Age-dependent differences of the depth of olfactory fossa in children

Abstract Objective: With this radio-anatomical study, we aimed to describe the distribution of the depth of the olfactory fossa based on the Keros classification in the pediatric population in our region and to reduce complication rates by providing normative data. Methods: This was a retrospective study conducted with computed tomography imaging of the paranasal sinuses of 390 pediatric patients referred over a six-year period in Sakarya and Kocaeli University Faculty of Medicine. Patients were divided into 3 groups as 1-6, 6-12, and 12-18 years old. The depth of the olfactory fossa was measured and classified according to the Keros classification. The incidence of Keros asymmetries was also investigated. Results: The distribution of the depth of a total of 780 olfactory fossa according to the Keros classification was 24.7% Keros I, 65.9% Keros II, and 9.4% Keros III. When the groups were evaluated with each other and within each group, it was seen that the prevalence of Keros I type was significantly higher in the first group (p < 0.05), and the prevalence of Keros type II was significantly higher in the second and third groups (p < 0.05). Apart from this, the number of Keros type III increased in the third group compared to the first two groups and showed a statistically significant difference (p < 0.05). Among all patients, asymmetry of the olfactory fossa was detected in 29 patients (7.4%). Although the number of olfactory fossa asymmetry was low in group I, it was not significantly different between the groups (p > 0.05). Conclusion: In our study, high Keros I rate and low Keros III rate in children aged -6 were remarkable. Especially for children under the age of six, questions arise about the validity of the Keros classification. More detailed studies in larger populations, in different ethnicities, and with various age groups are needed. Level of evidence: Level 3.

Could serum total cortisol level at admission predict mortality due to coronavirus disease 2019 in the intensive care unit? A prospective study

ABSTRACT BACKGROUND: Critical diseases usually cause hypercortisolemia via activation of the hypothalamic-pituitary-adrenal axis. OBJECTIVES: To investigate the relationship between serum total cortisol level and mortality among coronavirus disease 2019 (COVID-19) patients in the intensive care unit (ICU), at the time of their admission. DESIGN AND SETTING: Prospective study developed in a pandemic hospital in the city of Şırnak, Turkey. METHODS: We compared the serum total cortisol levels of 285 patients (141 COVID-19-negative patients and 144 COVID-19-positive patients) followed up in the ICU. RESULTS: The median cortisol level of COVID-19-positive patients was higher than that of COVID-19 negative patients (21.84 μg/dl versus 16.47 μg/dl; P < 0.001). In multivariate logistic regression analysis, mortality was associated with higher cortisol level (odds ratio: 1.20; 95% confidence interval: 1.08-1.35; P = 0.001). The cortisol cutoff point was 31 μg/dl (855 nmol/l) for predicting mortality among COVID-19-positive patients (area under the curve 0.932; sensitivity 59%; and specificity 95%). Among the COVID-19 positive patients with cortisol level ≤ 31 μg/dl (79%; 114 patients), the median survival was higher than among those with cortisol level > 31 μg/dl (21%; 30 patients) (32 days versus 19 days; log-rank test P < 0.001). CONCLUSION: Very high cortisol levels are associated with severe illness and increased risk of death, among COVID-19 patients in the ICU.

Do Blood Cell Parameters have a Predictive Role in the Etiology and Severity Pediatric Antrochoanal Polyp Cases?

Abstract Introduction There are no definitive parameters to guide the etiology and severity of pediatric antrochoanal polyps. Objective The aim of our study is to compare the values of blood cell distribution parameters in cases of pediatric antrochoanal polyps (ACPs) with those of the control group. These values may be guiding parameters in determining the etiology of ACPs and evaluating the severity of the disease and the risk of recurrence. Methods Blood count values of patients operated for pediatric ACPs were retrospectively analyzed and compared with the data of the control group with the same age and gender distribution. The ACPs group was divided into subgroups in terms of inflammation, severity, and recurrence, and these subgroups were statistically compared as well. Results When the ACP patient group and the control group were compared, there was no statistically significant difference between the two groups. When we compared the patients considering the CT findings, there was a statistically significant difference between the stage III patients and the control group in terms of mean platelet volume (MPV) and platelet-to-lymphocyte ratio (PLR) values (p < 0.05 in both). Similarly, the MPV and PLR values were significantly higher in the recurrence patient group than in the control group. (p < 0.05 in both). Conclusion As a result of the data obtained, it can be suggested that inflammatory parameters in pediatric cases of ACPs vary in terms of recurrence and the severity of the disease.

Individual sensitivity to cytogenetic effects of benzo[ alpha ]pyrene in cultured human lymphocytes: influence of glutathione S-transferase M1 genotype

Sister chromatid exchange (SCE) and chromosome aberrations (CA) in peripheral lymphocytes has been widely used in assessing exposure to mutagens and carcinogens. One of the extensively studied genotoxins is benzo[alpha]pyrene (BaP). We studied the ability of BaP to induce SCE and CA in 16 glutathione S-transferase M1 (GSTM1)-positive and 15 GSTM1-null individuals by analyzing 72-h whole-blood lymphocyte cultures, either BaP-untreated (controls) or treated with 5 æM of BaP for 24 or 48 h. There was no differences in the level of BaP-induced chromosomal aberrations between GSTM1-positive or null individuals when the cells were BaP-exposed for 24 h (0.083 ± 0.059 vs. 0.090 ± 0.058) or 48 h (0.092 ± 0.057 vs. 0.096 ± 0.050. The frequency of SCE in controls was GSTM1-positive = 2.96 ± 0.35 and GSTM1-null = 3.23 ± 0.56 while that for BaP-treated lymphocytes was GSTM1-positive = 5.56 ± 0.83 and GSTM1-null = 6.09 ± 1.11 and were not statistically significant. The rates of BaP-induced in vitro chromatid and chromosome-type gaps and breaks were similar in all groups, although GSTM1-null genotype chromatid-type breaks were more frequent (0.064 ± 0.039 per metaphase) than chromosome-type breaks (0.032 ± 0.027 per metaphase) after 48 h treatment with BaP (p < 0.001). These findings suggest that BaP-induced in vitro SCE and CA are not influenced by the GSTM1 genotype.