ABSTRACT
This article is the second part of an interesting qualitative research project which presents and interprets opinions made by diverse medical and nursing professionals regarding care provided to terminal patients and relationships with patients' relatives.
Subject(s)
Attitude of Health Personnel , Attitude to Death , Death , Terminally Ill , Humans , Interviews as TopicABSTRACT
The authors of this study are interested in listening to the experiences professional doctors and nurses who work face to face with patients in terminal phase of their illnesses have. For this reason, the authors carried out a series of in-depth interviews with these professionals in order to know the real difficulties and obstacles which these professionals experience in real cases, as well as the procedure methods followed with these patients. The authors publish the results obtained in eight of these interviews, four with doctors and four with nurses; given the length of these interviews, the authors have decided to publish them in two consecutive articles which form one complete study This study is qualitative and the analysis of data obtained has been structured around the proposed research questions, keeping the diversity and variability how to deal with patients, plus the experiences shown by those interviewed, by citing their words textually.
Subject(s)
Attitude of Health Personnel , Attitude to Death , Health Personnel , Terminal Care , Vocabulary , Humans , Interviews as TopicABSTRACT
Nasal T lymphoma constitute a type of lymphoproliferative very infrequent symdrome. One of the fondamental problems it presents to bring a high probability of survival obtain a precocious diagnose. It is due that it originates inespecific histologic lesions, and to its clinic. Only the close cooperation between the otorhinolaryngologist and the anatomopathologist can arrive to obtain a very speedy diagnose and in that way the possibility of a correct treatment, because newly treatments appear, to which this type of disease every day better respond. We present the cases of nasal T lymphomas diagnosticated in the ORL Service of the Toledo area during 15 years, their symptomotology, treatment, evolution and survival. Besides a up to date bibliographic revision on this controversial syndrome.
Subject(s)
Lymphoma, T-Cell/therapy , Nasal Cavity , Nose Neoplasms/therapy , Adult , Antineoplastic Combined Chemotherapy Protocols/therapeutic use , Combined Modality Therapy , Disease-Free Survival , Follow-Up Studies , Humans , Lymphoma, T-Cell/diagnosis , Lymphoma, T-Cell/diagnostic imaging , Lymphoma, T-Cell/drug therapy , Lymphoma, T-Cell/mortality , Lymphoma, T-Cell/radiotherapy , Magnetic Resonance Imaging , Male , Middle Aged , Nasal Cavity/diagnostic imaging , Nose Neoplasms/diagnosis , Nose Neoplasms/diagnostic imaging , Nose Neoplasms/drug therapy , Nose Neoplasms/mortality , Nose Neoplasms/radiotherapy , Time Factors , Tomography, X-Ray ComputedABSTRACT
A case ofparotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After an histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these caracteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world.
Subject(s)
Mycobacterium Infections/complications , Mycobacterium tuberculosis/isolation & purification , Parotitis/microbiology , Adult , Biopsy, Fine-Needle , Female , Humans , Mycobacterium Infections/diagnosis , Parotitis/diagnostic imaging , Parotitis/pathology , Tomography, X-Ray ComputedABSTRACT
Leishmaniasis consists in a zoonotic infection, that means affect animals. Due to the puncture of the female sand fly type Phlebotomus (Ancient World) or Lutzomya (New World) the human being can be also affected. The clinical manifestations are very varied, depending to factors related with host, vector and the proper parasit. In this present work, we expose the three unic cases of Leishmaniasis affecting the larynx, diagnosticated in the sanitary area of Toledo. Due to the specific characteristics that present each case different treatments for each one have been realised, and its results and treatment exposed.
Subject(s)
Laryngeal Diseases , Leishmaniasis , Aged , Amphotericin B/administration & dosage , Amphotericin B/therapeutic use , Animals , Antiprotozoal Agents/administration & dosage , Antiprotozoal Agents/therapeutic use , Chronic Disease , Diagnosis, Differential , Follow-Up Studies , Humans , Laryngeal Diseases/diagnosis , Laryngeal Diseases/diagnostic imaging , Laryngeal Diseases/drug therapy , Laryngeal Diseases/surgery , Laryngitis/diagnosis , Laryngoscopy , Leishmania donovani/isolation & purification , Leishmaniasis/diagnosis , Leishmaniasis/diagnostic imaging , Leishmaniasis/drug therapy , Leishmaniasis/surgery , Leishmaniasis, Visceral/diagnosis , Male , Middle Aged , Radiography, Thoracic , Time Factors , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
Se presenta un caso de tuberculosis parotídea (PTB), que durante su presentación clínica, pruebas complementarias exploratorias y tratamientos realizados; hizo sospechar como primera posibilidad, que presentaba un tumor en dicha glándula. Una vez estudiada histológicamente, se pudo comprobar como realmente el problema de la paciente era que había padecido una tuberculosis parotídea. Se hace una exposición del caso, así como las diferentes técnicas que se deben realizar ante un paciente de estas características, antes de llegar a someterle a una cirugía, que aunque segura, siempre entraña cierto riesgo de morbilidad. Sobre todo en estos tiempos en los que de nuevo la incidencia de tuberculosis está aumentando en el primer mundo
A case of parotid tuberculosis (PTB) that during its clinical presentation complementary proofs, exploration and realised treatment made suspect as first possibility a parotid tumor is presented. After and histologic study, it could be proved that the real problem of the patient was that she had suffered a parotid tuberculosis. An exposition of the case is made with the different technics that must be realised facing a patient of these characteristics, before thinking in surgery, although secure, but with its mortal risks in these times where the incidence of tuberculosis is increasing in the first world
Subject(s)
Female , Adult , Humans , Parotid Gland , Tuberculosis/diagnosis , Parotitis/etiology , Mycobacterium tuberculosis/isolation & purificationABSTRACT
In this paper we carried out an immunohistochemical study of cyclin D1 (DCS6 ) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at "Virgen de la Salud" Hospital (Toledo, Spain) for a time of 5 years. In the cases with lymph node metastasis we also studied cyclin D1 expression at this level. Furthermore we have analysed the value of cyclin D1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between cyclin D1 expression and other clinic and pathologic parameters.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Cyclin D1/biosynthesis , Laryngeal Neoplasms/metabolism , Aged , Humans , Immunohistochemistry , PrognosisABSTRACT
A case of severe miastenia beginning with dyspnea, secondary to a bilateral larynx paralysis in aduction is presented. During the evolution of the severe miastenia the affectation of the larynx musculature does not result infrequent, but however, after having realized a bibliographic revision, the infrequency resulting in this disease of the beginning through a bilateral larynx paralysis in aduction was verified. A wide exposition of the clinic case, methods of exploration to obtain the diagnosis of severe miastenia, and the different treatment options actually in use to control these disease, are realized.
Subject(s)
Myasthenia Gravis/complications , Respiratory Sounds/etiology , Vocal Cord Paralysis/complications , Humans , Male , Middle Aged , Vocal Cord Paralysis/etiologyABSTRACT
En este trabajo hemos estudiado la expresión inmunohistoquímica de la proteína ciclina D1 (DCS6) en una serie de 195 pacientes con cáncer de laringe que fueron diagnosticados, tratados y seguidos durante 5 años en el servicio ORL del Hospital «Virgen de la Salud» (Toledo). En los casos que presentaron metástasis ganglionares analizamos también la expresión de ciclina DI a dicho nivel. Además se estudia el valor pronóstico de la expresión de ciclina D1 en este tipo de tumores (desarrollo de recidivas, mortalidad por cáncer de laringe y supervivencia) y se analiza la posible relación de dicha expresión con otros parámetros clínico-patológicos
In this paper we carried out an immunohistochemical study of cyclin D1 (DCS6) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at fue Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain) for a time of 5 years. In the cases with lymph nade metastasis we also studied cyclin D1 expression at this level. Furthermore we have analysed fue value of cyclin D1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between cyclin D1 expression and other clinic and pathologic parameters
Subject(s)
Humans , Carcinoma, Squamous Cell/pathology , Cyclin D1/analysis , Laryngeal Neoplasms/pathology , Immunohistochemistry/methodsABSTRACT
In this paper we carried out an immunohistochemical study of protein p27KIP1 expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at "Virgen de la Salud" Hospital (Toledo, Spain). In the cases with lymph node metastasis we also studied p27KIP1 expression at this level. Furthermore we have analysed the value of protein p27KIP1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between p27KIP1 expression and other clinic and pathologic parameters.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Cyclin-Dependent Kinase Inhibitor p27/metabolism , Laryngeal Neoplasms/metabolism , Aged , Carcinoma, Squamous Cell/pathology , Humans , Immunohistochemistry , Laryngeal Neoplasms/pathology , Neoplasm Staging , Phenotype , PrognosisABSTRACT
En este trabajo hemos estudiado la expresión inmunohistoquímica del alproteína p27KIp1 en una serie de 195 pacientes con cáncer de laringe que fueron diagnosticados, tratados y seguidos durante al menos 5 años en el servicio ORL del Hospita "Virgen de la Salud" (Toledo). En los casos que presentaron metástasis ganglionares analizamos también la expresión de p27KIP1 a dicho nivel. Además se ha analizado el valor pronóstico de la expresión de p27KIP1 en este tipo de tumores (desarrollo de recidivas, mortalidad por cáncer de laringe y supervivencia) y estudiamos la posible relación de dicha expresión con otros parámetros clinicopatológicos
In this paper we carried out an immunohistochemical study of protein p27KIPI expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain). In the cases with lymph node metastasis we also studied p27KIPI expression at this level. Furthermore we have analysed the value of protein p27KIPI expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between p 27KIPI expression and other clinic and pathologic parameters
Subject(s)
Aged , Humans , Carcinoma, Squamous Cell/metabolism , Laryngeal Neoplasms/metabolism , Carcinoma, Squamous Cell/pathology , Immunohistochemistry , Phenotype , Prognosis , Neoplasm Staging , Laryngeal Neoplasms/pathologyABSTRACT
Juvenile Juvenile nasopharyngeal angiofibroma (JNA) is a benign and highly vascular tumor. In this article we present a case treated in our institution. We present form of presentation, exploration and intra-arterial pre-operative embolization by neuroradiology, and the treatment with the Le Fort technique. JNA has a complex anatomy, high recurrence and special histopathology, therefore the surgery is very complex and as an with high morbidity. The pre-operative embolization has decrease the hemorragic complications. We review the literature the of the JNA nowadays.
Subject(s)
Angiofibroma/pathology , Nasopharyngeal Neoplasms/pathology , Adolescent , Angiofibroma/surgery , Humans , Magnetic Resonance Imaging , Male , Nasopharyngeal Neoplasms/surgery , Osteotomy , Otorhinolaryngologic Surgical Procedures/methodsABSTRACT
El angiofibroma nasofaríngeo juvenil (AJN) es un infrecuente tumor benigno y altamente vascularizado. En esteartículo se presenta un caso tratado en nuestro servicio. Se describe la forma de presentación, pruebas diagnósticas, preparación previo al tratamiento mediante embolización de arterias nutricias por parte de los neurorradiólogos vasculares, y la vía de abordaje LeFort para el tratamiento.Debido a la complejidad del abordaje por su localización, alta recurrencia, e histopatología; la cirugía siempre ha tenido un cierto grado de morbilidad. La embolización preoperatoria ha contribuido a disminuirla.Se presenta una revisión bibliográfica de las últimastendencias sobre la situación actual sobre este tumor
Juvenile Juvenile nasopharyngeal angiofibroma (JNA) is a benign and highly vascular tumor. In this article we present a case treated in our institution. We present form of presentation, exploration and intra-arterial pre-operative embolization by neuroradiology, and the treatment with the Le Fort technique. JNA has a complex anatomy, high recurrence and special histopathology, therefore the surgery is very complex and as an with high morbidity. The pre-operative embolization has decrease the hemorragic complications. We review the literature the of the JNA nowadays
Subject(s)
Male , Adolescent , Humans , Angiofibroma/drug therapy , Angiofibroma/surgery , Angiofibroma , Embolization, Therapeutic/methods , Embolization, Therapeutic , Neoplasm Recurrence, Local/metabolism , Neoplasm Recurrence, Local/surgery , Angiofibroma/diagnosis , Morbidity/trends , Angiography , Tomography, X-Ray Computed , Neoplasm Recurrence, Local/drug therapyABSTRACT
In this paper we carried out an immunohistochemical study of protein p21WAF1 (EA10) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at "Virgen de la Salud" Hospital (Toledo, Spain). In the cases with lymph node metastasis we also studied p21WAF1 expression at this level. Furthermore we have analysed the value of protein p21WAF1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between p21WAF1 expression and other clinic and pathologic parameters.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Cell Cycle Proteins/metabolism , Laryngeal Neoplasms/metabolism , Aged , Carcinoma, Squamous Cell/pathology , Cyclin-Dependent Kinase Inhibitor p21 , Female , Humans , Immunohistochemistry , Laryngeal Neoplasms/pathology , Male , Neoplasm Staging , Prognosis , Tumor Suppressor Protein p53/metabolismABSTRACT
In this paper we carried out an immunohistochemical study of bcl-2 protein expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at "Virgen de la Salud" Hospital (Toledo, Spain). In the cases with lymphonode metastasis we also analysed bcl-2 protein expression at this level. Furthermore we have studied the value of bcl-2 protein expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we analysed the relationship between bcl-2 protein expression and other clinic and pathologic parameters.
Subject(s)
Carcinoma, Squamous Cell/metabolism , Laryngeal Neoplasms/metabolism , Proto-Oncogene Proteins c-bcl-2/metabolism , Tumor Suppressor Protein p53/immunology , Tumor Suppressor Protein p53/metabolism , Aged , Antibodies, Monoclonal/immunology , Carcinoma, Squamous Cell/immunology , Female , Humans , Immunohistochemistry , Laryngeal Neoplasms/immunology , Male , Neoplasm Staging , Prognosis , Proto-Oncogene Proteins c-bcl-2/immunologyABSTRACT
En este trabajo hemos estudiado la expresión inmunohistoquímica de la proteína p21WAF1 (EA10) en una serie de 195 pacientes con cáncer de laringe que fueron diagnosticados, tratados y seguidos durante al menos 5 años en el servicio de ORL del Hospital Virgen de la Salud (Toledo). En los casos que presentaron metástasis ganglionares analizamos también la expresión de p21WAF1 a dicho nivel. Además se ha analizado el valor pronóstico de la expresión de p21WAF1 en este tipo de tumores (desarrollo de recidivas, mortalidad por cáncer de laringe y supervivencia) y estudiamos la posible relación de dicha expresión con otros parámetros clínicopatológicos
In this paper we carried out an immunohistochemical study of protein p21WAF1 (EA 10) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain). In the cases with lymph node metastasis; we also studied p21WAF1 expression at this level. Furthermore we have analysed the value of protein p21WAF1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival (and we evaluate the relationship between p21WAF1 expression and other clinic and pathologic parameters. Keywords: p21WAFl Protein. Larynx cancerIn this paper we carried out an immunohistochemical study of bcl-2 protein expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo. Spain). In the cases with lymphonode metastasis we also analysed bcl-2 protein expression at this level. Furthermore we have studied the value of bcl-2 protein expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we analysed the relationship between bcl-2 protein expression and other clinic and pathologic parametersIn this paper we carried out an immunohistochemical study of protein Rb (G3-245) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain) for a time of 5 years. In the cases with lymph node metastasis we also studied Rb expression at this level. Furthermore we have analysed the value of Rb expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between Rb expression and other clinic and pathologic parameters
Subject(s)
Aged , Humans , Carcinoma, Squamous Cell/metabolism , Cell Cycle Proteins/metabolism , Laryngeal Neoplasms/metabolism , Carcinoma, Squamous Cell/pathology , Immunohistochemistry , Prognosis , Neoplasm Staging , Laryngeal Neoplasms/pathologyABSTRACT
En este trabajo hemos estudiado la expresión inmunohistoquímica de la proteína bcl-2 en 195 pacientes con cáncer de laringe que fueron diagnosticados, tratados y seguidos durante 5 años en el servicio ORL del Hospital Virgen de la Salud (Toledo). En los casos que presentaron metástasis ganglionares analizamos también la expresión de bcl-2 a dicho nivel. Además se ha estudiado el valor pronóstico de la expresión de bcl-2 en este tipo de tumores (desarrollo de recidivas, mortalidad por cáncer de laringe y supervivencia) y analizamod la posible relación de dicha expresión con otros parámetros clínicopatológicos
In this paper we carried out an immunohistochemical study of protein p21WAF1 (EA 10) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain). In the cases with lymph node metastasis; we also studied p21WAF1 expression at this level. Furthermore we have analysed the value of protein p21WAF1 expression as a prognostic factor (tumor recurrence, deads due to cancer and survival (and we evaluate the relationship between p21WAF1 expression and other clinic and pathologic parameters. Keywords: p21WAFl Protein. Larynx cancerIn this paper we carried out an immunohistochemical study of bcl-2 protein expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo. Spain). In the cases with lymphonode metastasis we also analysed bcl-2 protein expression at this level. Furthermore we have studied the value of bcl-2 protein expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we analysed the relationship between bcl-2 protein expression and other clinic and pathologic parametersIn this paper we carried out an immunohistochemical study of protein Rb (G3-245) expression in a series of 195 patients with laryngeal carcinoma that were diagnosticated, treated and followed at the Department of Otolaryngology at «Virgen de la Salud» Hospital (Toledo, Spain) for a time of 5 years. In the cases with lymph node metastasis we also studied Rb expression at this level. Furthermore we have analysed the value of Rb expression as a prognostic factor (tumor recurrence, deads due to cancer and survival) and we evaluate the relationship between Rb expression and other clinic and pathologic parameters
Subject(s)
Aged , Humans , Carcinoma, Squamous Cell/metabolism , Laryngeal Neoplasms/metabolism , Proto-Oncogene Proteins c-bcl-2/metabolism , Tumor Suppressor Protein p53/immunology , Antibodies, Monoclonal/immunology , Carcinoma, Squamous Cell/immunology , Immunohistochemistry , Prognosis , Neoplasm Staging , Laryngeal Neoplasms/immunology , Proto-Oncogene Proteins c-bcl-2/immunology , Tumor Suppressor Protein p53/metabolismABSTRACT
Estudiamos la expresión inmunohistoquímica de la proteína p53 (DO7) en una serie de 195 pacientes con el diagnóstico de carcinoma epidermoide de laringe, tratados y seguidos durante al menos 5 años en el servicio ORL del Hospital "Virgen de la Salud" (Toledo). En los casos con metástasis ganglionares, se valoró también la expresión de p53 a dicho nivel. Investigamos el valor de p53 como factor pronóstico (desarrollo de recidiva, muerte por cáncer y supervivencia) y analizamos la posible relación de dicha expresión de p53 con otros parámetros clínico-patológicos (AU)
Subject(s)
Male , Humans , Female , Aged , Prognosis , Neoplasm Invasiveness , Immunohistochemistry , Laryngeal Neoplasms , Neoplasm Staging , Tumor Suppressor Protein p53ABSTRACT
One of the Spain's pioneer out patient surgery units is the Toledo's one. We have realized a retrospective study of the 10th first years of its functioning. During this period, 4733 patients were operated, on tonsills and adenoids, laryngeal microsurgeries, septoplasties, miringotomies, and miringoplasties. We obtained a 91.8% of discharge from hospital in the same day and few complications (5.5% without hospitalization and 0.7% with). Thanks to a questionary we know that the degree of satisfaction of the patients is high, and so, added to our good statistic results, stimulate us to follow in this working line.
Subject(s)
Ambulatory Care , General Surgery/statistics & numerical data , Otolaryngology/organization & administration , Otorhinolaryngologic Surgical Procedures/methods , Otorhinolaryngologic Surgical Procedures/statistics & numerical data , Humans , Otolaryngology/statistics & numerical data , Retrospective Studies , SpainABSTRACT
Una de las unidades de cirugía mayor ambulatoria pioneras de Espala, es la de Toledo. Hemos realizado un estudio retrospectivo de los 10 primeros años de su funcionamiento. En este lapso, se han intervenido 4733 pacientes, realizándose cirugías de amígdalas y adenoides, microcirugías laringeas, septoplastias, miringotomías y miringoplastias. Hemos obtenido un 91,8 por ciento de altas en el día y escasas complicaciones (5,5 por ciento sin hospitalización, 0,7 por ciento con ingreso). Gracias a una encuesta, sabemos que el grado de satisfacción del usuario es alto, lo que, sumado a nuestros buenos resultados estadísticos, nos estimulan a seguir en esta línea de trabajo (AU)
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