ABSTRACT
Laryngopharyngeal reflux has been recognized since 2006 (Montreal Consensus) as an extradigestive manifestation of gastroesophageal reflux disease. However, despite numerous research studies, the relationship between these two pathologies is yet to be fully understood. The aim of this paper is to review the literature of the last five years available via the PubMed database, looking at the controversies about the prevalence, pathophysiology and diagnosis of laryngopharyngeal reflux.
Subject(s)
Gastroenterology , Laryngopharyngeal Reflux , Laryngoscopy , Otolaryngology , Esophageal pH Monitoring , Evidence-Based Medicine , Humans , Interdisciplinary Communication , Laryngopharyngeal Reflux/diagnosis , Laryngopharyngeal Reflux/drug therapy , Laryngopharyngeal Reflux/epidemiology , Laryngopharyngeal Reflux/physiopathology , Laryngoscopy/methods , Prevalence , Proton Pump Inhibitors/therapeutic use , Romania/epidemiologyABSTRACT
OBJECTIVES: The aim of this study is to present a clear picture of the epidemiological aspects pertaining to the cases of neck trauma addressing to the ENT Emergency Room, as well as to display the complexity of the diagnostic and therapeutic management employed in two important Romanian ENTDepartments - "Sfantul Spiridon" Hospital Iasi and SfantaMaria Hospital Bucharest MATERIAL AND METHODS: We conducted a retrospective study on 538 patients with neck trauma that were referred to the abovementioned ENT Departments between March 2009 March 2011, selecting 27 cases with forensic implications. RESULTS: In terms of aetiological mechanism, the most frequentneck injuries in our study were penetrating neck injuries due to assault or self-mutilation with white weapons (knives, razor blades, forks, glass) - 56%, followed by blunt trauma cases due to car accident, strangulation or accidental fall 44%. The most important clinical findings recorded at admission were polytraumas (24.14%), hematomas, fractures, subcutaneous emphysema or skin perforation with visceral damages(representing each 13.8%) and tissue rip (10.34%), important bleedings (6.89%), as well as perforation of neck organs(3.45%). The most frequent postoperative complications were postoperative pharyngo-cutaneous fistula (7.4%) and laryngotrachealstenosis (7.4%). There were also 3 other patients with long-term complications, such as acute mediastinitis (3.4%)recurrential paralysis with Gerhardt's syndrome (3.4%) and dysphagia (3.4%).
Subject(s)
Multiple Trauma/surgery , Neck Injuries/surgery , Otolaryngology , Wounds, Nonpenetrating/surgery , Wounds, Penetrating/surgery , Adult , Aged , Emergency Service, Hospital , Female , Humans , Incidence , Male , Middle Aged , Multiple Trauma/diagnosis , Multiple Trauma/epidemiology , Multiple Trauma/etiology , Neck Injuries/diagnosis , Neck Injuries/epidemiology , Neck Injuries/etiology , Otorhinolaryngologic Surgical Procedures/adverse effects , Otorhinolaryngologic Surgical Procedures/methods , Retrospective Studies , Romania/epidemiology , Treatment Outcome , Wounds, Nonpenetrating/diagnosis , Wounds, Nonpenetrating/epidemiology , Wounds, Nonpenetrating/etiology , Wounds, Penetrating/diagnosis , Wounds, Penetrating/epidemiology , Wounds, Penetrating/etiologyABSTRACT
AIM: This article focuses on the lateral sinus thrombophlebitis, which is a serious complication of the supurated otopathies. MATERIAL AND METHODS: It is based on a study of a significant number of both exo- and endocranial complications treated in the the "Sf Spiridon" Hospital- ORL department and at the "Prof. dr. N. Oblu"- Neurosurgery department (57 out of 251 cases admitted in the past 5 years). RESULTS: Among the 57 cases, there were 8 lateral sinus thrombophlebitis, as well as 6 cases where meningitis coexisted with other endocranial complications, such as lateral sinus thrombophlebitis or brain abscess. The article contains details about some cases with special problems of diagnostic and treatment. CONCLUSIONS: The symptoms of the presented cases are completely different from the common symptomatology. However, the diagnostic of such cases is possible due to the modern imaging methods as well. The lateral sinus thrombophlebitis is usually determined by different causes, one of them being the misuse of the antibiotics (class and daily/total dose). When endocranial complications occur the symptoms of the meningitis are masking the symptoms of other complications. Even if the CT scan or MRI exams performed right on the patient's admission show no other complications, the patient should be followed for a period of 15 up to 30 days after the treatment of the meningitis, by repeating imaging tests to identify a possible complication.
Subject(s)
Lateral Sinus Thrombosis/diagnosis , Lateral Sinus Thrombosis/therapy , Adult , Anti-Bacterial Agents/therapeutic use , Child , Humans , Lateral Sinus Thrombosis/diagnostic imaging , Lateral Sinus Thrombosis/drug therapy , Lateral Sinus Thrombosis/etiology , Lateral Sinus Thrombosis/surgery , Magnetic Resonance Angiography , Male , Tomography, X-Ray Computed , Treatment OutcomeABSTRACT
UNLABELLED: Control of blood pressure is far from satisfactory, reaching approximately 13% in Romania according the SEPHAR study. AIM: Assessment of blood pressure control in elderly by blood pressure monitoring at home. MATERIAL AND METHOD: 64 hypertensive patients (36 women and 28 men) with mean age of 76.3 years which blood pressure has been normalized by admitting in hospital were followed for a period of three months, by self-measuring blood pressure at home (twice a week). RESULTS: In the first week after hospital discharge the mean systolic pressure was 158 +/- 17.06 and after adjustment of treatment was 136.76 +/- 11.36 mmHg. To the end of the study blood pressure was controlled at a rate of 81.25%. CONCLUSIONS: To increase the percentage of therapeutic control of blood pressure at home, small changes in drug dosage are needed.
Subject(s)
Antihypertensive Agents/therapeutic use , Blood Pressure Monitoring, Ambulatory , Blood Pressure/drug effects , Hypertension/drug therapy , Aged , Algorithms , Antihypertensive Agents/adverse effects , Female , Humans , Hypertension/diagnosis , Male , Retrospective Studies , Risk FactorsABSTRACT
AIM: Comparison of blood pressure values measured by two methods. MATERIAL AND METHOD: 94 hypertensive patients (66 women and 28 men in relation to 2.36/1) were assessed classically and also by ABPM. For statistic evaluation we have used t - Student test, chi2 test, Pearson correlation coefficient and variation coefficient (cv%). RESULTS: It shows significant differences between mean values of systolic and diastolic blood pressure obtained by the 2 methods. CONCLUSIONS: ABPM measured values are more accurate compared to clinic, bringing also information on pattern hypertensive therapy.
Subject(s)
Blood Pressure Monitoring, Ambulatory , Hypertension/diagnosis , Aged , Aged, 80 and over , Diastole , Female , Humans , Hypertension/drug therapy , Hypertension/physiopathology , Male , Statistics, Nonparametric , SystoleABSTRACT
Authors report a number of 5 patients operated for posttraumatic duodenal wounds between 1990 and 1996. Urgency diagnosis, and therapeutical conduct are commented upon, under conditions of surgical teams sometimes very little trained in solving such lesions. Two out of the 5 cases have presented extensive injuries to the duodenum and pancreas, and have brought about surgery tactical and technical problems. These have had an immediate postoperative morbidity full of serious complications, which have necessitated other interventions of a high vital risk. There have been no deaths registered. It has been reported about the advantage, of using "a la Roux" loop anastomosis for solving duodenal wounds which compromise the viability of the duodenal wall on a larger surface than that initially appreciated, when are combined with ampulla detachments and pancreatic lesions.
