Effectiveness of indirect autofluorescent laryngoscopy in the diagnosis of cancerous and precancerous lesions of the larynx

Autofluorescent diagnostics are based on the ability of oxidized flavin mononucleotide [FMN] in normal cells to emit green fluorescence when exposed to blue light. Neoplastic cells have significantly lower concentrations of FMN and do not emit green fluorescence. Autofluorescent endoscopy is designed for early, accurate and minimally invasive diagnostics for laryngeal pathology. The aim of the present study was to evaluate the diagnostic potential and limitations of this imaging technique in comparison to laryngomicroscopy. In our investigation we used the System of Autofluorescent Endoscopy [SAFE 1000] designed by Pentax. We examined 32 patients using the SAFE 1000 system, and then all of the patients underwent indirect laryngomicroscopy [LMS]. In LMS, a biopsy was taken, and the diagnostic sensitivity of these two methods was compared according to the pathohistological diagnosis. For statistical evaluation we used Fisher's exact test. Comparable to indirect autofluorescence images, normal laryngeal mucosa showed a typical green fluorescence signal. Moderate and high epithelial dysplasia, carcinoma in situ and cancer displayed a diminished green fluorescence. False negative results were related to extreme hyperkeratosis. According to our results, the presented technique seems to be a promising diagnostic tool for the early detection of laryngeal cancer and its precursor lesions. It has the ability to give information about the nature of laryngeal lesions without devastation of the tissues. We believe that autofluorescent endoscopy in addition to laryngomicroscopy gives a more accurate diagnosis of laryngeal pathology than laryngomicroscopy alone

Prevalence and resistance patterns of oropharyngeal flora in acne patients treated with long term antibiotics

This is a cross sectional study aimed at the estimation of the prevalence and resistance patterns of Streptococcus pyogenes and Staphylococcus aureus in the oropharynx of antibiotic user and non-user individuals with acne. The main outcome measure was the presence or absence of S pyogenes and S aureus in the oropharynx as determined by culture and their resistance patterns to tetracyclines as determined by agar disk diffusion. Of 105 participants, 42 were using oral or topical antibiotics and 63 were not using antibiotics. Six [10%] of non-users had positive S pyogenes cultures compared with 13 [33%] of those successfully evaluated using antibiotics [n=39]. A total of 85% of S pyogenes cultures [11/13] from antibiotic users were resistant to at least tetracycline antibiotic compared with 20% from those non-antibiotic users [p=0.1]. Of non-antibiotic users 29% had positive S awe us cultures compared with 22% of antibiotic users. No significant differences in resistance patterns of S aureus were found. It was clear that S pyogenes colonization and resistance in the oropharynx are associated with antibiotic therapy in patients with acne. The clinical and long-term effects of this finding need further studies