Severe complication of posterior nasal packing: Case Report

Introduction: Severe Epistaxis is common in patients with head trauma, especially when associated with multiple fractures of the face and skull base. Several methods of controlling bleeding that can be imposed. The anterior nasal tapenade associated with posterior Foley catheter is one of the most widespread, and the universal availability of necessary materials or their apparent ease of execution. Methods: Case report on control of severe epistaxis after severe TBI, with posterior nasal packing by Foley catheter and control tomography showing multiple fractures of the skull base and penetration of the probe into the brain parenchyma. Conclusion: This is a rare but possible complication in the treatment of severe nose bleeds associated with fracture of the skull base. This brief report highlights risks related to the method and suggests some care to prevent complications related through a brief literature review...

Extramedullary plasmacytoma of the larynx

Introduction: The extramedullary plasmocytoma is one of the localized forms of malignancy of the plasma cells, which has multiple myeloma main diagnosis. Its main site to the head and neck, but with a rare presentation in the larynx. Objective: To describe a case of extramedullary plasmocytoma of the larynx, with literature review. Case Report: Patient female, 49, referring to intermittent dysphonia for 01 years with progressive worsening associated with vocal fatigue and vocal effort, with reddish lesion, smooth edges fold left ventricular endoscopy. Being subjected to excisional biopsy diagnosed with extramedullary histopathological plasmocytoma. Conclusion: Extramedullary Plasmocytoma must be considered in the differential diagnosis of rare tumors of the larynx. It is essential after the diagnosis of multiple myeloma research and a "follow up" appropriate...

Anthropometric data as predictors of obstructive sleep apnea severity / Medidas antropométricas preditoras da gravidade da apneia obstrutiva do sono

The Obstructive Sleep Apnea Syndrome is a chronic disease characterized by episodes upper airway collapse, and has been associated with increased cardiovascular morbidity. AIM: To correlate the neck, abdominal and pelvic circumference with the AHI and oxyhemoglobin saturation in OSA patients, and to correlate these values with disease severity. MATERIALS AND METHODS: A prospective descriptive study of 82 patients evaluated complaints suggesting OSA, from July 2008 to March 2010. All patients underwent polysomnography, an ENT clinical exam, measures of the BMI, abdominal, pelvic, and cervical circumferences. The mean, standard deviations and Spearman's correlations were analyzed. RESULTS: The mean AHI in men was 39 events/hr; in women it was 21 events/hr in women. The mean neck circumference was 34. 5 cm in women and 41. 3 cm in men, the mean abdominal circumference was 94. 3 cm in women and 101. 5 cm in men, and the pelvic circumference was 105. 7 cm in men and 108. 7 cm in women. The neck circumference correlated more closely to the AHI in men (r=+0. 389 p=0. 001). The relationship between the abdominal circumference correlated more with AHI than with the BMI in men (AbC r=+0. 358 p=0. 003 BMI r=+0. 321 p=0. 009). CONCLUSIONS: The neck circumference is the best anthropometric measurement of respiratory disorder severity compared to the AbC or the BMI.

Síndrome da Apneia Obstrutiva do Sono é uma doença crônica caracterizada por episódios de colapso da via aérea superior e está relacionada com aumento da morbidade cardiovascular. OBJETIVOS: Correlacionar a circunferência cervical, abdominal e pélvica com o índice de apneia e hipopneia e a saturação da oxi-hemoglobina de pacientes com Apneia Obstrutiva do Sono. MATERIAIS E MÉTODOS: Estudo descritivo prospectivo com 82 pacientes com queixas sugestivas de SAOS avaliados de julho de 2008 a março de 2010. Os pacientes foram submetidos à polissonografia, medidas do IMC e medidas antropométricas. Realizado avaliação da relação entre as variáveis. RESULTADOS: IAH médio entre os homens foi de 39 eventos/hora e 21 nas mulheres. A medida da circunferência cervical média foi 34,5cm para mulheres e 41,3cm para os homens, a abdominal média foi 94,3cm nas mulheres e 101,5cm nos homens e a pélvica foi 105,7cm nos homens e 108,7cm nas mulheres. Circunferência cervical apresentou a maior correlação com o IAH entre homens (r=0,389 p=0,001). A circunferência abdominal tem uma relação mais próxima com o IAH do que o IMC nos homens (CAb r=0,358 p=0,003, IMC r=0,321 p=0,009). CONCLUSÃO: Circunferência cervical é o melhor preditor antropométrico avaliado da gravidade dos distúrbios respiratórios.

Estenoses laringotraqueais em crianças: evolução do tratamento cirúrgico / Laaryngotracheal stenosis in children: surgical treatment evolution

Introdução: O tratamento cirúrgico atual das estenoses laringotraqueais pediátricas inclui uma ampla variedade de procedimentos cirúrgicos, desde abordagem endoscópica até procedimentos mais extensos, como a reconstrução laringotraqueal e a ressecção cricotraqueal. Objetivo: Discutir as indicações e comparar as diferentes abordagens das estenoses laringotraqueais. Métodos: Foi realizado estudo retrospectivo demonstrando a experiência deste serviço no período de 1980 a 2008, no qual 49 casos foram tratados de acordo com grau e a localização da estenose. Trinta e dois casos foram submetidos à cirurgia endoscópica, 12 casos submetidos à reconstrução laringotraqueal, três casos de ressecção cricotraqueal e dois casos de rotary door flap. Resultados: Casos de estenose grau I e II apresentam bons resultados após cirurgia endoscópica enquanto casos grau III e IV necessitam de procedimentos externos. Na maioria dos casos foi necessária combinação de duas ou mais técnicas para obtenção dos resultados esperados.

Introduction: Nowadays, the surgical treatment of pediatric stenosis includes a variety of surgical procedures, from endoscopic approaches to more extensive procedures, such as laryngotracheal reconstruction and cricotracheal resection. Objective: To discuss the surgical indications and to compare the different approaches of laryngotracheal stenosis. Methods: A retrospective study was performed to demonstrate the experience of this institution from 1980 to 2008, in which 49 patients were treated according to the grade and site of the stenosis. Thirty-two patients underwent endoscopic surgery, 12 laryngotracheal reconstructions, 3 cricotracheal resections and 2 rotary door flaps. Results: Grade I and mild grade II stenosis had good results with endoscopic surgery, whereas more severe stenosis - grade II, grade III and IV - required more extensive procedures. In most patients, more than 2 procedures within the several types above related were necessary to reach the expected success.

Associação entre idade ao diagnóstico de diabetes do tipo 2 e o uso de insulina / Relationship between age at diagnosis of type 2 diabetes and insulin requirement

Objetivos: Verificar a relação entre a idade ao diagnóstico de DM tipo 2 e a necessidade de uso insulina. Determinar os possíveis papéis do sexo, peso, pressão arterial, lipídios sangüíneos, relação cintura-quadril e circunferência abdominal no uso precoce de insulina em pacientes com DM tipo 2. Métodos: Medimos as variáveis do estudo nos pacientes que compareceram à Clínica de Diabetes do Ambulatório Central da Universidade de Caxias do Sul e naqueles que se apresentaram em duas Ações Comunitárias (forças-tarefas realizadas pela Universidade, cujo objetivo é de oferecer serviços de diferentes profissionais à comunidade) entre setembro de 2002 e agosto de 2003. Resultados: A amostra foi composta de 61,1% de mulheres e 38,9% de homens. Do total, 17,7 % usavam insulina. O tempo decorrido do diagnóstico de diabetes foi maior entre os usuários do que nos não-usuários de insulina (9,6 ± 9,2 vs 6,0 ± 6,1 anos; p=0,043). A média de idade ao diagnóstico foi similar entre usuários e não-usuários de insulina (52 ± 16,1 ± 11,4 vs 50 ±11,4 anos; p = 0,8) Conclusão: Não houve diferença estatisticamente significativa entre a idade ao diagnóstico de DM tipo 2 e o uso de insulina (AU)

Aim: To verify the relationship between age at diagnosis of Type 2 Diabetes and the need of insulin requirement. To determine the possible role of gender, blood pressure, blood lipids, waist to hip ratio, and abdominal circumference on the early onset of insulin use in patients with type 2 diabetes. Methods: We measured the study variables in patients who did attend to the Diabetic Clinic at the Central Ambulatory of the University of Caxias do Sul and in those presented in two Cumunitarian Actions (task-forces carried out by the University which the aim is to offer the services of different professionals to the community) between September 2002 and August 2003. Results: The sample was composed by 61,1% of women and 38,9% of men. From the total sample, 17,7 % of the patients where on insulin use. The time elapsed from the diagnosis of diabetes was greater in the users than in non-users of insulin (9,6 ± 9,2 vs 6,0 ± 6,1 years; p =0,043). The mean age at diagnosis was similar between users and non users of insulin (52 ± 16,1 ± 11,4 vs 50 ± 11,4 years; p = 0,8). Conclusion: There was not statistically significant difference between the age of diagnosis of type 2 diabetes and the use of insulin (AU)