ABSTRACT
El vértigo posicional paroxístico benigno es la entidad más frecuente dentro de los vértigos de origen periférico. Se caracteriza por crisis de vértigo desencadenadas por cambios posicionales de la cabeza y de corta duración. Suele presentarse en los mayores de 40-50 años, y hasta el 50% de los casos no se deben a una causa conocida, por lo que se habla de vértigo posicional paroxístico benigno idiopático. Debido a la alta incidencia del vértigo posicional paroxístico benigno, consideramos de especial trascendencia poseer los conocimientos necesarios para poder diagnosticar y tratar con eficacia esta afección en el ámbito de la medicina de atención primaria, ya que en la mayoría de los casos se obtienen excelentes resultados a través de unas maniobras específicas y fáciles de realizar (AU)
The benign paroxysmal positional vertigo is the most common disease in the group of peripheral vertigo. It's characterized by vertiginous sensation triggered by the positional changes of the head and usually lasts less than one minute. It is most frequently seen in middle-aged patients (40-50 years old) and in up 50% of cases we do not know the cause, so we refer to them as idiopathic benign paroxysmal positional vertigo. Because of the high incidence of benign paroxysmal positional vertigo in general population, it is of utmost importance to be aware of the differential diagnosis and to be able to treat this pathology with efficacy, because in most cases we can achieve excellent results performing specific and simple maneuvers (AU)
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Vertigo/diagnosis , Vertigo/therapy , Dizziness/complications , Dizziness/diagnosis , Diagnosis, Differential , Quality of Life , Narcolepsy/complications , Primary Health Care/methods , Primary Health Care/trends , Primary Health Care , Dizziness/physiopathology , Manipulation, Spinal , Musculoskeletal Manipulations/methods , Musculoskeletal Manipulations/trends , Musculoskeletal ManipulationsABSTRACT
The benign paroxysmal positional vertigo is the most common disease in the group of peripheral vertigo. It's characterized by vertiginous sensation triggered by the positional changes of the head and usually lasts less than one minute. It is most frequently seen in middle-aged patients (40-50 years old) and in up 50% of cases we do not know the cause, so we refer to them as idiopathic benign paroxysmal positional vertigo. Because of the high incidence of benign paroxysmal positional vertigo in general population, it is of utmost importance to be aware of the differential diagnosis and to be able to treat this pathology with efficacy, because in most cases we can achieve excellent results performing specific and simple maneuvers.
Subject(s)
Benign Paroxysmal Positional Vertigo/therapy , Primary Health Care , Adult , Benign Paroxysmal Positional Vertigo/diagnosis , Benign Paroxysmal Positional Vertigo/epidemiology , Diagnosis, Differential , Humans , Middle AgedABSTRACT
La hipoacusia súbita es una pérdida auditiva neurosensorial de rápida instauración (horas o días) en un individuo aparentemente sano. La etiología puede ser amplia y multifactorial. La mayoría de los pacientes no recuperan la audición en su evolución natural e incluso algunos pueden desarrollar una cofosis del oído afecto. Es una urgencia otológica, ya que la pronta instauración terapéutica logra ofrecer un mejor pronóstico auditivo. Debido al escaso conocimiento de esta enfermedad, puede ser infradiagnosticada en centros de atención primaria. En su diagnóstico no es necesario el manejo de instrumental avanzado: basta con una detallada historia clínica, una otoscopia normal y la correcta interpretación de la acumetría (diapasones). De esta forma se logra un diagnóstico certero en la mayoría de los casos, el cual se confirmará mediante audiometría (AU)
Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry (AU)
Subject(s)
Humans , Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sensorineural/therapy , Audiometry , Primary Health Care/methods , Diagnosis, DifferentialABSTRACT
Sudden hearing loss is a rapid loss of neurosensory hearing that may occur within hours or days in an apparently healthy patient. Its origins are variable and multifactorial. Most patients do not recover hearing if not treated, and some even develop cophosis (deafness) in the affected ear. It is an otological emergency, as early therapeutic management offers a better hearing prognosis. As there is limited knowledge on this condition, it may be underdiagnosed in Primary Health Care Centers. It should be suspected in patients with abrupt hearing loss or tinnitus. Sophisticated instruments are not required for its diagnosis, just a detailed history, basic otoscopy, and proper interpretation of the hearing test. In this way, an accurate diagnosis is achieved in most cases, which is confirmed by audiometry.
Subject(s)
Hearing Loss, Sensorineural/diagnosis , Hearing Loss, Sudden/diagnosis , Primary Health Care/methods , Audiometry/methods , Hearing Loss, Sensorineural/therapy , Hearing Loss, Sudden/therapy , Humans , Otoscopy/methods , Prognosis , Tinnitus/diagnosis , Tinnitus/therapyABSTRACT
Pharyngocutaneous fistula is a serious complication of total laryngectomy. This problem increases morbidity, prolongs hospitalization, and occasionally causes death. Numerous contributing factors have been implicated in fistula formation (1). We propose that gastroesophageal reflux, which often is subclinical, is an important trigger and should be prevented. We evaluated the effect of associating an antireflux agent like metoclopramide hydrochloride to our usual ranitidine of our protocol after total laryngectomy on reducing the incidence (p<0.05) of pharyngocutaneous fistula.
Subject(s)
Cutaneous Fistula , Dopamine Antagonists/therapeutic use , Gastroesophageal Reflux/prevention & control , Laryngectomy/adverse effects , Metoclopramide/therapeutic use , Pharyngeal Diseases , Cutaneous Fistula/epidemiology , Cutaneous Fistula/etiology , Cutaneous Fistula/prevention & control , Female , Humans , Incidence , Male , Middle Aged , Pharyngeal Diseases/epidemiology , Pharyngeal Diseases/etiology , Pharyngeal Diseases/prevention & control , Retrospective StudiesABSTRACT
La fístula faringocutánea es una importante complicación frecuente tras la laringuectomía total. Dicha complicación aumenta la morbilidad, prolonga el período de hospitalización y ocasionalmente puede comprometer el estado vital del paciente. Son varios los factores involucrados en la génesis de fístulas faringocutáneas (1), entre los cuales, el reflujo gastroesofágico, en ocasiones silente, puede ser uno de los desencadenantes más habituales. Evaluamos si la incorporación de la medicación antirreflujo, Clorhidrato de Metoclopramida, a nuestro protocolo postquirúrgico que sólo incluía ranitidina, reporta diferencias estadísticamente significativas (p < 0,05) a favor de la disminución de la incidencia de fistulas faringocutáneas (AU)
Pharyngocutaneous fistula is a serious complication of total laryngectomy. This problem increases morbidity, prolongs hospitalization, and occasionally causes death. Numerous contributing factors have been implicated in fistula formation (1). We propose that gastroesophageal reflux, which often is subclinical, is an important trigger and should be prevented. We evaluated the effect of associating an antireflux agent like metoclopramide hydrochloride to our usual ranitidine of our protocol after total laryngectomy on reducing the incidence (p<0.05) of pharyngocutaneous fistula (AU)
Subject(s)
Middle Aged , Male , Female , Humans , Cutaneous Fistula/epidemiology , Pharyngeal Diseases , Dopamine Antagonists/therapeutic use , Metoclopramide/therapeutic use , Laryngectomy/adverse effects , Gastroesophageal Reflux/prevention & control , Cutaneous Fistula/etiology , Cutaneous Fistula/prevention & control , Incidence , Retrospective StudiesABSTRACT
External nasal dilators have become popular among athletes and the general public. When applied to the nares, the device theoretically increases the nasal valve area and decreases total airway resistance. There are doubts regarding the true benefits of this device as opposed to a possible placebo effect. In order to resolve this question, the subjective sensation was compared with an objective measurement in two different groups: a group of 20 persons who complained of nasal insufficiency and a group of 20 control subjects. Computer rhinometry was used for objective measurements and psychological parameters were evaluated with a questionnaire.
Subject(s)
Nasal Obstruction/therapy , Adolescent , Adult , Dilatation/instrumentation , Female , Humans , Male , Placebo Effect , Surveys and Questionnaires , Treatment OutcomeABSTRACT
The nasogastric tube has traditionally been used as nutritional support for patients with head and neck cancers. We propose the percutaneous gastrostomy under fluoroscopic guidance as a part of therapy in selected patients with head and neck cancers, or in those who have chronic aspiration and dysphagia secondary to neurologic impairment. Our one-year experience with our series of nasogastric tube is reviewed.
Subject(s)
Enteral Nutrition/methods , Gastrostomy/methods , Aged , Deglutition Disorders , Female , Fluoroscopy , Head and Neck Neoplasms , Humans , Male , Middle AgedABSTRACT
Infections of aponeurotic sheets of the neck are more frequent in men than in women. Its etiology although varied is basically related to infectious pharyngo-tonsillar and dental pathology. In a great deal of cases there are factors which predispose clinical manifestations or becoming complications. Early diagnosis and precocious specific treatment re-establish the normality in the majority of cases but a percentage of them resort to surgery for the condition's control.
Subject(s)
Abscess/diagnostic imaging , Pharyngitis/diagnostic imaging , Staphylococcal Infections/drug therapy , Streptococcal Infections/drug therapy , Tonsillitis/diagnostic imaging , Adolescent , Adult , Aged , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Pharyngitis/microbiology , Pharyngitis/surgery , Radiography , Retrospective Studies , Tonsillitis/microbiology , Tonsillitis/surgeryABSTRACT
Systematical partial liberation of the septal cartilage through limited resection of the perpendicular plate of the ethmoid and/or vomer, as prior of endoscopic nasosinusal surgery, eases the exposure and approach to the whole sinusal complex, especially to maxillary sinus, so facilitating and shortening the length of the procedure. Furthermore facilitates the entrance inside the surgical cavity during cures, also decreases the patient's nuisances and hinder the occurrence of some complications, as postoperative synechiae.
Subject(s)
Endoscopy , Nasal Septum/surgery , Adolescent , Adult , Aged , Female , Humans , Male , Middle AgedABSTRACT
Three cases of the infrequent mucocutaneous Leishmaniasis, with nasal involvement in two of them and affection of the hypophrarynx and larynx in the other one are presented. We remark, in the case with laryngeal disease, that it was the onset of an AIDS in a patient unknown to be HIV+. Leishmaniasis of the larynx has not been described before as the onset of an AIDS. Symptomatology, evolution and treatment of this disease are revised, pointing out the increasing association, in our country, between leishmaniasis and AIDS, and considering the possibility of including the leishmania infection as an AIDS criteria in HIV+ patients, and to rule out an IVH infection in a patient with an atypical leishmaniasis either for the site involved or the evolutive course of the disease.
