RESUMEN
Raynaud's phenomenon is a condition characterized by intermittent vasoconstriction of arteries in the fingers and skin, triggered by cold temperatures or emotional stress, aimed at conserving body heat. This condition is classified into primary and secondary forms, with secondary Raynaud's often linked to connective tissue diseases, medications, infections, and occupational exposures. A notable clinical case involves a 51-year-old male experiencing episodes of painful, white discoloration of the tongue, which were managed through a comprehensive diagnostic process, including rheumatological and cardiological evaluations, to rule out connective tissue diseases and cardiac dysfunction. We highlight the complex pathophysiology of Raynaud's, involving vascular, neurogenic, and immune mechanisms. Management strategies focus on lifestyle modifications and pharmacologic treatments, such as calcium channel blockers, to reduce attack frequency and severity. For refractory cases, advanced therapies, including phosphodiesterase inhibitors, intravenous prostaglandins, and surgical sympathectomy, may be considered. Effective diagnosis and individualized treatment are crucial for preventing complications and improving patient outcomes.
RESUMEN
Pleomorphic adenoma (PA) most commonly manifests in the parotid gland, though it occasionally emerges in atypical locations. We present a case involving an 87-year-old female who exhibited chronic left-sided nasal symptoms, leading to the diagnosis of PA in the nasal cavity. This diagnosis was confirmed through rhinoscopy and subsequent pathological examination following the surgical excision of an 8x8 mm mass. The procedure, which included tumor-based cautery, alleviated her symptoms effectively. A follow-up strategy was established to monitor for any signs of recurrence. The patient has shown no signs of recurrence at subsequent three-month follow-up visits, highlighting the success of the intervention. This case underscores the importance of early recognition and intervention in atypical presentations of PA, which is crucial to prevent potential complications and ensure favorable outcomes.
RESUMEN
The following study describes a complex clinical course of recurrent and multifocal squamous cell carcinoma (SCC) of the tonsil, involving both initial and subsequent malignancies over several years. The patient, a 54-year-old male with a history of tobacco use, first presented with SCC of the left tonsil, treated with tonsillectomy and neck dissection. Despite clear margins post-surgery, the patient developed SCC in the right tonsil two years later, requiring further surgical intervention and a comprehensive treatment approach. The disease then progressed to the base of the tongue and right larynx, necessitating a total laryngectomy and subtotal glossectomy. The report emphasizes the critical role of advanced imaging and surgical techniques, including robotic-assisted surgery, in managing such complex cases. Additionally, the case highlights the challenges of treating advanced oropharyngeal SCC, the importance of multidisciplinary management, and the need for consistent follow-up to monitor treatment efficacy and manage complications. The case underscores the complexity of SCC in the head and neck region and the necessity for tailored therapeutic strategies to improve patient outcomes.
RESUMEN
In this case report, we detail a rare instance of sialadenitis secondary to bilateral hypertrophic torus mandibularis (TM) in a 70-year-old Caucasian male who presented with neck swelling, dysphagia, and weight loss. Radiographic evaluations revealed enlarged TM obstructing Wharton's duct, further complicated by a sialolith. The patient's treatment regimen included antibiotics, oral steroids, and sialogogues, accompanied by surgical removal of the hypertrophic TM and sialoendoscopy, which resulted in significant symptomatic relief and the resolution of sialadenitis. This case emphasizes the importance of recognizing mechanical etiologies in patients presenting with sialadenitis, particularly when linked to pronounced anatomical abnormalities like TM.
RESUMEN
Per- and polyfluoroalkyl substances (PFAS) are widely used in many industrial and domestic applications, which has resulted in unintentional human exposures and bioaccumulation in blood and other organs. Perfluorooctane sulfonate (PFOS) is among the most prevalent PFAS in the environment and has been postulated to affect brain functions in exposed organisms. However, the impacts of PFOS in early neural development have not been well described. We used zebrafish larvae to assess the effects of PFOS on two fundamental complex behaviors, prey capture and learning. Zebrafish exposed to PFOS concentrations ranging from 2 to 20 µM for differing 48-h periods were viable through early larval stages. In addition, PFOS uptake was unaffected by the presence of a chorion. We employed two different experimental paradigms; first we assessed the impacts of increasing organismal PFOS bioaccumulation on prey capture and learning, and second, we probed stage-specific sensitivity to PFOS by exposing zebrafish at different developmental stages (0-2 vs. 3-5 days post fertilization). Following both assays we measured the amount of PFOS present in each larva and found that PFOS levels varied in larvae from different groups within each experimental paradigm. Significant negative correlations were observed between larval PFOS accumulation and percentage of captured prey, whereas nonsignificant negative correlations were observed between PFOS accumulation and experienced-induced prey capture learning. These findings suggest that PFOS accumulation negatively affects larval zebrafish's ability to perform complicated multisensory behaviors and highlights the potential risks of PFOS exposure to animals in the wild, with implications for human health. Environ Toxicol Chem 2024;43:847-855. © 2023 SETAC.