Exercise-induced laryngochalasia: an imitator of exercise-induced bronchospasm.

BACKGROUND: Patients with exercise-induced laryngochalasia present with dyspnea and stridor during exercise. Symptoms are due to a subtotal occlusion of the larynx resulting from mucosal edema from the aryepiglottic folds being drawn into the endolarynx. METHODS: We report on three patients with exercise-induced bronchospasm, refractory to standard therapy. RESULTS: Spirometry with flow-volume loops revealed truncation of the inspiratory limb. Abnormal movement of the arytenoid region was visualized on laryngoscopy. A diagnosis of exercise-induced laryngochalasia was made. CONCLUSIONS: Evaluation of laryngeal motion in patients with refractory exercise-induced bronchospasm is important. Surgical correction with laser laryngoplasty is effective in carefully selected cases.

[The first 10 years of operation of the Red Cross House for runaway, throwaway and homeless adolescents in Reykjavík, Iceland.].

OBJECTIVE: The Red Cross House (RCH) is a 24-hour emergency shelter in Reykjavik, Iceland for adolescents. On the occasion of its 10th anniversary it was decided to analyse the data collected since inauguration. MATERIAL AND METHODS: During the first 10 years of running 475 adolescents, age 10-18, (grouped into runaways, throwaways and homeless adolescents) registered 927 visits. The admission records of the RCH were used for collecting data for subsequent analysis. RESULTS: The runaways and throwaways were more alike one another than the homeless. Most of the parents were living apart suggesting that conflicts were more likely to take place in stepfamilies and single parent families and the situation at home had enforced one parent to leave home. Many of the guests were school-dropouts particularly those coming from the country. A majority had been in contact with the social services, and many boys had been dealt with by the police. Prior use of alcohol, tobacco and drugs was common. Conflicts within the family was the most usual reason for the runaways and throwaways seeking assistance. The most common reason for the homeless visiting was having nowhere to stay, alcohol or drug abuse. CONCLUSIONS: The plight of the homeless was more serious than that of the runaways and throwaways. The homeless usually had a prior history of having run away or been throwaways from home. The preventive work of the RCH is reflected in keeping young people off the streets and offering assistance before it is too late.

Cancer of the nasopharynx in children and young adults in Scandinavia.

Reports have been published indicating an increase in the incidence of cancer in the head and neck, e.g. the tongue, in children and young adults under 40 years of age. In the present study the number of new cases of nasopharyngeal cancer in Scandinavia during the period 1958-1992 was reviewed in the respective national cancer registers. Altogether 3,675 patients were diagnosed with cancer of the nasopharynx. Of these, 371 or 10.1% were under 40 years of age at the time of diagnosis. Within this time period no increase was seen in the relative amount of young among nasopharynx cancer patients in Scandinavia. When considering the whole 35-year period the percentage of patients below 40 years varied between the countries from 7.5% to 18.3%. The majority of the cases in each country occurred in males, both among the young patients as well as in the older age groups. Malignant neoplasms of the nasopharynx are rare in Scandinavia. Both the relative and absolute amount of patients under 40 years of age at the time diagnosis was stable. No difference in the 5-year relative survival rates was seen between the patient group under 40 years when comparing it with all age groups combined.