Consequences of Chronic Nasal Obstruction on the Laryngeal Mucosa and Voice Quality of 4- to 12-Year-Old Children

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Comparative study of the behavior of p53 immunoexpression in smoking associated lesions: Reinke's edema and laryngeal carcinoma

Objective: To assess the behavior of the immunoexpression of protein p53 in Reinke's edema and laryngeal squamous cell carcinoma. Study design: retrospective. Methods: we recovered the histological paraffin blocks of patients who were subjected to Reinke's edema and laryngeal squamous cell carcinoma surgery in 2000-2011. The paraffin blocks were cut into 3-μm sections; the specimens were prepared in silanized slides (one slide for each paraffin block) and subjected to immunohistochemical reaction according to the Avidin Biotin Peroxidase method. Monoclonal primary anti-p53 antibodies were used at 1:50 dilution. Slides were examined under a light microscope at different magnitudes and results were interpreted based on the degree of brown staining in the nuclei of epithelial cells and in the extent of the fragment by using a semi-quantitative score from 0 to 3. Results: 67 slides of Reinke's edema and 60 slides of laryngeal squamous cell carcinoma were included. Scores 2 and 3 for staining of the nuclei of epithelial cells were recorded for 46 slides of Reinke's edema (68.65%) and for 57 slides of laryngeal squamous cell carcinoma (95%). As to the extent of the fragment, scores 2 and 3 were recorded for 74% slides of Reinke's edema and for 95% slides of carcinomas. Conclusion: the positive immunoexpression for protein p53, positive in 95% carcinomas and 74% Reinke's edemas, makes us aware of the possible preneoplastic condition of the latter lesion. Further studies are needed to identify and reveal the genetic changes that lead to these results. © 2013 Informa Healthcare USA, Inc.

The Lanz® endotracheal tube decreases tracheal injury in dogs

Purpose: To determine, in dogs anesthetized with nitrous oxide (N2O), whether the endotracheal tube (ETT) cuffed with a Lanz® pressure regulating valve decreases the tracheal consequences of tracheal intubation. Methods: Sixteen mixed-breed dogs were allocated to two groups according to the ETT used: Control group (n = 8) - Rüsch ETT, and Lanz group (n = 8) - ETT with Lanz® pressure regulating valve. The ETT cuffs in both groups were inflated with air to an intracuff pressure of 30 cm H2O. Anesthesia was induced and maintained with pentobarbitone and N2O (1.5 L·min-1) and O2 (1 L·min-1). ETT cuff pressures were measured before (control) and 60, 120, and 180 min during N2O administration. The dogs were sacrificed, and biopsy specimens from four predetermined areas of the tracheal mucosa in contact with the ETT were collected for light and scanning electron microscopy (SM) examination. Results: Cuff pressures in the Control group were higher than in the Lanz group at all time points studied (P < 0.001), with an increase over time only in the Control group (P < 0.001). Median neutrophilic inflammatory infiltration values of the epithelial surface, and in the subepithelial layer in contact with the cuff, were higher in the Control group as compared to the Lanz group (3.0 vs 1.0 and 3.0 vs 1.5 respectively) (P < 0.05). On SM examination, median histological grades were higher in the Control group compared to Lanz group (2.9 vs 1.9 respectively), (P < 0.05). Conclusions: The Lanz® ETT decreases tracheal mucosal injury in dogs.

Effect of high laryngeal mask airway intracuff pressure on the laryngopharyngeal mucosa of dogs

Objectives: To evaluate the effect of increased of laryngeal mask airway (LMA) intracuff pressures on the laryngopharyngeal mucosa. Study Design: Animal model. Methods: Sixteen mixed-breed dogs were randomly allocated to two groups, G1 (intracuff volume, 30 mL; n = 8) and G2 (intracuff volume, 54 mt; n = 8), to produce, respectively, high or very high intracuff pressures. Anesthesia was induced and maintained with pentobarbital. Intracuff pressures were measured immediately after insertion and inflation of a No. 4 laryngeal mask airway (LMA) and 30, 60, 90, and 120 minutes thereafter. The dogs were euthanized, and biopsy specimens from eight predetermined areas of the laryngopharynx in contact with LMA cuff were collected for light microscopic (LM) and scanning electron microscopic (SEM) examination. Results: Initial LMA cuff inflation in G1 and G2 resulted in intracuff pressures of 119 mm Hg +/- 4 mm Hg and 235 mm Hg +/- 13 mm Hg, respectively. Over a 2-hour period, the intracuff pressure decreased significantly in G1 (P < .001) and G2 (P < .01), and there was a significant difference between the groups over time (P < .001). The LM study of laryngopharyngeal mucosa in both groups showed mild congestion in the subepithelial layer. There were no differences between the groups (P > .10) or among the areas sampled (P > .10). In some areas of G2, the SEM study showed epithelial desquamation that was more intense than that in GI. Conclusions: the increase in LMA intracuff pressure caused only mild alterations in the laryngopharyngeal mucosa of the dog.

High laryngeal mask airway pressures resulting from nitrous oxide do not increase pharyngeal mucosal injury in dogs

Purpose: During general anesthesia, nitrous oxide (N2O) diffuses rapidly into the air-filled laryngeal mask airway (LMA) cuff, increasing intracuff pressure. There is no clear correlation between LMA intracuff pressure and pressure on the pharynx. We have studied the effects of high LMA intracuff pressures secondary to N2O on the pharyngeal mucosa of dogs.Methods: Sixteen mongrel dogs were randomly allocated to two groups: G1 (intracuff volume, 30 mL; n = 8) breathed a mixture of O-2 (1 L.min(-1)) and air (1 L.min(-1)) and G2 (intracuff volume, 30 mL; n=8) a mixture of O-2 (1 L.min(-1)) and N2O (1 L.min(-1)). Anesthesia was induced and maintained with pentobarbitone. LMA cuff pressure was measured at zero (control), 30, 60, 90 and 120 min after #4 LMA insertion. The dogs were sacrificed, and biopsy specimens from seven predetermined areas of the pharynx in contact with the LMA cuff were collected for light (LM) and scanning electron microscopic (SEM) examination by a blinded observer.Results: LMA intracuff pressure decreased with time in G1 (P < 0.001) and increased in G2 (P < 0.001). There was a significant difference between the groups (P < 0.001). In both groups, the LM study showed a normal epithelium covering the pharyngeal mucosa and mild congestion in the subepithelial layer There were no differences between the groups (P > 0.10) or among the areas sampled (P > 0.05). In both groups, the SEM study showed a normal pharyngeal mucosa with mild superficial desquamation. Few specimens in G1 and G2 showed more intense epithelial desquamation.Conclusion: High LMA intracuff pressures produced by N2O do not increase pharyngeal mucosal injury in dogs.

Efeitos de baixas pressões no balonete da máscara laríngea na mucosa faringolaríngea do cão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Laryngeal lesion in leprosy and the risk of aspiration

Leprosy affects the larynx, damaging its mucosa and sensory nerves and loss of sensation may result in aspiration of food and secretions. The laryngeal lesion may be insidious. Post-mortem studies showed bronchopneumonia that could have originated from aspiration. In patients with laryngeal symptoms, dysphagia or aspiration pneumonia loss of laryngeal sensation should be looked for.

Correlation Between Laryngeal Sensitivity and Penetration/Aspiration After Stroke

Stroke is the most common neurological disease in adults that is associated with deglutition disorders. The presence of laryngeal sensitivity is very important in developing safe swallowing without risk of pulmonary complications. The aim of this study was to correlate laryngeal sensitivity with laryngeal penetration and tracheal aspiration after swallows of three food consistencies (puree, thickened liquid, and liquid) in poststroke individuals in the late phase. A cross-sectional clinical study was performed with 91 post-ischemic stroke individuals, with oropharyngeal dysphagia, who were in rehabilitation center treatment from 2009 to 2011. They had a mean age of 68.1 years and average time since injury was 22.6 months; 39 had injury to the right hemisphere and 52 had injury to the left hemisphere. All underwent fiberoptic endoscopic evaluation of swallowing and evaluation of laryngeal sensitivity by touching the tip of the endoscope to the arytenoids and aryepiglottic folds. The linear correlation coefficient of Spearman was applied to evaluate the correlation between laryngeal penetration and tracheal aspiration and the presence/absence of laryngeal sensitivity. There was a negative correlation between the observation of penetration and tracheal aspiration and laryngeal sensitivity, with all bolus consistencies (p < 0.001 for aspiration and p a parts per thousand currency sign 0.01 for penetration). The absence of laryngeal sensitivity determines the more frequent findings of penetration and tracheal aspiration. This sensory stimulus in the mucosa of the pharynx and larynx is an essential element for safe swallowing and its deficiency associated with altered motor activity can cause laryngeal penetration and aspiration in poststroke individuals regardless of food consistency.

Avaliação histomorfométrica e ultra-estrutural da mucosa do cólon menor eqüino submetido a distensão

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Performance and intestinal mucosa development of broiler chickens fed diets containing Saccharomyces cerevisiae cell wall

Use of antibiotics as an additive in poultry diets to improve growth has been discussed in relation to bacterial resistance and the development of new products and management practices. This study was carried out to test the efficacy of a new substance (Saccharomyces cereviside cell walls, var. Calsberg- SCCW) obtained from the brewery industry, added (at 0.1 and 0.2%) to broiler chicken diets (based on corn and soybean meal), on performance and intestinal mucosa development. In Experiment 1 (carried out in litter-floor pens) the results revealed higher body weight gain,for the total experimental period and higher villus height at 7 d of age for the birds fed 0.2%,SCCW. In a field test using 44,000 broilers that,received feed containing 0.2% SCCW,. The results also showed higher body weight gain and better feed conversion for SCCW-supplemented birds. The present findings show that SCCW improved body weight gain in broiler chickens and that this effect can be attributed to the trophic effect of this product on the intestinal mucosa, because it increases villus height, particularly during the first 7. d of a chicken's life.

Morphometry and ultra-structure of the intestinal mucosa of broilers fed different additives

This study aimed at evaluating the effect of the use of different growth promoters on the morphometry and ultra-structure of the intestinal mucosa of 42-day-old broilers. A total number of 36 male Cobb broilers was distributed in a randomized experimental design with a 3 x 3 factorial arrangement, with 3 prebiotic and 3 probiotic sources in the feed, summing up 9 treatments, with 4 replicates each. There was a significant interaction (P<0.01) among the studied factor for villi height (VH) in all intestinal segments, and for crypt depth (CD) in the duodenum and the ileum. In the duodenum, higher villi were obtained in the control group, with the combination of B. subtilis and prebiotics, and with the single use of MOS+OA. No VH differences were observed between the control group and those fed prebiotics. In the jejunum, the highest villi were obtained with the use of the bacterial pool, followed by the control group, and by the use of B. subtilis. Higher villi were also obtained in the control group and in the groups fed MOS, when B. subtilis was used in combination with prebiotics, and when the bacterial pool was used individually or in combination with MOS. In the ileum, the highest villi were obtained with the individual use of B. subtilis, and when MOS+OA or MOS were individually used or in combination with the bacterial pool. As to duodenal CID, deeper crypts were observed in the control group and in those fed B. subtilis or MOS+OA. In the ileum, deeper crypts were also found in the control group and those fed B. subtilis. Deeper crypts were also found when the bacterial pool was individually used or in combination with MOS+OA, and with the individual use of MOS. It was concluded that the use of growth promoters was beneficial to Increase intestinal villi height when Bacillus subtilis was used in combination with prebiotics. The other growth promoters (MOS+OA, MOS, and bacterial pool), can be individually used in most situations. The tested growth promoters did not influence intestinal villi density.

Efeitos do espaço de alojamento e da idade sobre desenvolvimento, integridade e proteção da mucosa intestinal de frangos de corte

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Intestinal mucosa development in broiler chickens fed natural growth promoters

Fundação de Amparo à Pesquisa do Estado de São Paulo (FAPESP)

Saccharomyces Cerevisiae cell wall dietary supplementation on the performance and intestinal mucosa development and integrity of broiler chickens vaccinated against coccidiosis

This study was carried out to verify if Saccharomyces cerevisiae cell wall (SCCW) dietary supplementation (0.2%) was capable of protecting the intestinal mucosa of broiler chickens vaccinated against coccidiosis. Body weight gain, feed intake, feed conversion and intestinal mucosa morphometric parameters and epithelial loss were evaluated. In the experiment,400 day-old male chicks were distributed according to a completely randomized design in a 2x2 factorial arrangement. The following treatments were applied: T1 - no vaccination/ no SCCW supplementation; T2 - no vaccination/SCCW supplementation; T3 - vaccination/no SCCW supplementation; and T4 - vaccination/SCCW supplementation to four replicates of 25 birds each. Birds were vaccinated on the first day of age using a spray vaccine (Coccivac B®, Coopers), containing E. acervulina, E. maxima, E. mivati and E. tenella. S. cerevisiae cell wall was supplied from the first day of age. Live performance, intestinal morphometric parameters and epithelial loss were evaluated at 14, 21 and 28 days of age. Performance was affected by vaccination only at 21-days of age, when body weight gain was reduced in the vaccinated birds, but no body weight difference was observed on day 28. Vaccine also increased the crypt depth (p<0.05) in the duodenum and jejunum, suggesting a high cell activity in the crypt:villus transition area to maintain the epithelial cell turnover. Villi number/area (103,269 µm²) was not affected (p>0.05) by vaccine or cell wall supplementation, and epithelial loss was more pronounced in the duodenum and jejunum. In conclusion, the findings of this study suggest that S. cerevisiae cell wall supplementation may be an useful management tool to maintain the intestinal integrity of broilers vaccinated against coccidiosis.