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1.
Salud(i)ciencia (Impresa) ; 24(5): 252-256, mar.-abr. 2021. graf.
Article in Spanish | LILACS, BINACIS | ID: biblio-1283920

ABSTRACT

Lermoyez´ syndrome is an unusual clinical variant of Ménière's disease, because in both pathologies there is a peripheral vascular disorder, what It consists in the dilation of the labyrinthine membranes associated with an increase in the volume of the endolymph. Clinically, they have severe frequency fluctuations of hearing loss, tinnitus and vertigo attacks. FinaIly, it evolves to the deterioration of hearing in all frequencies. Lermoyez´ síndrome, or labyrinthine angiospasm, has an unknown etiopathogeny, although several theories have been proposed, but none explains its nature, nor its clinical course, being one of them the allergy. Their diagnosis is clinical, they present the typical triad (peripheral vertigo crisis with neurosensory hearing loss and tinnitus and/or otic fullness), but they characterised by the improvement in hearing just after a sudden vertigo attack. With the development of the disease, dizziness attacks and hearing recovery become more and more rare, and disappear. Treatment aims to relieve symptoms during crises and improve disease progression. It is present the clinical case of Lermoyez syndrome, in a male patient with allergic pathology, who was diagnosed with Ménière's disease at the beginning. It is a rare syndrome described described in classical ENT (ear-nose-throat)


El síndrome de Lermoyez es una variante clínica inusual de la enfermedad de Ménière. En ambas afecciones existe un trastorno vascular periférico, que consiste en la dilatación de las membranas laberínticas, asociadas con aumento del volumen de la endolinfa. Clínicamente, el individuo presenta fluctuaciones en la audición (hipoacusia neurosensorial en las frecuencias graves), acúfenos y ataques de vértigo. En su evolución final se deteriora la audición en todas las frecuencias. El síndrome de Lermoyez, o angioespasmo laberíntico, tiene una etiopatogenia desconocida, aunque se han propuesto varias teorías, pero ninguna explica su naturaleza ni su curso clínico, y una de ellas es la alergia. Su diagnóstico es clínico, presentan la triada típica (crisis de vértigo periférico con hipoacusia neurosensorial y acúfenos o plenitud ótica), pero el síndrome de Lermoyez se caracteriza por la mejora de la audición tras un ataque brusco de vértigo. Con el avance de la enfermedad, los ataques de vértigo y la recuperación de la audición llegan a ser cada vez más raros, hasta desaparecer. El tratamiento tiene como finalidad aliviar los síntomas durante las crisis y mejorar la evolución de la enfermedad. Se presenta un caso clínico de síndrome de Lermoyez, en un paciente varón con afección alérgica, cuyo diagnóstico de inicio fue de enfermedad de Ménière. Es un síndrome infrecuente, descrito en la otorrinolaringología clásica


Subject(s)
Humans , Male , Middle Aged , Otolaryngology , Vertigo , Dizziness , Hearing Loss , Meniere Disease
2.
Oncol. (Guayaquil) ; 31(1): 15-34, Abril 30, 2021.
Article in Spanish | LILACS | ID: biblio-1222456

ABSTRACT

Introducción: el uso de sales de platinos en patologías oncológicas es ampliamente usado, una de las preocupaciones de los profesionales de la salud es la presencia de eventos adversos en este grupo de pacientes que suelen ser vulnerables, por lo que es necesario la generación de consensos para realizar una selección óptima de pacientes candidatos a terapias basadas en platinos Objetivo: Realizar un consenso de expertos para la inelegibilidad al uso de platinos de acuerdo a varios criterios para realizar un tratamiento óptimo de acuerdo a la selección y categorización de pacientes Pregunta de salud cubierta por la Guía: ¿Qué pacientes portadores de cáncer de origen otorrinolaringológico no son elegibles para tratamiento con platinos? Población: La población objetivos son pacientes adultos con cáncer otorrinolaringológico. Resultados: Se establecieron consensos para la inelegibilidad al uso de platinos sobre los siguientes criterios: Edad >70 años, ECOG >1, Pérdida involuntaria de peso >20%, función auditiva "borderline": alteraciones Grado I, Alteraciones neurológicas Grado I, Trastornos de la función renal: CrCL <60 ml/min, Alteración hepática ≥ grado II Child-Pugh B, Comorbilidades: diabetes, HTA, alteraciones pulmonares, anemia e Insuficiencia cardiaca


Introduction: the use of platinum salts in oncological pathologies is widely used, one of the concerns of health professionals is the presence of adverse events in this group of patients who are usually vulnerable, so it is necessary to generate of consensus to make an optimal selection of candidate patients for platinum-based therapies Objective: To carry out a consensus of experts for the ineligibility for the use of points according to several criteria to carry out an optimal treatment according to the selection and categorization of patients Health question covered by the Guide: Which patients with otorhinolringological origin cancer are not eligible for treatment with platinums? Population: The target population is adult patients with ENT cancer. Results: consensus was established for the ineligibility for the use of lenses on the following crite-ria: Age> 70 years, ECOG> 1, Involuntary weight loss> 20%, "borderline" hearing function: Grade I al-terations, Neurological alterations Grade I, Renal function disorders: CrCL <60 ml / min, Hepatic im-pairment ≥ grade II Child-Pugh B, Comorbidities: diabetes, hypertension, pulmonary disorders, anemia and heart failure.


Subject(s)
Laryngeal Neoplasms , Platinum Compounds , Otolaryngology , Otorhinolaryngologic Diseases , Practice Guidelines as Topic
3.
Rev. bras. educ. méd ; 45(3): e133, 2021. tab
Article in Portuguese | LILACS | ID: biblio-1279849

ABSTRACT

Resumo: Introdução: Afecções otorrinolaringológicas são destaques entre as enfermidades mais frequentes na atenção primária. Acredita-se que a sobrecarga na atenção secundária seja consequência da baixa resolução dos problemas na atenção primária. Uma possível explicação para esse fato seria a deficiência na capacitação médica durante a graduação. Estima-se que a carga horária média de otorrinolaringologia seja 0,6% da carga horaria média total, após análise de 141 matrizes curriculares, correspondendo a aproximadamente 70,5% do total das escolas médicas em funcionamento em 2013. Nessa área, poucos estudos têm sido realizados em relação ao ensino e à necessidade de reavaliação curricular. Objetivo: O presente estudo tem o intuito de buscar um consenso sobre as competências necessárias ao generalista na especialidade de otorrinolaringologia. Métodos: Criou-se um questionário inicial que abordava as competências otorrinolaringológicas pertinentes à prática clínica dos médicos da atenção primária. Por meio da metodologia Delphi, no formato eletrônico, o questionário foi enviado para 20 especialistas com formações distintas: médicos generalistas, otorrinolaringologistas e médicos de família e comunidade. Essa heterogeneidade entre os especialistas contribuiu para garantir a confiabilidade dos resultados. Os resultados obtidos após cada rodada eram analisados pelos pesquisadores, que observavam as tendências e as opiniões dissonantes, bem como suas justificativas. Ao final da sistematização e compilação dos resultados, um novo questionário era elaborado e reenviado, iniciando uma nova rodada até que o consenso fosse estabelecido em todas competências. Resultados: Realizaram-se cinco rodadas para o estabelecimento do consenso em todas as 17 competências otorrinolaringológicas avaliadas pelas proposições, o possibilitou a definição do nível de competência dos conteúdos e procedimentos otorrinolaringológicos preconizados ao egresso de Medicina. Conclusão: Os dados obtidos neste trabalho podem servir para o embasamento, direcionamento e desenvolvimento do currículo otorrinolaringológico nos cursos de graduação de Medicina, visto que não se encontrou na literatura consenso estabelecendo as competências mínimas otorrinolaringológicas na formação curricular da graduação.


Abstract: Introduction: Otorhinolaryngological disorders are amongst the most prominent frequent diseases in primary care. The overload in secondary care is thought to be a consequence of the low resolution of these problems in primary care. A deficiency in undergraduate medical training may explain this fact. The average estimated time spent studying otorhinolaryngological practice is estimated to be 0.6% of the total average practice hours after analysis of data from 141 medical course syllabuses in Brazil, corresponding to approximately 70.5% of all the medical schools in operation in 2013. Few studies have been conducted in this area and regarding teaching and the need for curriculum reassessment. Objectives: This study seeks to ascertain a consensus on the skills required by the general practitioner in the specialty of otorhinolaryngology. Methods: An initial questionnaire was devised addressing the otorhinolaryngological skills relevant to primary care clinical practice. Using the Delphi method, the questionnaire was sent in electronic format to 20 specialists with training in three different specialties; this heterogeneity of the survey sample helped ensure the reliability of the results. The results obtained after each round were analyzed by one researcher and validated by another, observing any discrepant trends and opinions, as well as their justifications. Once the results had all been compiled and systematized, a new questionnaire was devised and sent out, starting a new round until consensus had been established for all the skills. Results: Five rounds were completed until a consensus was established for all 17 otorhinolaryngological skills evaluated by the propositions. Conclusions: The data obtained by this work can serve as a basis and guideline for developing an otorhinolaryngological curriculum for undergraduate medical training since no consensus was found in the literature establishing such a minimum skill set.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Otolaryngology/education , Delphi Technique , Competency-Based Education , Curriculum
4.
Montevideo; Ediciones Granada; 2021. 454 p. ilus.
Monography in Spanish | LILACS, BNUY, BNUY-Odon | ID: biblio-1282226
5.
Medwave ; 21(1)2021.
Article in English, Spanish | LILACS | ID: biblio-1252397

ABSTRACT

Introducción La enfermedad por coronavirus 2019, o COVID-19, se ha convertido en una pandemia. Dada que la mayor carga viral de coronavirus de tipo 2 causante del síndrome respiratorio agudo severo (SARS-CoV-2) se encuentra en la vía aérea, los otorrinolaringólogos tienen un elevado riesgo de infección. Múltiples recomendaciones han surgido con respecto a las medidas de protección, incluidos la suspensión de procedimientos y cirugías electivas. Objetivos Evaluar el impacto de la pandemia de COVID-19 en los programas de formación de otorrinolaringología a nivel nacional. Métodos Estudio transversal de encuesta en línea a residentes de otorrinolaringología realizado durante abril de 2020. Se analizaron datos demográficos, actividades clínicas, turnos de llamado, infección por COVID-19, exposición a pacientes COVID-19 positivos, despliegue a otras especialidades, procedimientos y cirugías realizadas. Se utilizaron los portafolios quirúrgicos de años previos para comparar los resultados. Resultados Completaron la encuesta 47 residentes, con 84% de tasa de respuesta; el 64% refirió haber acudido a su centro asistencial 10 días o menos durante el mes de abril de 2020. Con relación a procedimientos frecuentes tales como nasofibroscopía, endoscopia nasal rígida y drenaje de absceso periamigdalino, no fueron realizados por más del 40% de los residentes en el mes. Solo el 38% participó en cirugías, con un promedio de 0,6 procedimientos como primer cirujano; se constata una drástica disminución al comparar los registros de años anteriores. La mayoría de los residentes refieren estas medidas educativas complementarias: videoconferencias bibliográficas (87%), seminarios de casos clínicos en línea (60%), revisión de artículos (38%), entre otros. Conclusiones La formación clínica y quirúrgica disminuyó drásticamente durante abril de 2020. Se deben considerar ajustes a los planes de estudio para disminuir el impacto negativo de la pandemia en la formación de los residentes.


Introduction Coronavirus disease 2019, or COVID-19, has become a global pandemic. Given that the highest viral load of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is found in the airway, otolaryngologists are at high risk of infection. As a result, multiple recommendations have emerged regarding protective measures for surgical teams, including suspending non-urgent procedures and surgeries. Objectives To evaluate the impact of the COVID-19 pandemic on otolaryngology residency training programs nationwide. Methods A cross-sectional survey-based study was completed in April 2020. The participants were recruited through an online survey, sent by email to all Chilean otolaryngology residents. Demographics, clinical activities, on-call shifts, COVID-19 infection status, exposure to COVID-19 patients, deployment to other specialties, diagnostic/therapeutic procedures, and surgeries performed were analyzed. Self-reported surgical data logs from previous years were used to compare results. Results Forty-seven residents completed the survey (84% response rate); 64% of residents refer seeing patients ten days or less during April 2020. Commonly performed procedures such as flexible nasolaryngoscopy, rigid nasal endoscopy, and peritonsillar abscess drainage were not performed by over 40% of the residents in that month. Only 38% participated in surgeries, with an average of 0.6 surgeries as a first surgeon, a dramatic decrease in surgical exposure when comparing the data logs from previous years. Most residents refer the following measures taken by their residency program to improve residency training: bibliographic videoconferences (87%), online clinical case seminars (60%), weekly journal clubs (38%), among others. Conclusions Clinical and surgical opportunities decreased dramatically during April 2020. Adjustments to the regular academic curricula should be considered to decrease the negative impact of this pandemic on residency training.


Subject(s)
Humans , Male , Female , Adult , Otolaryngology/education , COVID-19 , Internship and Residency , Chile , Cross-Sectional Studies
6.
Acta otorrinolaringol. cir. cabeza cuello ; 49(2): 101-103, 2021. ilus
Article in Spanish | LILACS | ID: biblio-1280968

ABSTRACT

Este año celebramos los 60 años de fundada la Asociación Colombiana de Otorrinolaringología y cirugía de cabeza y cuello, estos sesenta años que se cumplen ,resultan ser una fecha muy importante para esta agremiación y donde considero importante recordar y homenajear a las cabezas lideres y fundadoras de esta sociedad. Descargas


Subject(s)
Humans , Otolaryngology/history , Academies and Institutes/history , Head/surgery , Neck/surgery , Colombia
7.
Acta otorrinolaringol. cir. cabeza cuello ; 49(3): 189-198, 2021. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1292708

ABSTRACT

Introducción: la infección por el coronavirus del síndrome respiratorio agudo grave de tipo 2 (SARS-CoV-2) tiene una elevada incidencia entre profesionales sanitarios, especialmente otorrinolaringólogos (ORL). El objetivo de este estudio fue recoger aspectos organizativos, de seguridad y de protección de los ORL durante el pico de la pandemia por la enfermedad por coronavirus de 2019 (COVID-19) en España. Material y métodos: estudio transversal con una encuesta por correo electrónico a los socios ORL de la Sociedad Española de Otorrinolaringología y Cirugía de Cabeza y Cuello (SEORL-CCC). Resultados: respondieron 408 profesionales. La atención a pacientes con COVID-19 representó más del 25 % de la actividad asistencial para el 24,4 % de los encuestados. 213 encuestados (52,6 %) respondieron que algún compañero había guardado cuarentena o dado positivo en la prueba. La cantidad de facultativos diagnosticados con COVID-19 o que guardó cuarentena por síntomas compatibles osciló entre 1 y 12 por hospital (media 2,2; mediana 2) y se encontró una mayor incidencia en las regiones con mayor incidencia de coronavirus (62,1 % frente a 41,8 %; p < 0,001), atención directa a pacientes con COVID-19 (81 % frente a 46,4 %; p = 0,001) y actividad de guardias (p = 0,01). El 61,5 % de los especialistas en hospitalización y el 40,4 % en consultas no contaron siempre con la protección personal aconsejada. Conclusiones: la pandemia por COVID-19 ha alterado la organización y la actividad asistencial de los servicios de otorrinolaringología. Importancia clínica: los especialistas ORL no han contado siempre con los equipos de protección aconsejados por los protocolos y una cantidad relevante se ha visto afectada por la COVID-19.


Introduction: severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has a high incidence among healthcare professionals, especially otorhinolaryngologists (ENT). Study objective: The objective of this study was to collect organizational, safety and protection aspects of otorhinolaryngologists during the peak of the coronavirus disease 2019 (COVID-19) pandemic in Spain. Material and methods: Cross-sectional study with an e-mail survey to the ENT partners of the Spanish Society of Otorhinolaryngology and Head and Neck Surgery (SEORL-CCC). Results: 408 professionals completed the survey. Care of patients with COVID-19 represented more than 25% of healthcare activity for 24.4% of respondents. 213 respondents (52.6%) answered that a colleague tested positive or had been quarantined. The number of ENT surgeons diagnosed with COVID-19 or who were quarantined for compatible symptoms ranged between 1 and 12 per hospital (mean 2.2; median 2) and was related to regions with the highest incidence of coronavirus (62.1% vs. 41,8%; p <0.001), direct care for patients with COVID-19 (81% vs. 46.4%; p = 0.001) and on call activity (p = 0.01). 61.5% of the specialists attending inpatients and 40.4% attending outpatients did not always have the recommended personal protective equipment (PPE). Conclusions: The COVID-19 pandemic has altered the organization and care activity of the otorhinolaryngology departments. Clinical importance: ENT specialists have not always had the protective equipment recommended by the protocols and a significant number have been affected by COVID-19.


Subject(s)
Humans , Coronavirus Infections , Otolaryngology , Attention , Equipment Safety
8.
Acta otorrinolaringol. cir. cabeza cuello ; 49(3): 207-214, 2021. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1292713

ABSTRACT

Introducción: la enfermedad por el nuevo coronavirus de 2019 (COVID-19) ha cambiado la practica quirúrgica. Su aparición en nuestro país ha provocado el aplazamiento masivo de las cirugías electivas. La evidencia actual sobre los desenlaces de las cirugías electivas de otorrinolaringología durante la pandemia de COVID-19 es limitada. Objetivo: describir la experiencia quirúrgica durante la pandemia de COVID-19 en un departamento de otorrinolaringología en Bogotá, Colombia. Métodos: estudio retrospectivo que incluyó las historias clínicas y las descripciones quirúrgicas de los pacientes que fueron llevados a cirugía de otorrinolaringología durante la pandemia de COVID-19 en dos hospitales, entre el 5 de mayo y el 15 de agosto de 2020 en Bogotá, Colombia. Resultados: Se incluyeron 199 pacientes (122 hombres con una mediana de edad de 28 años). Ningún paciente falleció o requirió del ingreso a una unidad de cuidados intensivos (UCI). El 97,5 % de las cirugías fueron electivas. 19,5 % pacientes desarrollaron síntomas relacionados con COVID-19 en el posoperatorio; de los pacientes evaluados, solo uno obtuvo un resultado positivo posquirúrgico para COVID-19 y no desarrolló ninguna complicación. Seis pacientes desarrollaron complicaciones después de la cirugía y uno tuvo neumonía con resultado negativo en la prueba de reacción en cadena de la polimerasa nasofaríngeo (PCR) para COVID-19. Conclusiones: a pesar de la alta exposición a aerosoles durante las cirugías de otorrinolaringología y la alta transmisibilidad del virus, los resultados sugieren que estas cirugías, con el uso apropiado del equipo de protección personal (EPP), y la adecuada selección de los pacientes son seguras para el paciente y para el otorrinolaringólogo.


Introduction: The 2019 novel coronavirus disease (COVID-19) has changed global surgical activity causing massive elective surgery postponement. Current evidence surrounding surgical outcomes after otorhinolaryngological surgical procedures during COVID-19 pandemic is limited. Objective: To describe our surgical experience during COVID-19 outbreak in an otolaryngology department in Bogotá, Colombia. Methods: This retrospective study analysed the records and surgical information of adults and children's patients who underwent an elective or emergency ENT surgery during COVID-19 outbreak at two hospitals between May 5 to August 15, 2020 in Bogotá, Colombia. Results: A total of 199 patients were enrolled (122 males, median age of 28 years). No patients died or required intensive unit care (ICU). Elective surgery represented the 97.5% surgeries. 19.5% patients had COVID-19 related symptoms in the postoperative period, from the tested patients only one obtained a positive COVID-19 polymerase chain reaction (PCR) test result and did not develop any associated respiratory complication. Six patients developed complications after surgery, and one had pneumonia with a negative COVID-19 PCR nasopharyngeal swab result. Conclusions: This study shows that despite the high exposure to droplets during otorhinolaryngologic surgeries and the inherent high transmissibility from the virus, the surgical procedures with correct patient selection and appropriate use of PPE can be safe for both the patient and the otolaryngologist.


Subject(s)
Humans , Coronavirus Infections , Otolaryngology , Surgical Procedures, Operative , Ambulatory Care Facilities
9.
Acta otorrinolaringol. cir. cabeza cuello ; 49(1): 73-76, 2021. ilus, tab, graf
Article in Spanish | LILACS, COLNAL | ID: biblio-1152179

ABSTRACT

En la actualidad la educación médica está pasando por un momento de crisis dado que se requiere de una implementación de estrategias pedagógicas basadas en modelos educativos constructivistas, que deje a un lado parte del modelo educativo tradicional. Actualmente se requiere de nuevos cambios al modelo pedagógico en la especialidad de otorrinolaringología para la formación de los médicos residentes de primera y segunda especialidad, debido al estado de pandemia global. Apoyarse en las tecnologías de la información y la comunicación aplicadas a la educación médica merece tener más relevancia en los programas formativos; asi mismo, es importante una mirada educativa donde la alteridad (nos-otros) tome relevancia con un papel activo entre el cuerpo docente y el estudiantado, sin dejar a un lado la participación de los centros de formación académica mediante un trabajo en conjunto. Este, es el nuevo horizonte educativo de los programas de posgrados médico-quirúrgicos.


Medical education is currently going through a time of crisis where it requires an implementation of pedagogical strategies based on constructivist educational models and leaves aside part of the traditional educational model. Currently, further changes and adjustments to the educational model in the specialty of otolaryngology are required for the training of first and second specialty resident physicians by the global pandemic state. Relying on information and communication technologies applied to medical education deserves more relevance in training programs, likewise an educational look where the otherness (We-Others) takes relevance with an active role among the groups of teachers and students without leaving aside the participation of the academic formation centers by means of a joint work, this is the new educational horizon for medical-surgical postgraduate programs.


Subject(s)
Humans , Otolaryngology/education , Teaching , Education, Medical/methods , COVID-19 , Internship and Residency
10.
Article in Spanish | LILACS | ID: biblio-1281082

ABSTRACT

La otitis media aguda (OMA) es una patología muy común en pediatría y constituye la indicación más frecuente de prescripción de antibióticos en la infancia. Para el diagnóstico se tienen en cuenta hallazgos en la otoscopia, diversos signos clínicos y el tiempo de evolución de los síntomas principales. La decisión de iniciar antibioticoterapia debe determinarse según cada paciente. La espera vigilante como alternativa a la antibioticoterapia inmediata en casos seleccionados reduce el uso de antibióticos sin aumentar el riesgo de daño al paciente y ha demostrado ser una medida costo-efectiva. El fármaco de elección para el tratamiento empírico de la OMA es la amoxicilina, aunque según nuestros resultados es la amoxicilina-IBL la utilizada como primera línea en ambos servicios.


Acute otitis media (AOM) is a pathology commonly found in pediatrics, and the most frequent cause of antibiotics prescription in infants. For its diagnostics, several criteria are taken in consideration, such as otoscopy observations, diverse clinical signs, and the time of evolution of the main symptoms. The decision to initiate antibiotic therapy must be determined particularly for each patient. As an alternative to immediate antibiotic therapy, watchful waiting is preferred in certain cases to reduce the antibiotic use without elevating the patients' risk and has been proven to be a cost-effective approach. The preferred drug for empiric antibiotic therapy in AOM is amoxicillin, although we have observed that the first choice in both our services, pediatrics and otorhinolaryngology, is amoxicillin-IBL.


Subject(s)
Otitis Media , Otoscopy , Amoxicillin , Otolaryngology , Pediatrics , Signs and Symptoms , Diagnosis
11.
Bol. méd. postgrado ; 36(2): 48-52, dic.2020. tab, graf
Article in Spanish | LILACS, LIVECS | ID: biblio-1117900

ABSTRACT

Se realizó un estudio retrospectivo de revisión de 95 historias clínicas con el objetivo de determinar los factores predisponentes a la disfonía por hiperfunción laríngea en pacientes adultos que asistieron a la consulta de Otorrinolaringología del Hospital Universitario Dr. Luis Gómez López durante el lapso enero-diciembre 2016 a Junio 2017. Entre los resultados se encontró una predominancia del sexo masculino (82,4%) y una edad entre 37 a 44 años en 96,8% de los casos; 38% de los pacientes son profesionales expuestos a contaminación ambiental, 25% son profesionales de la voz; 79% no refiere tener hábito tabáquico; 38% refirió abusar de la voz, siendo las principales causas el hablar en exceso, cantar y gritar. El 67,4% de los pacientes están expuestos a vapores tóxicos, 86,3% al humo del tabaco y 82,1% al humo de la leña. El grado de disfonía más frecuente diagnosticado por nasofibrolaringoscopía fue grado II (60%). Es importante la detección temprana de los factores predisponentes asociados a la disfonía por hiperfunción laríngea de forma de implementar acciones que favorezcan las condiciones laborales y ambientales y mitiguen su influencia en la fisiología de la voz(AU)


A retrospective review of 95 medical charts was carried out with the objective of determining the predisposing factors for laryngeal hyperfunction dysphonia in adult patients attending the otorhinolaryngology consult of the Hospital Universitario Dr. Luis Gómez López, during the period January-December 2016 to June 2017. The results show a male predominance (82.4%) and an age between 37 to 44 years in 96.8% of cases; 38% of patients are professionals exposed to environmental pollution and 25% are voice professionals; 79% of patients don't smoke; 38% of cases abuse voice by speaking frequently, singing and shouting. 67.4% of patients have been exposed to vapors, 86.3% to tobacco smoke and 82.1% to firewood. Degree of dysphonia diagnosed by nasofibrolaryngoscopy was grade II (60%). Early detection of predisposing factors associated to laryngeal hyperfunction dysphonia is important in order to implement environmental actions to mitigate their influence in voice physiology(AU)


Subject(s)
Humans , Male , Female , Middle Aged , Quality of Life , Voice Disorders , Laryngeal Diseases , Dysphonia/diagnosis , Dysphonia/etiology , Otolaryngology , Stress, Psychological , Voice Quality
12.
Säo Paulo med. j ; 138(3): 184-189, May-June 2020. tab, graf
Article in English | LILACS, SES-SP | ID: biblio-1139690

ABSTRACT

ABSTRACT BACKGROUND: The authors of randomized controlled trials will usually claim that they have met the randomization process criterion. However, sequence generation schemes differ and some schemes that are claimed to be randomized are not genuinely randomized. Even less well understood, and often more difficult to ascertain, is whether the allocation was really concealed. OBJECTIVE: To detect the extent of control over selection bias, in a comparison between two Cochrane groups: oral health and otorhinolaryngology; and to describe the methods used to control for this bias. DESIGN AND SETTING: Cross-sectional study conducted in a public university in São Paulo, Brazil. METHODS: The risk of selection bias in 1,714 records indexed in Medline database up to 2018 was assessed, independent of language and access. Two dimensions implicated in the allocation were considered: generation of the allocation sequence; and allocation concealment. RESULTS: We included 420 randomized controlled trials and all of them were evaluated to detect selection bias. In the sample studied, only 28 properly controlled the selection bias. Lack of control over selection bias was present in 80% of the studies evaluated in both groups. CONCLUSION: The two groups were similar regarding control over selection bias. They are also similar to the methods used. The dimension of allocation concealment appears to be a limiting factor with regard to production of randomized controlled trials with low risk of selection bias. The quality of reporting in studies on oral health and otorhinolaryngology is suboptimal and needs to be improved, in line with other fields of healthcare.


Subject(s)
Humans , Otolaryngology , Oral Health , Brazil , Selection Bias , Cross-Sectional Studies
13.
Rev. colomb. reumatol ; 27(2): 123-129, ene.-jun. 2020. tab, graf
Article in Spanish | LILACS | ID: biblio-1251646

ABSTRACT

RESUMEN La granulomatosis con poliangeítis (Wegener) es considerada como una enfermedad granulomatosa sistémica, no infecciosa, caracterizada histológicamente por una vasculitis necrosante de pequeño vaso. El tracto respiratorio superior e inferior son los más frecuentemente afectados, en asociación a manifestaciones renales. Sin embargo, también se describe el compromiso aislado de un solo órgano, como es el caso del globo ocular y la órbita. Presentamos el caso de una mujer cuya principal manifestación consistió en un proceso inflamatorio de tejido periorbitario y proptosis del globo ocular izquierdo. La paciente fue valorada en manejo conjunto con el servicio de plástica ocular, otorrinolaringología y finalmente se derivó a reumatología para inicio de terapia inmunosupresora. Se realizó una revisión de la literatura, en búsqueda de reportes de caso y series de caso que permitieran comparar las presentaciones clínicas y desenlaces más frecuentes.


A B S T R A C T Granulomatosis with polyangiitis (Wegener) is considered as a systemic, non-infectious granulomatous disease, histologically noted for its small vessel necrotising vasculitis. The upper and lower respiratory tracts are the most frequently affected, in association with renal manifestations. However, the isolated involvement of a single organ, such as the eyeball and the orbit is also described. The case is presented of a woman whose main manifestation was an inflammatory process of periorbital tissue and proptosis of the left eyeball. The patient was evaluated jointly with eye plastic surgery, and the ear, nose and throat, and rheumatology departments. A literature review was carried out, looking for case reports and case series that allowed comparisons to made between the clinical manifestations and the most frequent outcomes.


Subject(s)
Humans , Female , Middle Aged , Granulomatosis with Polyangiitis , Exophthalmos , Otolaryngology , Respiratory System , Vasculitis , Eye
17.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 273-280, May-June 2020.
Article in English | LILACS | ID: biblio-1132602

ABSTRACT

Abstract Introduction: We are facing a pandemic with a great impact worldwide, as a result of the rapid spread of the novel coronavirus (COVID-19). The medical community is still getting to know behavior of this virus and the consequences from a population point of view. All this knowledge is extremely dynamic, so some behaviors are still not well established. Otorhinolaryngologists have a central role in the management of this situation, in which they must assess the patient, avoid contamination to and by health professionals and other patients. Thus, the recommendations of the Brazilian Association of Otorhinolaryngology and Cervical-Facial Surgery (ABORL-CCF) have the main objective of reducing the spread of the new coronavirus during otorhinolaryngological care and assisting in the management of these patients. Methods: Review of the main recommendations of national and international scientific societies, decisions by government agencies and class councils. The topics will be related to the general aspects of COVID-19, personal protective equipment, care in patient assistance, endoscopic exam routines and the management of sinonasal, otological and pediatric evaluations related to COVID-19. Results: The use of personal protective equipment is considered crucial in routine ENT care. We recommend postponing appointments, exams and elective surgeries to reduce the spread of COVID-19. Similarly, we recommend changing routines in several areas of otolaryngology. Additionally, guidance is provided on the use of telemedicine resources during the pandemic period. Conclusions: We are still at the beginning of the COVID-19 pandemic and scientific evidence is still scarce and incomplete, so these ABORL-CCF recommendations for otorhinolaryngologists may be updated based on new knowledge and the pattern of the new coronavirus spread.


Resumo: Introdução: Estamos diante de uma pandemia de grande impacto mundial como resultado da rápida propagação do novo coronavírus, COVID-19. A comunidade médica está ainda conhecendo o comportamento desse vírus e as repercussões do ponto de vista populacional. Todo esse conhecimento é extremamente dinâmico, por isso algumas condutas ainda não estão bem estabelecidas. O otorrinolaringologista tem um papel central no manejo dessa situação em que deve avaliar o paciente e evitar a contaminação dos profissionais da saúde e dos demais pacientes. Dessa forma, as recomendações da Associação Brasileira de Otorrinolaringologia e Cirurgia Cérvico-Facial (ABORL-CCF) têm por objetivo principal reduzir a propagação do novo coronavírus durante o atendimento otorrinolaringológico e auxiliar no manejo desses pacientes. Método: Revisão das principais recomendações das sociedades científicas nacionais, internacionais, decisões de órgãos governamentais e de conselhos de classe. Os tópicos serão relativos aos aspectos gerais do COVID-19, equipamentos de proteção individual, cuidados no atendimento ao paciente, as rotinas dos exames endoscópicos e o manejo de aspectos nasossinusais, otológicos e pediátricos relacionados ao COVID-19. Resultados: É considerado crucial o uso de equipamento de proteção individual no atendimento otorrinolaringológico de rotina. Recomendamos postergar atendimentos, exames e cirurgias eletivas para diminuir a propagação do COVID-19. Da mesma forma, recomendamos mudança de rotinas em diversas áreas da otorrinolaringologia. Além disso, orientações sobre o uso do recurso da telemedicina durante o período de vigência da pandemia. Conclusões: Estamos ainda no início da pandemia do COVID-19 e as evidências científicas são ainda escassas, por isso essas recomendações da ABORL-CCF para os otorrinolaringologistas podem sofrer atualizações baseadas nos novos conhecimentos e no padrão de disseminação do novo coronavírus.


Subject(s)
Humans , Otolaryngology/standards , Pneumonia, Viral/prevention & control , Coronavirus Infections/prevention & control , Pandemics/prevention & control , Personal Protective Equipment/standards , Betacoronavirus , Societies, Medical , Practice Patterns, Physicians' , Practice Guidelines as Topic , Infectious Disease Transmission, Patient-to-Professional/prevention & control , Coronavirus Infections
18.
Braz. j. otorhinolaryngol. (Impr.) ; 86(3): 287-293, May-June 2020. tab
Article in English | LILACS | ID: biblio-1132600

ABSTRACT

Abstract Introduction: Targeted needs assessment which includes identifying the needs of learners is a key step of program development. However, this step is commonly underestimated in postgraduate medical education programs, including otolaryngology residency training. Determining the needs of otolaryngologists may help educators to design more purposeful continuing medical education training programs. Furthermore, needs of specialists may provide a clearer insight about effectiveness of the residency programs in that specialty. Objective: To determine training needs of otolaryngology specialists and to identify deficiencies in otolaryngology residency training programs. Methods: Seventy-eight otolaryngology specialists, who completed all data gathering forms properly, were included in this descriptive, cross-sectional study. Demographic data of the participants were collected. Training needs of the participants were determined in seven basic areas of otolaryngology via two-round Delphi method. The basic areas were otology-neurotology, rhinology, laryngology, head and neck surgery, pediatric otolaryngology, sleep disorders and facial plastic surgery. Additionally, we asked an open-ended question to investigate the reasons why the participants perceived themselves incompetent and undereducated, or why they needed further training in some of the basic otolaryngology areas. Results: Facial plastic surgery, otology-neurotology and head and neck surgery were the most cited training areas in the needs assessment. Training needs differed according to experience and place of work. Financial expectations, deficiencies in residency training, regression in knowledge and skills, and special interest were effective determinants on decisions of the participants while determining their training needs. Conclusion: Otolaryngologists need further training in some areas of their field due to different reasons. Determining these areas and reasons will help in designing more effective continuous medical education activities and residency training programs in otolaryngology.


Resumo: Introdução: A avaliação de necessidades específicas, que inclui a identificação das necessidades dos alunos, é um passo fundamental no desenvolvimento de programas educacionais. No entanto, essa etapa costuma ser subestimada em programas de pós-graduação em educação médica, inclusive na residência em otorrinolaringologia. Determinar as necessidades dos otorrinolaringologistas pode ajudar os educadores a projetar programas mais direcionados de treinamento em educação médica continuada. Além disso, a análise das necessidades dos especialistas pode oferecer uma visão clara sobre a eficácia dos programas de residência nessa especialidade. Objetivo: Determinar as necessidades de treinamento de especialistas em otorrinolaringologia e identificar deficiências nos programas de residência em otorrinolaringologia. Método: Este estudo descritivo e transversal incluiu 78 especialistas em otorrinolaringologia que preencheram todos os formulários de coleta de dados adequadamente. Os dados demográficos dos participantes foram coletados. As necessidades de treinamento dos participantes foram determinadas em sete áreas básicas da otorrinolaringologia com o método Delphi em duas rodadas. As áreas básicas foram otologia/neurotologia, rinologia, laringologia, cirurgia de cabeça e pescoço, otorrinolaringologia pediátrica, distúrbios do sono e cirurgia plástica facial. Além disso, uma pergunta aberta foi usada para investigar os motivos pelos quais os participantes consideravam ter pouco conhecimento ou ser incapazes de atuar nessa área, ou por que precisavam de mais treinamento em algumas dessas áreas básicas. Resultados: Na avaliação das necessidades, cirurgia plástica facial, otologia-neurotologia e cirurgia de cabeça e pescoço foram as áreas de treinamento mais relatadas. As necessidades de treinamento variaram de acordo com a experiência e o local de trabalho. Expectativas financeiras, deficiências no treinamento durante a residência, regressão do conhecimento e habilidades, além de interesse especial, foram determinantes efetivos nas decisões dos participantes ao identificar suas necessidades de treinamento. Conclusão: Por diferentes motivos, os otorrinolaringologistas precisam de mais treinamento em algumas áreas. A determinação dessas áreas e motivos ajudará a planejar atividades de educação médica continuada e programas de treinamento em residência em otorrinolaringologia mais eficazes.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Otolaryngology/education , Needs Assessment/statistics & numerical data , Otolaryngologists/education , Internship and Residency/statistics & numerical data , Cross-Sectional Studies , Surveys and Questionnaires , Otolaryngologists/statistics & numerical data
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