Gustatory Function of Patients With and Without Cholesteatoma Undergoing Middle Ear Surgery.

OBJECTIVE: To compare measured and perceived taste function before and after surgery of patients with chronic otitis media with cholesteatoma (OMCC) to patients without cholesteatoma (patients with chronic suppurative otitis media [CSOM] and patients with lateral skull base lesions [LSB]). METHODS: This prospective cohort study included 29 patients undergoing surgery for unilateral OMCC. The chorda tympani nerve (CTN) was resected in 8 of these patients. Fourteen patients undergoing surgery for unilateral CSOM and 5 patients undergoing surgery for unilateral LSB (with CTN resection) served as the comparison group. Taste function was measured using taste strips on both sides of the tongue before surgery, 2 weeks postoperatively and 3 months postoperatively. The affected side of the tongue was compared to the unaffected side. A questionnaire on taste perception was completed at each visit. RESULTS: Preoperatively, cholesteatoma patients showed higher taste strip scores than non-cholesteatoma patients, indicating a larger difference between the healthy and affected sides of the tongue. Despite this difference in measured taste function few cholesteatoma patients reported taste alteration before surgery (3/29 [10.3%]). Postoperatively, patients with CTN resection (OMCC patients with CTN resection and LSB patients) showed a decreased measured taste function. Subjectively, only approximately 20% of these patients reported taste alteration 3 months postoperatively. CONCLUSIONS: Before surgery, cholesteatoma patients displayed an impaired measured taste function compared to patients without cholesteatoma (CSOM, LSB). Subjectively this was often unnoticed. After surgery, despite removal of the CTN and consequent reduction of measured taste function, few patients reported taste alteration and subjective taste perception was seen to be improving. In regards to middle ear surgery, perceived taste function does not seem to reflect measured gustatory function.

Reduction of otorhinolaryngological consultations due to the COVID-19 lockdown and its impact on disease progression.

OBJECTIVES: To compare consultations at the Otorhinolaryngological Department at a tertiary referral centre between the COVID-19 lockdown in 2020 and the same period in 2019, as well as to study the impact of deferring visits on disease progression. METHODS: The emergency consultations during these time periods were analysed retrospectively. The effect of postponing appointments on disease progression was examined for 122 patients with chronic rhinosinusitis, for 50 patients with a benign tumour and for 22 patients with the diagnosis of a malignant tumour. To compare disease progression, patients with the diagnosis of a malignant tumour were matched to patients seen over the same period in 2019. RESULTS: During the lockdown, a reduction of 44.1% in emergency consultations compared with 2019 was observed. The largest significant decrease of consultation numbers was seen for otitis media and for Eustachian tube dysfunction. Fewer patients with tonsillitis sought emergency assistance; however, no difference in frequency of abscesses was observed. Disease progression was seen in 44.4% of patients with chronic rhinosinusitis. In 2020, 18.8% of patients with the diagnosis of a malignant tumour showed disease progression, yet no difference from the previous year was observed. CONCLUSION: Fewer emergency consultations took place during the COVID-19 lockdown; among others, there were fewer visits due to otitis media and tonsillitis. However, no change in the incidence of complications was noted. Almost 50% of patients with chronic rhinosinusitis showed disease progression, leading to prolonged suffering due to the rescheduling of appointments. The treatment of patients with the diagnosis of a malignant tumour was not affected by the postponement of consultations.

A COVID-19 na América Latina e suas repercussões para a odontologia

[Extract]. Diante do novo coronavírus, se observa pouca ou nenhuma discussão sobre a saúde bucal em tempos de COVID-19. Entre os profissionais que mais se expõem aos aerossóis, principal rota de transmissão do vírus, estão o dentista e sua equipe. Além disso, o dentista está, invariavelmente, em contato com a saliva, responsável por boa parte das infecções. Devido ao alto risco de exposição ao coronavírus pelos dentistas, é urgente que se estabeleçam medidas seguras de trabalho, considerando a viabilidade dos sistemas de saúde e a preservação da saúde de pacientes e profissionais. Levando em conta esses aspectos, e cumprindo a missão de dar visibilidade às ações de saúde pública e de saúde bucal em países latinos, os pesquisadores do Observatório Iberoamericano de Políticas Públicas em Saúde Bucal organizaram em seu site um espaço todo dedicado ao coronavírus (https://sites.usp.br/iberoamericanoralhealth/). No site, disponível nos idiomas inglês, português, espanhol e francês, o leitor tem acesso a recomendações informadas pelas melhores evidências, compiladas pelo grupo de pesquisadores, por formuladores de políticas e por outros stakeholders, para orientar o funcionamento dos serviços de odontologia durante os momentos mais agudos da pandemia. As informações sobre as ações governamentais que estão sendo realizados são organizadas por país, destacando-se as características específicas de como estão funcionando as quarentenas e as restrições de circulação de pessoas. Juntamente com protocolos de atendimento odontológico e boletins epidemiológicos, todo o material pode ser acessado de forma rápida, intuitiva e organizada.

Photoselective vaporization of the prostate: study outcomes as a function of risk of bias, conflicts of interest, and industrial sponsorship.

PURPOSE: To investigate the outcomes of comparative studies on photoselective vaporization of the prostate (PVP) as a function of risk of bias (RoB), conflicts of interest (COI), and industrial sponsorship (IS). METHODS: We performed a systematic literature search for comparative studies on PVP [randomized controlled trials (RCTs) and non-randomized comparative studies (NRCSs)]. Study selection as well as comprehensive assessment of RoB, COIs, and IS were performed in duplicate. The identified studies were further rated by two independent board-certified urologists as either PVP-favourable or PVP-unfavourable. Descriptive statistics were performed among all identified studies and among the subgroups of studies rated as favourable and unfavourable, respectively. RESULTS: Sixty-five studies qualified for inclusion (25 RTCs and 40 NRCSs) of which 56 (86%) were rated favourable and 9 (14%) unfavourable. A majority of all studies mentioned the absence/presence of potential COIs (78%). In contrast, a sponsorship statement was only found in 29% of the investigations. Studies rated favourable demonstrated a higher percentage of COIs (39% versus 22%). IS was exclusively found among favourable studies. Furthermore, a serious or critical RoB was more often found in favourably rated NRCSs. CONCLUSIONS: COIs and IS seem to be associated with favourable study outcomes in comparative studies on PVP. The transparency of the whole research process from study conception to the dissemination of the results has to be further improved to prevent a harmful effect of COIs and IS on the internal validity of studies.

Hirschsprung's disease: the importance of early diagnosis.

Congenital intestinal aganglionosis, also called Hirschsprung disease (HD), is defined as the absence of ganglionic cells in the myenteric (Auerbach) and submucosal (Meissner) plexus, due to a failure in the enteric nervous system development. The extent of intestinal involvement may vary according to the age of embryo development in which this failure occurs. It is not unusual for other malformations to be present, as well as chromosomal trisomies, manly trisomy 21. Enterocolitis is a frequent, life threatening, and feared complication of HD. Moreover, oligohydramnios is a well-known condition frequently associated with malformations, including those related to the gastrointestinal tract. The authors report the case of a newborn that presented a delayed meconium passage. On the third day of life, he presented enterocolitis-the outcome of which was favorable with clinical treatment. While the diagnosis of HD was awaiting confirmation, the enterocolitis relapsed and this time he died due to septic shock. The autopsy findings were compatible with a short segment of congenital intestinal aganglionosis. No other malformation was found. The authors call attention for an early diagnosis of HD whenever the meconium passage does not happen for at least 48 hours and for the risk factors of enterocolitis. This case also demonstrates HD associated with oligohydramnios.

Perfil da sexualidade feminina em universitárias de um curso de medicina de Santa Catarina / Profile of female sexuality in medicine students from a course of Santa Catarina

Introdução: A sexualidade é uma das dimensões do ser humano que envolve gênero, identidade, orientação sexual, erotismo, envolvimento emocional, reprodução e relacionamentos. Objetivo: Caracterizar o perfil da sexualidade feminina em estudantes de curso de medicina. Métodos: Estudo transversal, onde foi utilizado um questionário, para avaliar as características da sexualidade feminina em estudantes do Curso de Medicina da Universidade do Sul de Santa Catarina. Resultados: Obteve-se as respostas de 82,75% da população total de alunas matriculadas no primeiro semestre do ano de 2010. Com relação às informações sexuais recebidas, apenas 0,9% das estudantes disseram que pode influenciar negativamente na sua satisfação sexual. Os contraceptivos orais foram os mais utilizados em 57,5%. As mulheres que relataram preocupação do parceiro em fazê-las ter orgasmos atingiram o dobro de orgasmos comparados as que não, e 59,2% das estudantes chegam bastante ao orgasmo. Conclusão: A sexualidade feminina é algo individual e depende de cada personalidade, apesar de algumas características serem comuns à várias mulheres. A mulher deve ser incentivada a se descobrir para desvendar seus desejos, fantasias, seus locais de maiores estímulos sexuais, o como chegar ao orgasmo entre outros. A conversa com o parceiro demonstrou grande importância, pois se concluiu o valor da intimidade como motivação feminina para o sexo.

Introduction: Sexuality is one of the dimensions of the human being that involves gender identity, sexual orientation, eroticism, emotional involvement, reproduction and relationships. Objective: To characterize the profile of female sexuality in students of a medical school. Methods: A cross-sectional study where a questionnaire was used to evaluate the characteristics of female sexuality among students of Medical School of the University of South Santa Catarina. Results: We obtained the answers from 82.75% of the total population of students enrolled in the first half of 2010. With respect to the sex information received only 0.9% of students say may negatively influence their sexual satisfaction. Oral contraceptives were the most used in 57.5%. Women who reported concern about the partner get them to orgasms were twice as many orgasms compared to those who do no, and 59.2% of students get enough to orgasm. Conclusion: There is a recipe to be followed on female sexuality, because that is individual and depends on each person, although some features are common to many women. The woman should be encouraged to discover to uncover your desires, fantasies, their places of greatest sexual stimuli, as the orgasm among others. The conversation with the partner showed great importance because it appears the value of intimacy as motivation for the femalesex.