Perfil de consulta ambulatoria otorrinolaringológica en pandemia por COVID-19 / Profile of patients in otorhinolaryngological consultation in a COVID-19 pandemic

Introducción: La patología otorrinolaringológica (ORL) presenta alta incidencia en atención primaria, alcanzando hasta 49% de las consultas, sin embargo, la pandemia por SARS-CoV-2 repercutió de manera transversal en los servicios sanitarios, pudiendo haber influido en el perfil de consulta, por lo que se requiere un análisis para la elaboración de estrategias que permitan asegurar la atención sanitaria ante eventos de esta magnitud. Objetivo: Analizar el perfil de consulta libre por patología ORL ambulatoria en un centro médico privado en La Serena durante los años 2019 y 2020. Material y Método: Estudio analítico de corte transversal sobre consultas ambulatorias durante los años 2019 y 2020 realizadas en un centro privado de atención abierta en La Serena. Se estimaron frecuencias en números absolutos y proporciones, estimación de promedios y medianas. Resultados: Durante 2019 hubo un total de 11.932 consultas y en 2020 hubo 9.576. Se observó un predominio de sexo femenino en las consultas de 51% en ambos años. La mediana en 2019 fue de 35 años y en 2020 de 39 años. En 2020 las patologías con mayor consulta fueron nariz (44%), oído (37%) y faringolaringe (14%). Existió un aumento significativo en la consulta por patología cocleovestibular durante 2020. Conclusión: En 2020 hubo una disminución del 19,7% de las consultas dado, probablemente, a las restricciones de movilidad y aforos. Existió un aumento significativo en la proporción de consultas por patologías cocleovestibulares, como vértigo periférico, hipoacusia súbita y tinnitus, atribuido probablemente al estrés emocional generado por la pandemia.

Introduction: Otolaryngological (ENT) pathology presents high incidence in primary care reaching up to 49% of morbidity consultations, however, the pandemic by SARS-CoV-2 had a transversal impact on health services, and may have influenced the consultation profile, so an analysis is required for the development of strategies to ensure health care in the face of events of this magnitude. Aim: To analyze the profile of spontaneous consultation for outpatient ENT pathology in a medical center in La Serena city during 2019 and 2020. Material and Methods: Cross-sectional analytical study of outpatient consultations during the years 2019 and 2020 performed in a private open care center in the commune of La Serena. Frequencies were estimated in absolute numbers and proportions; averages and medians were estimated. Results: During 2019 there were a total of 11,932 consultations and in 2020 there were 9,576. There was a predominance of female sex in the consultations of 51%. The median in 2019 was 35 years and in 2020 it was 39 years. In 2020, the pathologies with the highest number of consultations were nose (44%), ear (37%) and laryngopharynx (14%). There was an increase in consultation for cochleovestibular pathology during 2020. Conclusion: In 2020 there was a 19.7% of consultation decrease probably due to mobility and capacity restrictions. There was a significant increase in the proportion of consultations for cochleovestibular pathologies such as peripheral vertigo, hearing loss and tinnitus, probably attributed to the emotional stress generated by the pandemic.

Las sentencias más comunes en otorrinolaringología / Most frequent sentences in otorhinolaryngology

Las sentencias más comunes en otorrinolaringología. En el presente estudio, se presentan en forma muy concisa los conocimientos más comunes, importantes y útiles de la especialidad a manera de breves sentencias, que si bien son conocidos por la mayoría de los especialistas eventualmente pueden ser olvidados o desconocidos por una minoría.

Most frequent sentences in otorhinolaryngology. The most important, frequent and useful pieces of knowledge of otorhinolaryngology are presented. They are approached with short and precise sentences which, although very familiar for the specialist, tend to be forgotten or unknown by some of them.

Efficiency of Short-term Admission Medical Records in Patients with Common Otolaryngologic Diseases / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: A more simple medical record form has been needed for a more qualified and cost-effective health care. A short-term admission medical record (SAMR) is a standard fill-in-the-blank form on the patients' conditions for common otolaryngologic diseases. The aim of this study is to determine the efficiency of the SAMRs. MATERIALS AND METHOD: Nineteen doctors who had residency training in the Department of Otolaryngology of Ewha Womans University Mokdong Hospital from the year 1995 through 2000 were included in this study. Questionnaires consisted of 11 comparative questions: the subjects were instructed to express their degrees of satisfaction with conventional medical records (CMRs) and SAMRs on a 100mm visual analogue scale for each question. The degrees of satisfaction with SAMRs were compared to those with CMRs. RESULTS: There were no statistically significant differences in the degrees of satisfaction between the two types of records for accurate evaluation of patients' condition, efficient communication between medical and paramedical personnels, and the value of verified records in the medicolegal conflicts and insurance claims. However, the degrees of satisfaction with SAMRs were higher than those with CMRs for communication between doctors, the value in medical research, time-saving, simplicity, paper-saving and their convertibility into electronic medical records. CONCLUSION: SAMRs provides patients of common otolaryngologic diseases with not only the necessary conditions of medical records, but also the basis of computer-based patient records. In addition, SAMRs may be also be more cost-effective than CMRs.

Analgesic Effects of Preoperative Versus Postoperative Tiaprofenic Acid in Pediatric Tonsillectomy & Adenoidectomy / 대한마취과학회지

BACKGROUND: The aim of this study was to investigate the pre-emptive effect of preoperative intravenous tiaprofenic acid in children aged 4~11 years after tonsillectomy and adenoidectomy. METHODS: We compared in 45 children the effect of preoperative with postoperative tiaprofenic acid (5 mg/kg) on pain after tonsillectomy and adenoidectomy, which was approved by Ethics Committee. Informed consents were obtained from all their parents. After induction of anesthesia, patients were allocated randomly to receive a tiaprofenic acid intravenously either before (n=15) or immediately after (n=15) surgery. The control group was received saline (n=15). Postoperative pain was rated on a faces scale for postoperative 48 hours. Tiaprofenic acid was given when patient complained pain. The cumulative pain score within 3 hours and 48 hours, time to the first analgesic administration, total requirement of analgesics for 48 hours and the first time of swallowing 50 ml water were checked. RESULTS: Postoperative pain score of the preoperative group was significantly lower than the postoperative group at 9, 42, and 48 hours after operation. The cumulative pain scores during the first 3 hours were 15+/-4 (p <0.05 vs postoperative), 21+/-7 and 22+/-5 in pre, postoperative and saline groups respectively. The cumulative pain scores for 48 hours were 40+/-18 (p <0.05 vs postoperative), 61+/-17 and 63+/-18 in pre, postoperative and saline groups respectively. The times of the first swallowing were 6 (5~6)(p <0.05 vs postoperative) hours, 7 (6.7~9)hours, and 8 (4.5~8.7)hours after operation in pre, postoperative, and saline groups respectively. CONCLUSIONS: Preoperative tiaprofenic acid in the tonsillectomy and adenoidectomy was effective on the reducing the intensity of the postoperative pain. The time to the first swallowing was shorter in the preoperative than postoperative group. The results of this study support the theory of pre-emptive analgesia.

Comparison of Preoperative with Postoperative Tiaprofenic Acid on Pain after Adult Local Tonsillectomy / 대한마취과학회지

BACKGREOUND: The aim of this study was to compare the pre-emptive effect of preoperative with postoperative tiaprofenic acid in adult local tonsillectomy. METHODS: We compared in forty adults the effect of preoperative with postoperative tiaprofenic acid on pain after tonsillectomy in a double-blind, randomized study, which was approved by the Ethics Committee. Informed consents were obtained. Patients were allocated randomly to receive a tiaprofenic acid (200 mg) intravenously either before (n=20) or immediately after (n=20) surgery. Postoperative pain was rated by self-rating visual analog scale for the first 24 hours. Tiaprofenic acid (200 mg) was given when patient complained pain. Time to the first analgesic administration, total requirement of analgesics for 48 hours and the first time of swallowing 100 ml water were checked. RESULTS: Postoperative 1 hour pain score of the preoperative group was significantly lower than postoperative groups (p<0.05). Times to the first analgesic administration, the total requirement of analgesics for 48 hours and the times of the first swallowing of 100 ml water were not significantly different between the two groups. CONCLUSIONS: Preoperative intravenous tiaprofenic acid (200 mg) in adult local tonsillectomy was effective on the reducing the intensity of the postoperative pain only 1 hour after operation. The use of preoperative tiaprofenic acid in adult local tonsillectomy was associated with a more calm recovery. The results of this study do not support the theory of preemptive analgesia.

There is Some Differences in the Changes of Liver Enzyme Levels among the Type of Surgery under Enflurane Inhalation Anesthesia / 대한마취과학회지

BACKGROUND: There are many factors which cause postoperative hepatic dysfunction. Anesthetic agents are not the most common factor and there aremany other factors such as preoperative condition of the patients, site and duration of the operation, operation per se and so on. The purposeof this study is to evaluate postoperative liver function with respect to different types of surgery. METHOD: Fourty three patients were classified into three groups; 11 patients for tympanoplasty with mastoidectomy (Group 1), 16 patients for total abdominal hysterectomy (Group 2), 15 patients for subtotal gastrectomy (Group 3). All patients were anesthesized with about 2 vol% of enflurane combined with 50% nitrous oxide. Serum glutamic oxalacetic transaminase (SGOT), serum glutamic pyruvic transaminase (SGPT) and alkaline phosphatase (ALP) were measured before anesthesia, 1, 3 and 7 days after surgery in all group, respectively. RESULT: In Group 1 and 2, postoperative SGOT and SGPT levels were maintained with preoperative level during the 7days, but in Group 3, those levels were increased in the 1st day but below upper limit (p<0.05) and decreased thereafter. Alkaline phosphatase level was maintained within the normal range for all the group during the 7 days. CONCLUSION: We consider that postoperative liver functioin may be influenced by different types of surgery, and also may be influenced by anesthetic time.