Medicina-Lithuania最新文献

{"title":"The Effect and Treatment of PIK3CA Mutations in Breast Cancer: Current Understanding and Future Directions.","authors":"Young-Bin Cho, Kyoung-Sik Park","doi":"10.3390/medicina61030518","DOIUrl":"10.3390/medicina61030518","url":null,"abstract":"<p><p>Gene mutations in PIK3CA, the catalytic subunit of phosphoinositide 3-kinases, are significantly associated with prognosis in breast cancer. This association suggests that breast cancer patients with PIK3CA mutations should receive PIK3CA mutant-specific treatment. This review aimed to investigate novel treatments for PIK3CA-mutant breast cancer. This study investigated the effects of PIK3CA mutations in breast cancer with respect to gene ontology and the PI3K/AKT/mTOR pathway. Subsequently, we comprehensively examined all clinical trials that targeted breast cancer patients with PIK3CA mutations. Finally, this review explored the potential of a new treatment for noncoding RNA.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944057/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722305","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of Prosthetic Emergence Profile on Peri-Implant Marginal Bone Stability: A Comprehensive Review.","authors":"Rossana Izzetti, Chiara Cinquini, Marco Nisi, Michele Covelli, Fortunato Alfonsi, Antonio Barone","doi":"10.3390/medicina61030517","DOIUrl":"10.3390/medicina61030517","url":null,"abstract":"<p><p>The prosthetic emergence profile is a factor potentially affecting marginal bone level around dental implants. The aim of this review is to provide a comprehensive analysis of the influence of the prosthetic emergence profile on peri-implant marginal bone-level stability. The marginal bone level is an important parameter in implant dentistry, reflecting the stability of dental implants, and it is a critical indicator of long-term implant success. Minimizing marginal bone loss around dental implants is a key factor for maintaining implant function, supporting peri-implant soft tissues, and achieving predictable aesthetic outcomes. The scientific literature presents various examples of evidence on the influence of emergence angle and prosthetic designs on marginal bone loss. Several studies suggest that emergence angles exceeding 30° and convex prosthetic designs may increase the risk of peri-implantitis and bone resorption, while others find no significant correlation. Moreover, several studies demonstrated the positive influence of taper joint connections on marginal bone stability. Although the current literature remains diverse, it is essential to prioritize cleanability and minimize plaque accumulation for a successful implant-prosthetic restoration. Proper maintenance and a continuous follow-up to monitor marginal bone loss are beneficial for obtaining stable and optimal long-term results.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943486/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722224","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Impact of Virtual Reality Alone and in Combination with Conventional Therapy on Balance in Parkinson's Disease: A Systematic Review with a Meta-Analysis of Randomized Controlled Trials.","authors":"Giorgio De Natale, Erda Qorri, Jasemin Todri, Orges Lena","doi":"10.3390/medicina61030524","DOIUrl":"10.3390/medicina61030524","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Virtual reality (VR)-based interventions provide immersive and interactive environments that can enhance motor learning and deliver real-time feedback, offering potential advantages over conventional therapies. This systematic review evaluated the impact of non-immersive and immersive VR exergaming interventions versus conventional therapy on balance in Parkinson's disease (PD) through a detailed analysis of randomized controlled trials (RCTs). <i>Materials and Methods</i>: A comprehensive search was conducted across the PubMed, Lilacs, IBECS, CENTRAL, Web of Science (WOS), EBSCOHost, and SciELO databases. Article selection and duplicate removal were managed using Rayyan QCRI. The quality of the evidence was assessed using the GRADE system. <i>Results</i>: From an initial screening of 100 studies, 58 underwent title and abstract screening. After full-text evaluation, 11 RCTs met the inclusion criteria, involving 518 participants with PD (average age: 67.3 years; 67.95% men). The balance outcomes were primarily measured using the Berg balance scale (BBS), employed in most studies (n = 9). The pooled analysis demonstrated a significant improvement in the balance scores for the experimental groups compared to the controls, with a standardized mean difference (SMD) of 0.58 [95% CI: 0.07, 1.09, <i>p</i> = 0.03]. However, the heterogeneity was substantial (I² = 77%). The analysis of the six-minute walking test (6 MWT), as another outcome of four articles, revealed a mean difference of 32.99 m [95% CI: -8.02, 74.00], but the effect was not statistically significant (<i>p</i> = 0.11). The heterogeneity for this outcome was moderate (I² = 41%), indicating some variability across studies. Alternative tools, such as the Tinetti Performance-Oriented Mobility Assessment (POMA) scale, the UPDRS III, and the sensory organization test (SOT), were also evaluated where possible. <i>Conclusions</i>: VR-based interventions offer promise for improving balance in Parkinson's disease, enhancing rehabilitation engagement. Their integration into clinical practice could complement conventional therapy. However, further research is needed to optimize protocols, standardize parameters, and maximize their impact on mobility, independence, and quality of life.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944244/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722154","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Metformin Increases Serum Isthmin-1 Levels and Lowers Low-Density Lipoprotein: Potential Implications for Lipid Metabolism in T2DM.","authors":"Merve Yilmaz Bozoglan, Tuncay Kuloglu, Nevzat Gozel, Faruk Kılınc, Erkan Cakmak, Ramazan Fazıl Akkoç, Betül Dağoğlu Hark","doi":"10.3390/medicina61030522","DOIUrl":"10.3390/medicina61030522","url":null,"abstract":"<p><p><i>Background and Objectives:</i> Type 2 Diabetes Mellitus (T2DM) is a metabolic disease caused by the failure of the skeletal muscle, liver and adipose tissue to respond to insulin. Metformin is the first choice for the treatment of T2DM. Isthmin 1 (Ism1) is a newly discovered adipokine that affects all carbohydrate, lipid and protein metabolism. This study examines the changes in serum and salivary levels of Ism1 in patients using metformin, considering its potential as a follow-up marker for T2DM if present in the salivary glands. <i>Materials and Methods:</i> The study included 30 newly diagnosed T2DM patients and 30 non-diabetic controls. Ism1 was measured by ELISA in serum and saliva after 3 months and compared with routine biochemical parameters. Immunostaining of Ism1 was performed in salivary glands. <i>Results:</i> Ism1 was immunohistochemically detected in salivary glands for the first time. Serum Ism1 levels increased significantly after 3 months of metformin treatment (<i>p</i> = 0.028). The increase in salivary Ism1 levels did not reach statistical significance. Fasting plasma glucose (FPG) (<i>p</i> < 0.001), HbA1c (<i>p</i> < 0.001) and LDL (<i>p</i> = 0.015) levels decreased with metformin. There was a significant negative correlation between the increase in Ism1 levels and the decrease in LDL levels (rho = -0.362, <i>p</i> = 0.05). <i>Conclusions:</i> Despite its first detection in salivary glands, the hypothesis that Ism1 may be a surveillance marker in T2DM could not be confirmed. The negative correlation of Ism1 with LDL levels suggests that Ism1 may contribute to the ameliorative effect of metformin on serum lipids. Further studies are needed to support this conclusion.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944227/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722041","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Paraclitoral Epidermal Cysts: A Literature Systematic Review.","authors":"Clarissa Costa, Marta Barba, Alice Cola, Matteo Frigerio","doi":"10.3390/medicina61030520","DOIUrl":"10.3390/medicina61030520","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Epidermal inclusion cysts are benign lesions with usually good prognosis. Clitoral epidermal cysts are very uncommon and can be spontaneous or caused by a prior surgical operation, usually female genital mutilation. Surgical removal of the cyst is the preferred treatment, and it is associated with excellent postoperative results. <i>Materials and Methods</i>: We present the medical history and surgical treatment of a 39-year-old woman with a symptomatic epidermal clitoral cyst. To discuss our case in the context of a synopsis of similar published cases, we conducted a systematic review of epidermal clitoral cysts to synthesize available knowledge on symptoms, diagnosis, etiology, and management about this rare condition. <i>Results</i>: A total of 46 studies, describing 162 patients, were identified. The presence of clitoral cysts should be suspected in patients complaining of vaginal bulging, sexual discomfort, and urinary symptoms. Clinical examination as well as other instrumental techniques represent a useful tool for diagnosis. The gold standard treatment is to perform surgical excision. Follow-up is needed to diagnose possible recurrences. <i>Conclusions</i>: We present the first systematic review focusing on epidermal clitoral cysts including both spontaneous and traumatic etiologies. It is important to include these lesions in the differential diagnosis of congenital clitoromegaly and clitoral mass, especially in the case of history of FGM, trauma, or surgery in the genital area.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943952/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722321","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anti-Virulence Properties of Curcumin/CuO-NPs and Their Role in Accelerating Wound Healing In Vivo.","authors":"Amr M Shehabeldine, Bahaa M Badr, Fathy M Elkady, Toru Watanabe, Mostafa A Abdel-Maksoud, Abdulaziz M Alamri, Salman Alrokayan, Amer M Abdelaziz","doi":"10.3390/medicina61030515","DOIUrl":"10.3390/medicina61030515","url":null,"abstract":"<p><p><i>Background and Objectives</i>: This study introduces an innovative approach to accelerating wound healing by leveraging the bactericidal properties of mycosynthesized copper oxide nanoparticles (CuO-NPs) and their combination with curcumin against <i>Pseudomonas aeruginosa</i>. The study aims to evaluate their antimicrobial efficacy, impact on quorum sensing-associated virulence factors, and potential therapeutic applications in wound healing. <i>Materials and Methods</i>: The minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) of CuO-NPs were determined to be 25 μg/mL and 50 μg/mL, respectively. At sub-inhibitory concentrations (0.5 MIC, 0.25 MIC, and 0.125 MIC), their effects on <i>P. aeruginosa</i> growth and quorum sensing-associated virulence factors were assessed. Antioxidant activity and cytotoxicity were also evaluated. Additionally, the combination of CuO-NPs and curcumin (CUR) was tested for its enhanced wound-healing efficacy. <i>Results</i>: While CuO-NPs did not inhibit <i>P. aeruginosa</i> growth at sub-inhibitory concentrations, they significantly reduced quorum sensing-associated virulence factors in a dose-dependent manner: LasB elastase (81.8%, 60.6%, and 53.03%), LasA protease (70%, 68.5%, and 57.1%), and pyocyanin (85.7%, 71.4%, and 55.9%). CuO-NPs exhibited strong antioxidant activity by scavenging free radicals. The combination of CuO-NPs and CUR demonstrated the highest wound-healing efficacy, outperforming the negative control and Mebo ointment by 193.9% and 61.6%, respectively. Additionally, CuO-NPs exhibited selective cytotoxicity against HepG2 cancer cells while displaying minimal toxicity toward normal human skin cells. <i>Conclusions</i>: CuO-NPs, particularly in combination with CUR, show promising potential as a therapeutic agent for wound healing by inhibiting quorum sensing-associated virulence factors, exhibiting strong antioxidant activity, and demonstrating selective cytotoxicity. These findings highlight their potential biomedical applications.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943691/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement of Limbic System Anatomical Volumes in Patients Diagnosed with Schizophrenia Using Vol2brain and Comparison with Healthy Individuals.","authors":"Mert Ocak, Buket Oguz","doi":"10.3390/medicina61030525","DOIUrl":"10.3390/medicina61030525","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Schizophrenia is a chronic psychiatric disorder affecting approximately 24 million people worldwide, characterized by structural and functional brain abnormalities. Despite its prevalence, automated segmentation tools like Vol2Brain have been underutilized in large-sample studies examining limbic system anatomical volumes in patients with schizophrenia. This study aimed to assess volume differences in all major limbic system structures between schizophrenia patients and healthy controls using Vol2Brain. <i>Method</i>: This retrospective study included 68 schizophrenia patients and 68 healthy controls, with MRI scans obtained from OpenNeuro. Limbic system volumetric and cortical thickness measurements were conducted using Vol2Brain, an automated segmentation platform. <i>Results</i>: Schizophrenia patients exhibited significantly reduced volumes in the amygdala, hippocampus, anterior cingulate gyrus, posterior cingulate gyrus, and middle cingulate gyrus compared to controls. However, the left amygdala volume was larger in schizophrenia patients. A cortical thickness analysis revealed that schizophrenia patients had thinner limbic cortices, particularly in the anterior and posterior cingulate gyri and the right parahippocampal gyrus. In contrast, the right anterior cingulate gyrus was thicker in schizophrenia patients. The differences in total and left parahippocampal gyrus volumes and cortical thickness did not reach statistical significance. <i>Conclusions</i>: These findings reinforce previous evidence of limbic system abnormalities in patients with schizophrenia, which may contribute to cognitive and emotional dysregulation. The study also highlights Vol2Brain's potential as a rapid, cost-free, and reliable alternative for brain volume analysis, facilitating more standardized and reproducible neuroimaging assessments in psychiatric research.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943912/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143721926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cross-Cultural Adaptation and Validation of Incontinence Outcome Questionnaire for Serbian Population.","authors":"Sladjana Kovacevic, Ivan Vukovic, Uros Bumbasirevic, Marko Zivkovic, Slavisa Savic, Zoran Bukumiric, Nikola Panajotovic, Petar Bulat, Bojan Cegar","doi":"10.3390/medicina61030509","DOIUrl":"10.3390/medicina61030509","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Stress urinary incontinence (SUI) impacts 4-50% of adult women, frequently resulting in embarrassment, diminished self-esteem, and social withdrawal, significantly affecting quality of life. The aim of our study is to cross-culturally adapt and validate the Urinary Incontinence Outcome Questionnaire (IOQ) for the Serbian population and to assess the multifaceted impact of SUI on the quality of life among women. <i>Materials and Methods</i>: A cross-sectional study involved a total of 150 women: 100 undergoing surgical management for SUI (ST group) and 50 receiving non-surgical treatments, including vaginal estrogen, pessaries, electrical stimulation, or collagen fillers (NST group). The participants completed questionnaires on demographics, fatigue (MFI), anxiety and depression (HADS), and quality of life (SF-36), as well as the IOQ. <i>Results</i>: The ST group had a mean age of 60.0 ± 10.0 years, with 65% married, 65% with secondary education, 62% non-smokers, and 78% with comorbid conditions, primarily cardiovascular disease (59%). The NST group showed similar characteristics, with a significant difference in cardiovascular comorbidity (<i>p</i> = 0.049). All IOQ subscales demonstrated good internal consistency (Cronbach alpha > 0.7), except for the subscale Complications (Cronbach alpha = 0.440). The IOQ score for \"Symptoms pre-operative\" had the highest mean value (62.8 ± 18.6), while \"Hospital Re-admission\" had the lowest (303 ± 17.1). A comparison of the SF-36 scores showed significant differences in the Energy (<i>p</i> = 0.025) and Emotional well-being (<i>p</i> = 0.015) domains between the ST and NST groups. <i>Conclusions</i>: The Serbian version of the IOQ has been validated, demonstrating psychometric features that endorse its application in clinical and research contexts. This study highlights the significant impact of SUI on quality of life and the need for a comprehensive approach to treatment. The results emphasize the importance of addressing both the physical and psychological aspects of SUI to improve the lives of affected women.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944165/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722129","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Impact of a Tongue Training Device on Tongue Muscle Strength in Patients with Obstructive Sleep Apnea After Modified Uvulopalatopharyngoplasty: A Pilot Study.","authors":"Yung-An Tsou, Chien-Hao Huang, Yu-Jen Chou, Hsueh-Hsin Kao, Jui-Kun Chiang, Yee-Hsin Kao","doi":"10.3390/medicina61030511","DOIUrl":"10.3390/medicina61030511","url":null,"abstract":"<p><p><i>Background and Objectives</i>: Sufficient evidence supports the Iowa Oral Performance Instrument (IOPI) as a reliable tool for measuring tongue strength and endurance as well as an effective assessment instrument for intervention studies. This study aimed to investigate the impact of a tongue training device, the HEAL, on tongue muscle strength in patients with obstructive sleep apnea (OSA) following modified uvulopalatopharyngoplasty (UPPP), utilizing the IOPI for evaluation. <i>Materials and Methods</i>: We introduced a tongue strengthener, the HEAL, made from medical-grade silicone, designed to improve tongue strength. Each patient was provided with the HEAL and instructed to begin using it one month after undergoing modified UPPP for OSA. The tongue strength of OSA patients was measured using the IOPI both before using the HEAL and approximately 6 weeks later. <i>Results</i>: A total of 66 participants with OSA underwent modified UPPP and were included in the final analysis. The mean age was 39.15 ± 8.84 years, and the mean BMI was 27.41 ± 4.03 kg/m². The duration between the pre- and post-assessment of tongue strength using the HEAL was 42.95 ± 17.97 days. The mean tongue strength pressure before and after using the HEAL was 32.16 ± 16.00 kilopascals (kPa) and 42.95 ± 17.97 kPa, respectively. Tongue strength increased by an average of approximately 52.8% after using the HEAL for an approximate duration of 6 weeks. <i>Conclusions</i>: In the current study, participants with OSA who had undergone modified UPPP and subsequently used the HEAL demonstrated an average improvement of 10.79 kPa in tongue strength-an increase of over 50%-as measured by the IOPI. The interval between the pre- and post-assessment of tongue strength was approximately six weeks. Further studies are needed to validate these findings.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11943516/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722335","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Flexible Nasendoscopy in Stevens-Johnson Syndrome/Toxic Epidermal Necrolysis: A Ten-Year Otolaryngology Experience.","authors":"Matthew Min Xian Yii, Antonia Rowson, Milan van Ammers, Jessica Prasad","doi":"10.3390/medicina61030513","DOIUrl":"10.3390/medicina61030513","url":null,"abstract":"<p><p><i>Background and Objectives</i>: The primary objective of this study was to identify factors predictive of laryngeal involvement in patients with Stevens-Johnson syndrome/toxic epidermal necrolysis (SJS/TEN). The secondary objective was to observe the effect of laryngeal involvement upon short-term patient prognosis, including intensive care unit (ICU) stay and intubation rates. We present the largest cohort of patients examined for upper aerodigestive manifestations of SJS/TEN. <i>Materials and Methods</i>: We performed a retrospective observational analytic study of patients at a state-wide Australian Burns referral center between January 2013 to December 2022. Inclusion criteria were adult patients who underwent flexible nasendoscopy (FNE) with biopsy-proven SJS/TEN. Data collected from medical records included patient factors, aerodigestive symptoms, bedside examination, FNE findings, TEN-specific severity-of-illness score (SCORTEN) on admission, and patient outcomes such as intubation and ICU admission. <i>Results</i>: Fifty-four patients with biopsy-proven SJS/TEN underwent FNE, with 17 (31.5%) identified to have laryngeal involvement. Laryngeal involvement was not significantly associated with intubation, ICU stay, or mortality (<i>p</i> > 0.05). The presence of either aerodigestive symptoms or oral cavity involvement was highly sensitive (94.1%, 95% CI 73.0-99.7%) for laryngeal involvement. <i>Conclusions</i>: We did not find laryngeal involvement in SJS/TEN to significantly impact short-term outcomes, including intubation or mortality. FNE is the gold standard of upper aerodigestive assessment. Simple clinical evaluation of the oral cavity and a history of aerodigestive symptoms also provided a sensitive predictor of the laryngeal complications of SJS/TEN.</p>","PeriodicalId":49830,"journal":{"name":"Medicina-Lithuania","volume":"61 3","pages":""},"PeriodicalIF":2.4,"publicationDate":"2025-03-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11944104/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143722050","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}