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Papers by pedro benitez

Research paper thumbnail of The impact of atopy, sinus opacification, and nasal patency on quality of life in patients with severe nasal polyposis

Otolaryngology-head and Neck Surgery, 2006

Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate ... more Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate the association between quality of life and atopy, sinus opacification, and nasal patency in severe nasal polyposis. One hundred nine patients completed the Medical Outcome Study Short Form-36 (SF-36) survey. Symptoms, polyp size, atopy, nasal patency, and sinus opacification were also scored. Patients showed worse scores in all SF-36 domains, except for physical functioning, compared with Spanish population. Atopic patients had worse scores in role physical, body pain, vitality, and mental health than nonatopic patients. Atopic patients showed lower physical component summary (44.7 +/- 1.1) and mental component summary (38.4 +/- 1.0) than nonatopic patients (48.3 +/- 1.6, 40.6 +/- 1.3; P < 0.05), respectively. There were no correlations between quality of life and symptoms, polyp size, CT scan, nasal patency, and atopy. Nasal polyposis has a considerable impact on quality of life and atopy worsens this impact. C-4.

Research paper thumbnail of Parapharyngeal angiolipoma causing obstructive sleep apnoea syndrome

Acta Oto-laryngologica, 2004

Obstructive sleep apnoea syndrome (OSAS) is the cessation of airflow with the continuance of resp... more Obstructive sleep apnoea syndrome (OSAS) is the cessation of airflow with the continuance of respiratory effort during sleep. OSAS associated with a neck mass is extremely rare. Angiolipoma is a rare, benign, fatty tumour composed of mature lipocytes and multiple areas containing angiomatous elements. The treatment for an angiolipoma is surgical excision. We report the case of a 47-year-old male who presented with a history of loud snoring associated with sleep apnoea. A polysomnographic study demonstrated an apnoea-hypopnoea index of 72/h. CT showed a 3.5 x 3 x 8 cm3 hypoattenuated mass of fat density in the left parapharyngeal space causing an impression on the nasopharynx and oropharynx with a peripheral hyperintense area. A cervical transparotid surgical approach was used. A histological study led to the definitive diagnosis of angiolipomal without evidence of malignancy. After surgery, the snoring disappeared and the patient remained tumour-free after 54 months of follow-up. This is the first case in the literature of a patient with nocturnal polysomnographic-documented OSAS caused by a left parapharyngeal angiolipoma.

Research paper thumbnail of Solitary Fibrous Tumor of the Larynx

Otolaryngology-head and Neck Surgery, 2005

Background True mesenchymal, non-cartilaginous neoplasms of the larynx are rare. Extrapleural sol... more Background True mesenchymal, non-cartilaginous neoplasms of the larynx are rare. Extrapleural solitary fibrous tumor (SFT) is a localized neoplasm characterized by proliferation of thin-walled vessels and collagen-producing cells and is considered within the ''hemangiopericytoma-solitary fibrous tumor'' spectrum. SFT primary in the larynx is exceptional. Design Case report set in a comparison with other cases reported in the English literature (MEDLINE 1966(MEDLINE to 2007. Results A 49year old white male presented with difficulty breathing, progressive over the past 2 years. He denied dysphagia and weight loss. Past medical history was significant for asthma. He denied cigarette smoking or alcohol abuse. There were no cervical deformities on physical exam. Fiberoptic laryngoscopy was performed upon stabilization of respiratory function. A smooth, round, submucosal mass measuring 2.3 cm in greatest diameter arising from the inferior surface of left true vocal cord was causing near total obstruction of the endolaryngeal space. The mass was excised. The surface mucosa was intact and unremarkable. A cellular, spindle cell neoplasm was arranged in loose fascicles, associated with heavy collagen fiber deposition. The collagen was wiry and heavy. Cells were bland with cytoplasmic extensions. The nuclei were vesicular to hyperchromatic and elongated with inconspicuous nucleoli. Vessels were prominent and delicate, with patulous spaces. Mitotic figures were easily identified, but atypical forms were not present. The cells were strongly and diffusely immunoreactive with CD34 and bcl-2, while non-reactive with cytokeratin, EMA, actin, ALK-1, S100, desmin, and CD117. These findings confirmed a diagnosis of extraplural solitary fibrous tumor. Without further disease, the patient is alive without evidence of disease, 12 months after surgery. Conclusions The characteristic histologic pattern of solitary fibrous tumor can be noted in extrapulmonary locations. Development in the larynx is uncommon, but the tumor presents as a polypoid mass with characteristic histologic and immunophenotypic features. Conservative local excision is the treatment of choice to yield an excellent prognosis.

Research paper thumbnail of Transoral approach to drain streptococcus pneumoniae spinal epidural abscess in an HIV-infected adult

Acta Oto-laryngologica, 2004

Spinal epidural abscess due to Streptococcus pneumoniae is extremely rare in adults. It typically... more Spinal epidural abscess due to Streptococcus pneumoniae is extremely rare in adults. It typically occurs in the thoracic, lumbar or lumbosacral epidural spaces, and less frequently in the cervical epidural space. The principal causative microbial agent is Staphylococcus aureus, representing 70% of cases, while 1.6% of cases are caused by S. pneumoniae. We report the first case of an HIV-infected patient with a cervical spinal epidural abscess. The patient was a 43-year-old male with pneumococcal bacteremia and a metatarsal abscess. He reported cervical pain with muscle spasm during cephalic flexion and extension, fever and a painful tumefaction on the second metatarsal of the left foot. MRI confirmed that the retropharyngeal abscess extended to the cervical spinal epidural space. Antibiotic therapy with cefotaxime plus vancomycin was initiated and a transoral surgical approach was used to achieve retropharyngeal and local debridement of the metatarsal abscess. Blood and pus cultures were positive for S. pneumoniae. After 4 months of follow-up the patient remained asymptomatic, without clinical or MRI evidence of recurrence.

Research paper thumbnail of Cavernous Haemangioma of the Internal Auditory Canal

Acta Oto-laryngologica, 2002

Cavernous haemangioma is a rare neoplasm that can be easily misdiagnosed as acoustic neuroma when... more Cavernous haemangioma is a rare neoplasm that can be easily misdiagnosed as acoustic neuroma when it occurs in the internal auditory canal (IAC) or cerebello-pontine angle. A right cavernous haemangioma is reported in a 61-year-old male. The lesion was associated with non-pulsative tinnitus, deteriorating hearing loss and facial nerve dysfunction (House and Brackmann grade IV). A T1-weighted Gd-diethylenetriaminepentaacetic acid-enhanced MRI scan demonstrated a small hyperintense lesion confined to the right IAC. The tumor was completely resected via a retrosigmoidal approach. Histologic examination demonstrated a vascular tumor composed of an irregular, dilated vascular space with collagenous walls lined by a vascular endothelium. Facial nerve function remained unchanged and the patient remained well with no evidence of recurrence 2 years after surgery. We conclude that progressive hearing loss associated with facial nerve dysfunction, particularly when the lesion in the IAC is small, should raise the possibility of cavernous haemangioma.

Research paper thumbnail of Solitary Fibrous Tumour of the Nasal Cavity and Paranasal Sinuses

Acta Oto-laryngologica, 2003

Solitary fibrous tumour (SFT) is an uncommon unilateral benign lesion that usually arises from th... more Solitary fibrous tumour (SFT) is an uncommon unilateral benign lesion that usually arises from the pleura. Recently, SFT has been described in many other locations, such as the mediastinum, head and neck, orbit and urogenital system. To date, only 21 cases of SFT arising from the nasal cavity and paranasal sinuses have been reported in the literature. We describe a case of SFT localized in the right nasal cavity with extension to the right ethmoid and sphenoid sinuses in a 43-year-old man who presented with a 6-month history of unilateral right-sided nasal obstruction, rhinorrhoea and recurrent epistaxis. CT showed a large mass arising from the right anterior ethmoid and sphenoid sinuses. Histopathologically, the lesion consisted of a non-encapsulated mass with spindle-shaped cells within a collagenous stroma. Definitive diagnosis was obtained by means of immunohistochemical analysis, which showed vimentin and CD34 cells. The tumour was removed by endoscopic sinus surgery, and the patient remained free of tumour after 12 months of follow-up.

Research paper thumbnail of Proinflammatory cytokines and eosinophil cationic protein on glandular secretion from human nasal mucosa: Regulation by corticosteroids

Journal of Allergy and Clinical Immunology, 2001

Background: Airway hypersecretion is a common finding in rhinitis and asthma in which proinflamma... more Background: Airway hypersecretion is a common finding in rhinitis and asthma in which proinflammatory cytokines are upregulated. The effect of inflammation on glandular secretion remains unclear. Objective: We sought to investigate the effect of proinflammatory cytokines and eosinophil products in in vitro lactoferrin glandular secretion from human nasal mucosa and the role of corticosteroids and IL-10 in modulating this effect. Methods: Nasal explants from patients undergoing turbinectomies were incubated in a controlled atmosphere (50% N 2 , 5% CO 2 , and 45% O 2 ) at 37°C. Nasal explants were incubated with or without IL-1β, IL-4, IL-5, IL-8, eotaxin, GM-CSF, TNF-α, eosinophil cationic protein (ECP), IL-10, and budesonide in a time-course and dose-response fashion. Lactoferrin concentrations in culture supernatants were measured by means of ELISA. Results: ECP (up to 30%) caused a dose-related stimulation of lactoferrin secretion. TNF-α (20 ng/mL) induced a significant increase of lactoferrin release from 8 hours (27.7% ± 17.8%, P < .05) to 24 hours (40.8% ± 17.2%, P < .01) compared with that found in media-treated explants. At 24 hours, TNF-α caused a dose-related stimulation of lactoferrin secretion (up to 35%). IL-1β (65.3% ± 15.2%, P < .05) and GM-CSF (15.7% ± 6.7%, P < .05), both at 20 ng/mL, exerted a stimulatory effect only at 24 hours, and IL-4, IL-5, IL-8, and eotaxin had no significant effect. Budesonide caused a dose-related inhibition of lactoferrin secretion induced by IL-1β (down to -76%) and TNF-α (down to -70%), whereas IL-10 had no effect. Conclusions: ECP and some proinflammatory cytokines (IL-1β, TNF-α, and GM-CSF) may contribute to glandular hypersecretion in the inflamed nose. Corticosteroids may reduce nasal hypersecretion by blocking the direct effect of proinflammatory cytokines on glandular output. (J Allergy Clin Immunol 2001;108:87-93.)

Research paper thumbnail of The impact of asthma and aspirin sensitivity on quality of life of patients with nasal polyposis

Quality of Life Research, 2005

Background: Nasal polyposis is not a life-threatening disease but may have a great impact on pati... more Background: Nasal polyposis is not a life-threatening disease but may have a great impact on patient’s quality of life. Objective: To investigate the impact of nasal polyps on quality of life compared with the Spanish general population using the SF-36 questionnaire; and to evaluate the impact of asthma and aspirin sensitivity on quality of life in patients with nasal polyposis. Methods: We included 130 patients with nasal polyposis and evaluated nasal symptom, CT scan, polyp size, and quality of life. Results: In comparison with the Spanish general population, patients with nasal polyposis had worse scores on all SF-36 domains except for physical functioning. Asthmatic patients with nasal polyposis had worse quality of life than nonasthmatic patients on role physical, body pain, and vitality (p Conclusion: These results suggest that nasal polyposis has a considerable impact on quality of life. Moreover, asthma but not aspirin sensitivity has an additional negative impact on the quality of life of patients with nasal polyposis.

Research paper thumbnail of Cyclooxygenase 1 and cyclooxygenase 2 expression is abnormally regulated in human nasal polyps

Journal of Allergy and Clinical Immunology, 2002

Background: There is evidence that impairment of prostanoid metabolism might be involved in the p... more Background: There is evidence that impairment of prostanoid metabolism might be involved in the pathogenesis of nasal polyps (NPs). Prostanoids are synthesized by 2 cyclooxygenase (Cox) enzymes, one constitutive (Cox-1) and another inducible (Cox-2). Objective: The aim of these studies was to investigate Cox-1 and Cox-2 regulation in NPs of aspirin-tolerant human patients compared with that seen in nasal mucosa (NM). Methods: Cultured explants from human NPs and healthy mucosa from patients undergoing polypectomy and corrective nasal surgery, respectively, were examined for Cox-1 and Cox-2 expression by means of semiquantitative competitive PCR and Western blotting. Results: Cox-1 mRNA was spontaneously upregulated in cultured NM but not in NPs. A spontaneous but delayed upregulation of Cox-2 mRNA was found in NPs (24 hours) compared with that seen in NM (6 hours). After cytokine stimulation (IFN-γ, IL-1β, and TNF-α), the induction of Cox-2 mRNA and protein was also faster in NM (1 hour) than in NPs (4 hours). Conclusion: These data showing an abnormal regulation of Cox-1 and Cox-2 in NPs from aspirin-tolerant patients reinforce the concept that prostanoid metabolism might be important in the pathogenesis of inflammatory nasal diseases and suggest a potential role for this alteration in the formation of NPs. (J Allergy Clin Immunol 2002;109:824-30.)

Research paper thumbnail of Expression of the glucocorticoid receptor alpha and beta isoforms in human nasal mucosa and polyp epithelial cells

Respiratory Medicine, 2003

The lower sensitivity of the inflamed nasal mucosa to glucocorticoids might be related to an incr... more The lower sensitivity of the inflamed nasal mucosa to glucocorticoids might be related to an increased expression of the glucocorticoid receptor (GR) beta isoform.We investigated GRa and GRb mRNA expression in epithelial cells from nasal mucosa and nasal polyps.GRa mRNA was at least1000 times more expressed than GRb mRNA in both tissues.GRb expression (mean7SEM of 10 3 cDNA copies/mg of total RNA) was higher in nasal polyps (1.1570.19; n=27; Po0.01) than in nasal mucosa (0.6270.10; n=32). Nasal polyps with43% of inflammatory cells had higher GRb levels (1.4070.29; n=16) than both nasal mucosa (Po0.01) and polyps with r3% of inflammatory cells (0.8070.18; n=11; Po0.05).No difference in GRbexpression was found between nasalmucosa and polyps with r 3% of inflammatory cells. GRb expression correlated with the inflammatory cell number, especially with mast cells (r=0.50, Po0.0001). There was no difference in GRa mRNA expression between nasal mucosa and nasal polyps. In summary,GRa is far more expressed than GRbin bothtissues.The increased expression of GRb may be related to the presence of inflammatory cells.

Research paper thumbnail of Peripheral Primitive Neuroectodermal Tumour of the Left Maxillary Sinus

Acta Oto-laryngologica, 2003

Peripheral primitive neuroectodermal tumours (pPNETs) are highly malignant, small-cell neoplasms ... more Peripheral primitive neuroectodermal tumours (pPNETs) are highly malignant, small-cell neoplasms found mainly in children and young adults. Recent advances in immunohistochemistry and genetic typing have led to reports of a close relationship between pPNET and the previously ...

Research paper thumbnail of The impact of atopy, sinus opacification, and nasal patency on quality of life in patients with severe nasal polyposis

Otolaryngology-head and Neck Surgery, 2006

Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate ... more Nasal polyposis has a great impact on the quality of life. The aim of this study was to evaluate the association between quality of life and atopy, sinus opacification, and nasal patency in severe nasal polyposis. One hundred nine patients completed the Medical Outcome Study Short Form-36 (SF-36) survey. Symptoms, polyp size, atopy, nasal patency, and sinus opacification were also scored. Patients showed worse scores in all SF-36 domains, except for physical functioning, compared with Spanish population. Atopic patients had worse scores in role physical, body pain, vitality, and mental health than nonatopic patients. Atopic patients showed lower physical component summary (44.7 +/- 1.1) and mental component summary (38.4 +/- 1.0) than nonatopic patients (48.3 +/- 1.6, 40.6 +/- 1.3; P &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05), respectively. There were no correlations between quality of life and symptoms, polyp size, CT scan, nasal patency, and atopy. Nasal polyposis has a considerable impact on quality of life and atopy worsens this impact. C-4.

Research paper thumbnail of Parapharyngeal angiolipoma causing obstructive sleep apnoea syndrome

Acta Oto-laryngologica, 2004

Obstructive sleep apnoea syndrome (OSAS) is the cessation of airflow with the continuance of resp... more Obstructive sleep apnoea syndrome (OSAS) is the cessation of airflow with the continuance of respiratory effort during sleep. OSAS associated with a neck mass is extremely rare. Angiolipoma is a rare, benign, fatty tumour composed of mature lipocytes and multiple areas containing angiomatous elements. The treatment for an angiolipoma is surgical excision. We report the case of a 47-year-old male who presented with a history of loud snoring associated with sleep apnoea. A polysomnographic study demonstrated an apnoea-hypopnoea index of 72/h. CT showed a 3.5 x 3 x 8 cm3 hypoattenuated mass of fat density in the left parapharyngeal space causing an impression on the nasopharynx and oropharynx with a peripheral hyperintense area. A cervical transparotid surgical approach was used. A histological study led to the definitive diagnosis of angiolipomal without evidence of malignancy. After surgery, the snoring disappeared and the patient remained tumour-free after 54 months of follow-up. This is the first case in the literature of a patient with nocturnal polysomnographic-documented OSAS caused by a left parapharyngeal angiolipoma.

Research paper thumbnail of Solitary Fibrous Tumor of the Larynx

Otolaryngology-head and Neck Surgery, 2005

Background True mesenchymal, non-cartilaginous neoplasms of the larynx are rare. Extrapleural sol... more Background True mesenchymal, non-cartilaginous neoplasms of the larynx are rare. Extrapleural solitary fibrous tumor (SFT) is a localized neoplasm characterized by proliferation of thin-walled vessels and collagen-producing cells and is considered within the ''hemangiopericytoma-solitary fibrous tumor'' spectrum. SFT primary in the larynx is exceptional. Design Case report set in a comparison with other cases reported in the English literature (MEDLINE 1966(MEDLINE to 2007. Results A 49year old white male presented with difficulty breathing, progressive over the past 2 years. He denied dysphagia and weight loss. Past medical history was significant for asthma. He denied cigarette smoking or alcohol abuse. There were no cervical deformities on physical exam. Fiberoptic laryngoscopy was performed upon stabilization of respiratory function. A smooth, round, submucosal mass measuring 2.3 cm in greatest diameter arising from the inferior surface of left true vocal cord was causing near total obstruction of the endolaryngeal space. The mass was excised. The surface mucosa was intact and unremarkable. A cellular, spindle cell neoplasm was arranged in loose fascicles, associated with heavy collagen fiber deposition. The collagen was wiry and heavy. Cells were bland with cytoplasmic extensions. The nuclei were vesicular to hyperchromatic and elongated with inconspicuous nucleoli. Vessels were prominent and delicate, with patulous spaces. Mitotic figures were easily identified, but atypical forms were not present. The cells were strongly and diffusely immunoreactive with CD34 and bcl-2, while non-reactive with cytokeratin, EMA, actin, ALK-1, S100, desmin, and CD117. These findings confirmed a diagnosis of extraplural solitary fibrous tumor. Without further disease, the patient is alive without evidence of disease, 12 months after surgery. Conclusions The characteristic histologic pattern of solitary fibrous tumor can be noted in extrapulmonary locations. Development in the larynx is uncommon, but the tumor presents as a polypoid mass with characteristic histologic and immunophenotypic features. Conservative local excision is the treatment of choice to yield an excellent prognosis.

Research paper thumbnail of Transoral approach to drain streptococcus pneumoniae spinal epidural abscess in an HIV-infected adult

Acta Oto-laryngologica, 2004

Spinal epidural abscess due to Streptococcus pneumoniae is extremely rare in adults. It typically... more Spinal epidural abscess due to Streptococcus pneumoniae is extremely rare in adults. It typically occurs in the thoracic, lumbar or lumbosacral epidural spaces, and less frequently in the cervical epidural space. The principal causative microbial agent is Staphylococcus aureus, representing 70% of cases, while 1.6% of cases are caused by S. pneumoniae. We report the first case of an HIV-infected patient with a cervical spinal epidural abscess. The patient was a 43-year-old male with pneumococcal bacteremia and a metatarsal abscess. He reported cervical pain with muscle spasm during cephalic flexion and extension, fever and a painful tumefaction on the second metatarsal of the left foot. MRI confirmed that the retropharyngeal abscess extended to the cervical spinal epidural space. Antibiotic therapy with cefotaxime plus vancomycin was initiated and a transoral surgical approach was used to achieve retropharyngeal and local debridement of the metatarsal abscess. Blood and pus cultures were positive for S. pneumoniae. After 4 months of follow-up the patient remained asymptomatic, without clinical or MRI evidence of recurrence.

Research paper thumbnail of Cavernous Haemangioma of the Internal Auditory Canal

Acta Oto-laryngologica, 2002

Cavernous haemangioma is a rare neoplasm that can be easily misdiagnosed as acoustic neuroma when... more Cavernous haemangioma is a rare neoplasm that can be easily misdiagnosed as acoustic neuroma when it occurs in the internal auditory canal (IAC) or cerebello-pontine angle. A right cavernous haemangioma is reported in a 61-year-old male. The lesion was associated with non-pulsative tinnitus, deteriorating hearing loss and facial nerve dysfunction (House and Brackmann grade IV). A T1-weighted Gd-diethylenetriaminepentaacetic acid-enhanced MRI scan demonstrated a small hyperintense lesion confined to the right IAC. The tumor was completely resected via a retrosigmoidal approach. Histologic examination demonstrated a vascular tumor composed of an irregular, dilated vascular space with collagenous walls lined by a vascular endothelium. Facial nerve function remained unchanged and the patient remained well with no evidence of recurrence 2 years after surgery. We conclude that progressive hearing loss associated with facial nerve dysfunction, particularly when the lesion in the IAC is small, should raise the possibility of cavernous haemangioma.

Research paper thumbnail of Solitary Fibrous Tumour of the Nasal Cavity and Paranasal Sinuses

Acta Oto-laryngologica, 2003

Solitary fibrous tumour (SFT) is an uncommon unilateral benign lesion that usually arises from th... more Solitary fibrous tumour (SFT) is an uncommon unilateral benign lesion that usually arises from the pleura. Recently, SFT has been described in many other locations, such as the mediastinum, head and neck, orbit and urogenital system. To date, only 21 cases of SFT arising from the nasal cavity and paranasal sinuses have been reported in the literature. We describe a case of SFT localized in the right nasal cavity with extension to the right ethmoid and sphenoid sinuses in a 43-year-old man who presented with a 6-month history of unilateral right-sided nasal obstruction, rhinorrhoea and recurrent epistaxis. CT showed a large mass arising from the right anterior ethmoid and sphenoid sinuses. Histopathologically, the lesion consisted of a non-encapsulated mass with spindle-shaped cells within a collagenous stroma. Definitive diagnosis was obtained by means of immunohistochemical analysis, which showed vimentin and CD34 cells. The tumour was removed by endoscopic sinus surgery, and the patient remained free of tumour after 12 months of follow-up.

Research paper thumbnail of Proinflammatory cytokines and eosinophil cationic protein on glandular secretion from human nasal mucosa: Regulation by corticosteroids

Journal of Allergy and Clinical Immunology, 2001

Background: Airway hypersecretion is a common finding in rhinitis and asthma in which proinflamma... more Background: Airway hypersecretion is a common finding in rhinitis and asthma in which proinflammatory cytokines are upregulated. The effect of inflammation on glandular secretion remains unclear. Objective: We sought to investigate the effect of proinflammatory cytokines and eosinophil products in in vitro lactoferrin glandular secretion from human nasal mucosa and the role of corticosteroids and IL-10 in modulating this effect. Methods: Nasal explants from patients undergoing turbinectomies were incubated in a controlled atmosphere (50% N 2 , 5% CO 2 , and 45% O 2 ) at 37°C. Nasal explants were incubated with or without IL-1β, IL-4, IL-5, IL-8, eotaxin, GM-CSF, TNF-α, eosinophil cationic protein (ECP), IL-10, and budesonide in a time-course and dose-response fashion. Lactoferrin concentrations in culture supernatants were measured by means of ELISA. Results: ECP (up to 30%) caused a dose-related stimulation of lactoferrin secretion. TNF-α (20 ng/mL) induced a significant increase of lactoferrin release from 8 hours (27.7% ± 17.8%, P < .05) to 24 hours (40.8% ± 17.2%, P < .01) compared with that found in media-treated explants. At 24 hours, TNF-α caused a dose-related stimulation of lactoferrin secretion (up to 35%). IL-1β (65.3% ± 15.2%, P < .05) and GM-CSF (15.7% ± 6.7%, P < .05), both at 20 ng/mL, exerted a stimulatory effect only at 24 hours, and IL-4, IL-5, IL-8, and eotaxin had no significant effect. Budesonide caused a dose-related inhibition of lactoferrin secretion induced by IL-1β (down to -76%) and TNF-α (down to -70%), whereas IL-10 had no effect. Conclusions: ECP and some proinflammatory cytokines (IL-1β, TNF-α, and GM-CSF) may contribute to glandular hypersecretion in the inflamed nose. Corticosteroids may reduce nasal hypersecretion by blocking the direct effect of proinflammatory cytokines on glandular output. (J Allergy Clin Immunol 2001;108:87-93.)

Research paper thumbnail of The impact of asthma and aspirin sensitivity on quality of life of patients with nasal polyposis

Quality of Life Research, 2005

Background: Nasal polyposis is not a life-threatening disease but may have a great impact on pati... more Background: Nasal polyposis is not a life-threatening disease but may have a great impact on patient’s quality of life. Objective: To investigate the impact of nasal polyps on quality of life compared with the Spanish general population using the SF-36 questionnaire; and to evaluate the impact of asthma and aspirin sensitivity on quality of life in patients with nasal polyposis. Methods: We included 130 patients with nasal polyposis and evaluated nasal symptom, CT scan, polyp size, and quality of life. Results: In comparison with the Spanish general population, patients with nasal polyposis had worse scores on all SF-36 domains except for physical functioning. Asthmatic patients with nasal polyposis had worse quality of life than nonasthmatic patients on role physical, body pain, and vitality (p Conclusion: These results suggest that nasal polyposis has a considerable impact on quality of life. Moreover, asthma but not aspirin sensitivity has an additional negative impact on the quality of life of patients with nasal polyposis.

Research paper thumbnail of Cyclooxygenase 1 and cyclooxygenase 2 expression is abnormally regulated in human nasal polyps

Journal of Allergy and Clinical Immunology, 2002

Background: There is evidence that impairment of prostanoid metabolism might be involved in the p... more Background: There is evidence that impairment of prostanoid metabolism might be involved in the pathogenesis of nasal polyps (NPs). Prostanoids are synthesized by 2 cyclooxygenase (Cox) enzymes, one constitutive (Cox-1) and another inducible (Cox-2). Objective: The aim of these studies was to investigate Cox-1 and Cox-2 regulation in NPs of aspirin-tolerant human patients compared with that seen in nasal mucosa (NM). Methods: Cultured explants from human NPs and healthy mucosa from patients undergoing polypectomy and corrective nasal surgery, respectively, were examined for Cox-1 and Cox-2 expression by means of semiquantitative competitive PCR and Western blotting. Results: Cox-1 mRNA was spontaneously upregulated in cultured NM but not in NPs. A spontaneous but delayed upregulation of Cox-2 mRNA was found in NPs (24 hours) compared with that seen in NM (6 hours). After cytokine stimulation (IFN-γ, IL-1β, and TNF-α), the induction of Cox-2 mRNA and protein was also faster in NM (1 hour) than in NPs (4 hours). Conclusion: These data showing an abnormal regulation of Cox-1 and Cox-2 in NPs from aspirin-tolerant patients reinforce the concept that prostanoid metabolism might be important in the pathogenesis of inflammatory nasal diseases and suggest a potential role for this alteration in the formation of NPs. (J Allergy Clin Immunol 2002;109:824-30.)

Research paper thumbnail of Expression of the glucocorticoid receptor alpha and beta isoforms in human nasal mucosa and polyp epithelial cells

Respiratory Medicine, 2003

The lower sensitivity of the inflamed nasal mucosa to glucocorticoids might be related to an incr... more The lower sensitivity of the inflamed nasal mucosa to glucocorticoids might be related to an increased expression of the glucocorticoid receptor (GR) beta isoform.We investigated GRa and GRb mRNA expression in epithelial cells from nasal mucosa and nasal polyps.GRa mRNA was at least1000 times more expressed than GRb mRNA in both tissues.GRb expression (mean7SEM of 10 3 cDNA copies/mg of total RNA) was higher in nasal polyps (1.1570.19; n=27; Po0.01) than in nasal mucosa (0.6270.10; n=32). Nasal polyps with43% of inflammatory cells had higher GRb levels (1.4070.29; n=16) than both nasal mucosa (Po0.01) and polyps with r3% of inflammatory cells (0.8070.18; n=11; Po0.05).No difference in GRbexpression was found between nasalmucosa and polyps with r 3% of inflammatory cells. GRb expression correlated with the inflammatory cell number, especially with mast cells (r=0.50, Po0.0001). There was no difference in GRa mRNA expression between nasal mucosa and nasal polyps. In summary,GRa is far more expressed than GRbin bothtissues.The increased expression of GRb may be related to the presence of inflammatory cells.

Research paper thumbnail of Peripheral Primitive Neuroectodermal Tumour of the Left Maxillary Sinus

Acta Oto-laryngologica, 2003

Peripheral primitive neuroectodermal tumours (pPNETs) are highly malignant, small-cell neoplasms ... more Peripheral primitive neuroectodermal tumours (pPNETs) are highly malignant, small-cell neoplasms found mainly in children and young adults. Recent advances in immunohistochemistry and genetic typing have led to reports of a close relationship between pPNET and the previously ...