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Jaffal H, Tumlin P, McArdle E. Management of Supraglottic Stenosis Using Interarytenoid Z-plasty: How I Do It. J Laryngol Otol 2024:1-12. [PMID: 38705584 DOI: 10.1017/s0022215124000926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/07/2024]
Affiliation(s)
- Hussein Jaffal
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Parker Tumlin
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
| | - Erica McArdle
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, West Virginia, USA
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McArdle E, Shetty S, Coutinho D, Ramadan HH, Makary CA. Correlation of patient reported outcome measures with endoscopic findings in pediatric chronic adenoiditis and chronic rhinosinusitis. Int J Pediatr Otorhinolaryngol 2024; 179:111936. [PMID: 38583371 DOI: 10.1016/j.ijporl.2024.111936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Revised: 03/24/2024] [Accepted: 03/31/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND Studies in adult chronic rhinosinusitis (CRS) showed poor correlation between patient reported outcome measures (PROMs) and objective findings. Our goal is to study the correlation between the sinus and nasal quality of life (SN-5) and the 22-items sinonasal outcome test (SNOT-22) surveys with endoscopy findings in children with chronic adenoiditis (CA) and CRS. METHODS Cross-sectional study of all pediatric patients (age 2-18) presenting for CA or CRS was performed. Patients and caregivers were asked to fill the SN-5 and SNOT-22 questionnaires at initial and follow up visits. Demographics and comorbidities were collected. Objective findings included endoscopy Modified Lund-Kennedy (MLK) scores and adenoid tissue size. RESULTS 124 children were included, with mean age of 9.9 years (SD = 4.8) and 46.8% female. 36.3% had allergic rhinitis, 23.4% had asthma, and 4% had obstructive sleep apnea. Moderate correlation was found between the rhinologic domain of SNOT-22 and MLK scores (r = 0.36, p = 0.001) and between SN5 scores and adenoid size in all patients (r = 0.39, p < 0.001). SNOT-22 scores showed moderate correlation with adenoid size (r = 0.42, p < 0.001) more specifically in CA patients (r = 0.54, p < 0.001). The correlation of SN5 and MLK scores were higher in children with allergic rhinitis or asthma. The correlation between SN5 and adenoid size was lower in children with allergic rhinitis or asthma. CONCLUSION There is discrepancy between the subjective measures and the objective findings in children with CA or CRS. The physical exam findings may not reflect the effect of CRS on the quality of life of children.
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Affiliation(s)
- Erica McArdle
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
| | - Sameer Shetty
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Dominic Coutinho
- School of Medicine, West Virginia University, Morgantown, WV, USA
| | - Hassan H Ramadan
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA
| | - Chadi A Makary
- Department of Otolaryngology-Head and Neck Surgery, West Virginia University, Morgantown, WV, USA.
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Kais A, McArdle E, Chaiban R, Cui R, Makary CA, Ramadan HH. Role of Acute Rhinosinusitis in Periorbital Infections in Children. Int J Pediatr Otorhinolaryngol 2024; 176:111813. [PMID: 38043186 DOI: 10.1016/j.ijporl.2023.111813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2023] [Revised: 11/23/2023] [Accepted: 11/27/2023] [Indexed: 12/05/2023]
Abstract
OBJECTIVE Periorbital cellulitis in children are commonly caused by acute rhinosinusitis (ARS). This study investigated the association of ARS and the severity of periorbital cellulitis in children. STUDY DESIGN Retrospective case-control study of children with periorbital cellulitis with ARS versus periorbital cellulitis without ARS. SETTING Patients were seen at West Virginia University Children's Hospitals between August 2011 to August 2022. METHODS Patients were divided into cases and controls based on presence or absence of ARS. ARS was defined based on clinical symptoms with objective presence of disease on CT scan. Patients' characteristics, treatment, hospital length of stay, and readmission were collected. RESULTS The sample consisted of 118 pediatric patients with orbital cellulitis. Patients with ARS were younger than patients without ARS (6.3 vs 8.5, p = 0.025), however there were no sex differences between two groups (p = 0.540). The ARS group had higher incidence of postseptal cellulitis (51.5% vs 9.6%, p < 0.001). As compared to patients without ARS, patients with ARS were more likely to be admitted (p < 0.001), have a longer length of stay (median of 3.5 days vs 0.5 days, p < 0.001), require IV antibiotics (95.3% vs 54.9%, p < 0.001), and require surgical intervention (23.1% vs 5.8%, p < 0.001). Readmission rate was similar between the two groups. CONCLUSION Children presenting with acute periorbital cellulitis who have ARS tend to have more severe infection requiring higher level of care. ARS should be assessed and incorporated into the plan of care of pediatric patients with periorbital infections.
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Affiliation(s)
- Amani Kais
- West Virginia University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, P.O. Box 9200, Morgantown, WV, 26506, USA
| | - Erica McArdle
- West Virginia University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, P.O. Box 9200, Morgantown, WV, 26506, USA
| | - Rafka Chaiban
- West Virginia University School of medicine, Department of Pediatrics, P.O. Box 9100, Morgantown, WV, 26506-9600, USA
| | - Ruifeng Cui
- West Virginia University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, P.O. Box 9200, Morgantown, WV, 26506, USA
| | - Chadi A Makary
- West Virginia University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, P.O. Box 9200, Morgantown, WV, 26506, USA.
| | - Hassan H Ramadan
- West Virginia University School of Medicine, Department of Otolaryngology - Head and Neck Surgery, P.O. Box 9200, Morgantown, WV, 26506, USA
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O'Brien S, Buckley C, Butler T, Cunningham Z, Keane S, McArdle E, Mitchell P, Donnelly SC. Persistent diaphragmatic weakness and peripheral muscle weakness are associated with anosmia in the long-COVID syndrome. QJM 2023; 116:603-604. [PMID: 36794902 DOI: 10.1093/qjmed/hcad025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/08/2023] [Indexed: 02/17/2023] Open
Affiliation(s)
- S O'Brien
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - C Buckley
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - T Butler
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - Z Cunningham
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S Keane
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - E McArdle
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - P Mitchell
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
| | - S C Donnelly
- From the Department of Medicine, Tallaght University Hospital, Dublin, Ireland
- School of Medicine, Trinity College Dublin, Dublin, Ireland
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McDermott H, Morris D, McArdle E, O'Mahony G, Kelly S, Cormican M, Cunney R. Isolation of NDM-1-producing Klebsiella pnemoniae in Ireland, July 2011. Euro Surveill 2012. [DOI: 10.2807/ese.17.07.20087-en] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
We report the identification of New Delhi metallo-beta-lactamase 1 (NDM-1)-producing Klebsiella pnemoniae in Ireland. The organism was resistant to multiple antibiotic classes, including carbapenems, and PCR and sequencing confirmed the presence of the blaNDM-1 gene, carried on a 98kb plasmid. The organism was isolated from an infant, who was born in India and moved to Ireland at the age of four months. This is the first reported isolation of an NDM-1-producing Enterobacteriaceae strain in Ireland.
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Affiliation(s)
- H McDermott
- Department of Clinical Microbiology, Children’s University Hospital, Temple Street, Dublin, Ireland
| | - D Morris
- Antimicrobial Resistance and Microbial Ecology Group, National University of Ireland, Galway, Ireland
| | - E McArdle
- Department of Public Health, Health Services Executive, Dr Steeven’s Hospital, Dublin, Ireland
| | - G O'Mahony
- Department of Clinical Microbiology, Children’s University Hospital, Temple Street, Dublin, Ireland
| | - S Kelly
- Department of Clinical Microbiology, Children’s University Hospital, Temple Street, Dublin, Ireland
| | - M Cormican
- Antimicrobial Resistance and Microbial Ecology Group, National University of Ireland, Galway, Ireland
| | - R Cunney
- Department of Clinical Microbiology, Children’s University Hospital, Temple Street, Dublin, Ireland
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McDermott H, Morris D, McArdle E, O'Mahony G, Kelly S, Cormican M, Cunney R. Isolation of NDM-1-producing Klebsiella pnemoniae in Ireland, July 2011. Euro Surveill 2012; 17:20087. [PMID: 22370013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
We report the identification of New Delhi metallo-betalactamase 1 (NDM-1)-producing Klebsiella pnemoniae in Ireland. The organism was resistant to multiple antibiotic classes, including carbapenems, and PCR and sequencing confirmed the presence of the blaNDM-1 gene, carried on a 98 kb plasmid. The organism was isolated from an infant, who was born in India and moved to Ireland at the age of four months. This is the first reported isolation of an NDM-1-producing Enterobacteriaceae strain in Ireland.
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Affiliation(s)
- H McDermott
- Department of Clinical Microbiology, Children's University Hospital, Temple Street, Dublin, Ireland
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Crean JK, Furlong F, Mitchell D, McArdle E, Godson C, Martin F. Connective tissue growth factor/CCN2 stimulates actin disassembly through Akt/protein kinase B-mediated phosphorylation and cytoplasmic translocation of p27(Kip-1). FASEB J 2006; 20:1712-4. [PMID: 16790529 DOI: 10.1096/fj.05-5010fje] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Connective tissue growth factor (CTGF/CCN2) is a 38-kDa secreted protein, a prototypic member of the CCN family, which is up-regulated in many diseases, including atherosclerosis, pulmonary fibrosis, and diabetic nephropathy. We previously showed that CTGF can cause actin disassembly with concurrent down-regulation of the small GTPase Rho A and proposed an integrated signaling network connecting focal adhesion dissolution and actin disassembly with cell polarization and migration. Here, we further delineate the role of CTGF in cell migration and actin disassembly in human mesangial cells, a primary target in the development of renal glomerulosclerosis. The functional response of mesangial cells to treatment with CTGF was associated with the phosphorylation of Akt/protein kinase B (PKB) and resultant phosphorylation of a number of Akt/PKB substrates. Two of these substrates were identified as FKHR and p27(Kip-1). CTGF stimulated the phosphorylation and cytoplasmic translocation of p27(Kip-1) on serine 10. Addition of the PI-3 kinase inhibitor LY294002 abrogated this response; moreover, addition of the Akt/PKB inhibitor interleukin (IL)-6-hydroxymethyl-chiro-inositol-2(R)-2-methyl-3-O-octadecylcarbonate prevented p27(Kip-1) phosphorylation in response to CTGF. Immunocytochemistry revealed that serine 10 phosphorylated p27(Kip-1) colocalized with the ends of actin filaments in cells treated with CTGF. Further investigation of other Akt/PKB sites on p27(Kip-1), revealed that phosphorylation on threonine 157 was necessary for CTGF mediated p27(Kip-1) cytoplasmic localization; mutation of the threonine 157 site prevented cytoplasmic localization, protected against actin disassembly and inhibited cell migration. CTGF also stimulated an increased association between Rho A and p27(Kip-1). Interestingly, this resulted in an increase in phosphorylation of LIM kinase and subsequent phosphorylation of cofilin, suggesting that CTGF mediated p27(Kip-1) activation results in uncoupling of the Rho A/LIM kinase/cofilin pathway. Confirming the central role of Akt/PKB, CTGF-stimulated actin depolymerization only in wild-type mouse embryonic fibroblasts (MEFs) compared to Akt-1/3 (PKB alpha/gamma) knockout MEFs. These data reveal important mechanistic insights into how CTGF may contribute to mesangial cell dysfunction in the diabetic milieu and sheds new light on the proposed role of p27(Kip-1) as a mediator of actin rearrangement.
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Affiliation(s)
- J K Crean
- University College Dublin, School of Biomolecular and Biomedical Science, Conway Institute of Biomolecular and Biomedical Research, Belfield, Dublin 4, Ireland.
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Howlin J, McBryan J, Napoletano S, Lambe T, McArdle E, Shioda T, Martin F. CITED1 homozygous null mice display aberrant pubertal mammary ductal morphogenesis. Oncogene 2006; 25:1532-42. [PMID: 16278680 DOI: 10.1038/sj.onc.1209183] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Expression microarray analysis identified CITED1 among a group of genes specifically upregulated in the pubertal mouse mammary gland. At puberty, CITED1 localizes to the luminal epithelial cell population of the mammary ducts and the body cells of the terminal end buds. Generation of CITED1 gene knockout mice showed that homozygous null mutants exhibit retarded mammary ductal growth at puberty and, in addition, dilated ductal structures with a lack of spatial restriction of the subtending branches. Analysis of CITED1 homozygous null and heterozygous null mammary gland gene expression using microarrays suggested that the mammary-specific phenotype seen in the homozygous null females is due to a disturbance in the transcription of a number of key mediators of pubertal ductal morphogenesis. These include estrogen and TGFbeta responsive genes, such as the EGFR/ErbB2 ligand, amphiregulin, whose transcription we suggest is directly or indirectly regulated by CITED1.
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Affiliation(s)
- J Howlin
- UCD Conway Institute and School of Biomolecular and Biomedical Science, University College Dublin, Belfield, Dublin, Ireland
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Smith A, O'Flanagan D, Igoe D, Cronin J, Forde D, McArdle E, Ko D. Outcome of medical screening of Kosovan refugees in Ireland: 1999. Commun Dis Public Health 2000; 3:291-4. [PMID: 11280262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
In March 1999 armed conflict broke out in Kosova and about 900,000 ethnic Albanians were displaced. We reviewed the health care offered to the 945 Kosovan refugees who arrived in Ireland in 1999, which included screening for tuberculosis (TB) and hepatitis B. On arrival in Ireland 540 refugees had already received oral polio vaccine (57%), 512 diphtheria, tetanus, and acellular pertussis or diphtheria and tetanus vaccine (54%), 310 BCG (33%), 207 measles, mumps, and rubella vaccine (22%) and 60 Haemophilus influenzae type b (6%). Twelve refugees were diagnosed with TB. Twenty-six refugees were HBsAg positive (3%) and 168 were anti-HBcAg positive (18%). Organised screening of Kosovan refugees on a voluntary basis (uptake > 95%) revealed low percentages who had been immunised and relatively high rates of TB and hepatitis B. The provision of optimum immunisation, screening, and treatment services to address these issues requires substantial staffing and financial resources.
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Affiliation(s)
- A Smith
- National Disease Surveillance Centre, St Patrick Dun's Hospital, Lower Grand Canal Street, Dublin 2, Republic of Ireland.
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