PCR and low isolation of mixed B. abortus and B. melitensis in all species. In cattle, 33% of isolates were from lymph nodes, while in sheep 38.0% were from the liver and kidney and only from tonsils in pigs (2/4). Brucella infections identified with AMOS-PCR were present in seropositive and mainly seronegative (75.6–100%) livestock with the potential to cause brucellosis during pregnancy or breeding. This study demonstrated the value of the polyphasic approach, especially with chronic infections and the potential risk of these asymptomatic animals. Full article

Background: Globally, oral diseases are common, pose an economic burden, and significantly decline the quality of life of affected individuals. Recently, researchers have substantially highlighted the effect of depression on oral disease incidence and development. In this study, we elucidated the correlation between depression and oral diseases. Methods: Using two-sample Mendelian randomization (MR), the association between depression and the risk of 17 oral diseases was evaluated. Three methods were used to perform MR analysis: the inverse variance-weighted, weighted median, and MR-Egger methods. Furthermore, Cochran’s Q test, MR-Egger intercept test, MR Pleiotropy RESidual Sum and Outlier test, and leave-one-out analysis were performed to analyze sensitivity. Results: After implementing multiple test corrections, we observed that genetic susceptibility to depression was associated with an increased risk of mouth ulcers, toothache, loose teeth, bleeding gums, painful gums, chronic periodontitis, chronic tonsil and adenoid diseases, peritonsillar abscess, and excessive tooth attrition. However, a causal relationship between depression and other oral diseases was not observed. Sensitivity analysis confirmed the robustness of the results. Conclusions: We confirmed the causal relationship between depression and several oral diseases, thereby providing a novel viewpoint on the prevention and treatment of oral diseases. Our findings suggest the integration of depression control into routine clinical care to enhance the effectiveness of oral disease treatment. Full article

Background: Actinomyces is a genus of Gram-positive anaerobic or microaerophilic bacteria with a branched filamentous shape. Their presence in tonsil tissue is usually determined by histopathological examination. In the crypts of removed tonsils, they have a prevalence ranging from 0.8% to 61.6%. The role of Actinomyces in diseases of the palatine tonsils is not clearly defined. The aim of the study was to determine the importance of Actinomyces in the pathology of palatine tonsils and to assess the impact of these bacteria on the clinical data. Methods: the retrospective analysis of the histopathological findings of patients undergoing tonsillectomy in our hospital from January 2017 to the end of December 2019 was performed in terms of the occurrence of Actinomyces. The data were collected based on the medical history. The study included 481 patients aged 3–82 years. From the study group, 100 adult patients were randomly selected, and a telephone survey was conducted. The questions included the co-occurrence of bronchial asthma, halitosis, tonsilloliths, and cigarette smoking. The questions were related to the complications following tonsillectomy and the severity of postoperative pain. Existence of a relationship was investigated between occurrence of tonsillar Actinomyces and age, sex, body mass index, and medical condition (obstructive sleep apnea, chronic palatine tonsillitis), respectively. The size of the removed tonsils was assessed and compared depending on the presence of the bacteria. Results: patients aged 18 years and older had a higher probability of presenting Actinomyces. The estimated odds ratio for the presence of the bacteria per year of age was 1.023 [1.007, 1.041]. No statistically significant results were found for the other variables. The co-occurrence of the bacteria and halitosis was close to statistical significance (p = 0.064). Conclusions: multivariate analysis of the role of Actinomyces in tonsillar pathology showed that these microorganisms should be considered saprophytes of the oropharyngeal microflora that had no significant relationship with the pathology of palatine tonsils. Further studies on their influence on halitosis are warranted. Full article

There is a paucity of large-scale population-based study whether patients with Sjögren’s syndrome are at higher risk of chronic otitis media. This study aimed to investigate the association of chronic otitis media with Sjögren’s syndrome by utilizing the representative dataset of the Taiwanese population. We identified 9473 patients with chronic otitis media as cases. We used propensity score matching to select 28,419 controls. We used multiple logistic regression analysis to examine the association of chronic otitis media with prior Sjögren’s syndrome after adjusting for age, sex, monthly income category, geographic location and urbanization level of the patient’s residence, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. Chi-square tests showed a statistically significant difference in Sjögren’s syndrome between patients with chronic otitis media and controls (4.89% vs. 2.93%, p < 0.001). In addition, we found patients with chronic otitis media were more likely to have Sjögren’s syndrome (OR = 1.698, 95% CI = 1.509~1.910) relative to controls after adjusting for age, income, geographic location, residential urbanization level, allergic rhinitis, chronic rhinosinusitis and tonsillitis and adenoiditis. We also found that of the male patients, patients with chronic otitis media had a greater tendency to Sjögren’s syndrome than controls (adjusted OR = 1.982, 95% CI = 1.584~2.481). Similarly, a statistically significant association between Sjögren’s syndrome and chronic otitis media remains in female sampled patients (adjusted OR = 1.604, 95% CI = 1.396~1.842). We found that patients with Sjögren’s syndrome were associated with the occurrence of chronic otitis media. It may guide physicians as they counsel patients with Sjögren’s syndrome on the possibility of chronic otitis media occurrence. Full article

Recent studies identified viral and bacterial factors, including HSV-1 and H. pylori, as possible factors associated with diseases such as chronic tonsillitis and cancers, including head and neck squamous cell carcinoma (HNSCC). We assessed the prevalence of HSV-1/2 and H. pylori in patients with HNSCC, chronic tonsillitis, and healthy individuals using PCR after DNA isolation. Associations were sought between the presence of HSV-1, H. pylori, and clinicopathological and demographic characteristics and stimulant use. HSV-1 and H. pylori were most frequently identified in controls (HSV-1: 12.5% and H. pylori: 6.3%). There were 7 (7.8%) and 8 (8.6%) patients with positive HSV-1 in HNSCC and chronic tonsillitis patients, respectively, while the prevalence of H. pylori was 0/90 (0%) and 3/93 (3.2%), respectively. More cases of HSV-1 were observed in older individuals in the control group. All positive HSV-1 cases in the HNSCC group were associated with advanced tumor stage (T3/T4). The prevalence of HSV-1 and H. pylori was highest in the controls compared to HNSCC and chronic tonsillitis patients, which indicates that the pathogens were not risk factors. However, since all positive HSV-1 cases in the HNSCC group were observed only in patients with advanced tumor stage, we suggested a possible link between HSV-1 and tumor progression. Further follow-up of the study groups is planned. Full article

Shear wave elastography (SWE) is a non-invasive imaging technique used to quantify the elasticity/stiffness of any tissue. There are normative SWE studies on tonsils in healthy children in the literature. The purpose of this study is to analyze the palatine tonsils in children with acute tonsillitis using ultrasound and SWE. In this prospective study, pediatric patients aged 4–18 years diagnosed with acute tonsillitis and healthy children were included. Those with antibiotic use, chronic tonsillitis, adenoid hypertrophy, and having chronic disease, immunodeficiency, and autoimmune disease, or any rheumatological disease were excluded. The volume and elasticity of palatine tonsil were measured via ultrasound and SWE. The study included 81 (46 female, 35 male) acute tonsillitis patients, and 63 (38 female, 25 male) healthy children between the ages of 4 and 18. Elasticity (kPa) values of tonsils were found significantly higher in the tonsillitis group (SWE-R: 25.39 ± 4.64, SWE-L: 25.01 ± 4.17) compared to the normal group (SWE-R: 9.71 ± 2.37, SWE-L: 9.39 ± 2.19) (p < 0.001). In the tonsillitis group, a significant positive correlation was found between tonsil volume and elasticity (r: 0.774, p: 0.002). In conclusion, in pediatric patients with acute tonsillitis, higher kPa values were obtained with SWE in the palatine tonsils. Full article