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Lower airway bronchoscopic interpretation
Published in Don Hayes, Kara D. Meister, Pediatric Bronchoscopy for Clinicians, 2023
Kimberley R. Kaspy, Sara M. Zak
Tracheal obstructionThe trachea can also be subjected to obstruction, whether from a foreign body or from intraluminal lesions. Foreign body removal is discussed in Chapter 9 and should generally be performed in conjunction with a rigid bronchoscopy by pediatric otolaryngology.Figure 5.6 demonstrates respiratory papillomatosis, caused by the human papilloma virus (HPV). This virus causes wart-like lesions in the airway, generally beginning in the upper airway/larynx, but can spread down into the lower airway. As there is a risk of malignant transformation of these lesions, it is important that they are closely monitored and treated. Potential endoscopic interventions for treatment are discussed in Chapter 9.Sarcomas and other cancerous lesions can be found in the airway and can cause obstruction, though these are rare in children.25Subglottic hemangiomas and cysts can also cause obstruction in the upper trachea.
Larynx
Published in Neeraj Sethi, R. James A. England, Neil de Zoysa, Head, Neck and Thyroid Surgery, 2020
More common in the paediatric population than adults, laryngeal papillomatosis is frequently due to exposure to human papillomavirus (HPV) types 11 and 6. In paediatric patients, this exposure may occur during passage through the birth canal, as both HPV subtypes are known to be associated with genital warts.
Prevention
Published in William Bonnez, Guide to Genital HPV Diseases and Prevention, 2019
William Bonnez, Darron R. Brown, Cynthia M. Rand
There is now evidence that Gardasil is effective in 27- to 45-year-old women. Data are needed in populations that are immunodeficient, especially those infected with HIV, or immunosuppressed, for example to prevent an allogeneic graft rejection or treat an autoimmune disorder. Recurrent respiratory papillomatosis is a rare but crippling disease, and it would be important to evaluate the impact on this disease of the HPV vaccination of young girls, and eventually young boys, but also of pregnant women with external genital warts or other genital HPV infections. The presence of antibodies in the birth canal, might be effective in reducing the rate of transmission of HPV during vaginal delivery.
Systemic bevacizumab for recurrent respiratory papillomatosis. A case series
Published in Acta Oto-Laryngologica Case Reports, 2023
Kristine Grubbe Gregersen, Jeppe Friborg, Claus Andrup Kristensen, Kristian Hveysel Bork
Monitoring the treatment effect was done by the laryngologist by laryngeal and tracheobronchial endoscopy. Computed Tomography (CT) scan was not used as no patients showed signs of pulmonary spread. Surgery was performed before treatment introduction to minimize the amount of visual papillomatosis and upon recurrence after discontinuation of treatment. The endpoints were the resulting increase in interval between surgeries or visual and symptomatic regression as evaluated by the otolaryngologists. Due to the heterogeneity of the small cohort, we emphasized the results in partial response (PR) – regression but still multiple visible papilloma and in need of repeated surgery, good response (GR) – hardly visible papilloma and no need of repeated surgery and complete response (CR) – in the one patient that showed no recurrence of visible papilloma even though treatment with bevacizumab was stopped.
A Systematic Review of the Benefit of B-Vitamins as a Complementary Treatment in Cancer Patients
Published in Nutrition and Cancer, 2022
L. Heilfort, S. Kutschan, J. Dörfler, M. Freuding, J. Büntzel, K. Münstedt, J. Hübner
Disease-free interval, tumor response and progression and recurrence rate of cancer were the main endpoints of Byar et al. (24) and Newling et al. (25) and the high-dose trials Chalermchai et al. (27) and Corrie et al. (29). Nearly all trials reported that vitamin B6 had no significant effect on these endpoints (Byar et al. (24) and Newling et al. (25): after bladder-cancer resection; Chalermchai et al. (27) and Corrie et al. (29): colorectal and breast cancer). However, Byar et al. (24) and Chalermchai et al. (27) also mentioned significant results in particular aspects. Chalermchai et al. (27) showed significant differences in partial tumor response in favor of the low-dose vitamin B6-group (400 mg/day: 57.9%, 200 mg/day: 20%, P = 0.038). Byar et al. (24) reported that there was a lower recurrence rate of bladder cancer in the vitamin B6 arm when the first 10 mo, after cancer resection were omitted from the analysis (P = 0.03). Additionally, this study named a significant difference in progression of disease: patients taking 25 mg of vitamin B6 daily experienced fewer new tumors during the study compared to their original tumor load than patients in the placebo group (P = 0.026). Nevertheless, no difference could be observed in the increase of tumor grade or in the development of papillomatosis.
Incremental healthcare resource utilization and costs for patients with cervical, vaginal, vulvar, anal, and oropharyngeal cancer in the United States
Published in Current Medical Research and Opinion, 2021
Vimalanand Prabhu, Niranjan Kathe, Kunal Saxena, Anuj Walia, Riddhi Markan, Evan Myers, Mark Einstein
Human papillomavirus (HPV) infects approximately 79 million people in the United States (US)1. There are over 14 million documented new infections per year, but this is likely higher as not all are tested. HPV types are classified as high-risk HPV types (e.g. HPV types 16 and 18) and low-risk HPV types (e.g. 6 and 11) based on their risk of causing cancer. Low-risk HPV types cause diseases such as genital warts and recurrent respiratory papillomatosis, while high-risk types can cause precancers lesions as well as cancers attributable to HPV by varying degrees (cervical: 91%, vulvar: 69%, vaginal: 75%, anal: 91%, and oropharyngeal: 70%)2,3. Currently, approximately 43,000 new cancer cases occur annually in the US at body sites where HPV infections is typically found (HPV-related cancers)4,5. Among women, HPV-related cancers account for 3.3% of all cancers6. Of those, 72% are found on the cervix (53.4%), vagina (3.4%), or the vulva (15.2%), while the others are anal (16.4%) and oropharyngeal cancer (11.6%)4. Among males, HPV-related cancers represents 2.0% of all cancers with most of them being oropharyngeal (78.2%) and the others being anal and penile cancers (14.4 and 7.4%, respectively)4.