ABSTRACT
PURPOSE: Achromobacter xylosoxidans is an emerging pathogen mainly associated with resistant nosocomial infections. This bacteria had been isolated in the ear together with other pathogens in cultures from patients with chronic otitis media, but it had never been reported as a cause of osteomyelitis of the external auditory canal. CASE PRESENTATION: We present a unique case of a healthy 81-year-old woman who presented with left chronic otorrhea refractory to topical and oral antibiotic treatment. Otomicroscopy revealed an erythematous and exudative external auditory canal (EAC) with scant otorrhea. The tympanic membrane was intact, but an area of bone remodeling with a small cavity anterior and inferior to the bony tympanic frame was observed. Otic culture isolated multi-drug-resistant A. xylosoxidans, only sensitive to meropenem and cotrimoxazole. Temporal bone computed tomography showed an excavation of the floor of the EAC compatible with osteomyelitis. Targeted antibiotherapy for 12 weeks was conducted, with subsequent resolution of symptoms and no progression of the bone erosion. CONCLUSIONS: Atypical pathogens such as A. xylosoxidans can be the cause of chronic otitis externa. Early diagnosis and specific antibiotherapy can prevent the development of further complications, such as osteomyelitis. In these cases, otic cultures play an essential role to identify the causal germ. This is the first case of EAC osteomyelitis due to A. xylosoxidans reported to date.
Subject(s)
Achromobacter denitrificans , Ear Diseases , Osteomyelitis , Otitis Externa , Female , Humans , Aged, 80 and over , Ear Canal/diagnostic imaging , Otitis Externa/diagnosis , Otitis Externa/drug therapy , Osteomyelitis/diagnosis , Osteomyelitis/drug therapy , Osteomyelitis/complicationsABSTRACT
Active middle ear implants (AMEI) are implantable options for patients with sensorineural, conductive, or mixed hearing loss who are not good candidates for hearing aids. The aim of this study was to compare audiological, surgical, quality of life, and sound quality outcomes in adults <60 and ≥60 years receiving an AMEI. Twenty adult patients who underwent AMEI implantation were divided into two groups, <60 and ≥60 y. Preoperative tests included pure-tone average and speech discrimination score (SDS) at 65 dB for disyllabic words in quiet. Postoperative measures included AMEI-aided bone conduction threshold, free-field warble-tone threshold, and SDS at 65 dB for disyllabic words in quiet 12 months after the AMEI fitting. Subjective benefit was evaluated using the Nijmegen Cochlear Implant Questionnaire (NCIQ), Glasgow Benefit Inventory (GBI), and Hearing Implant Sound Quality Index (HISQUI19). Mean functional gain was 32 and 30 dB, and SDS at 65 dB improved from 19 to 95% and from 31 to 84% in the <60 and ≥60 y groups, respectively. All NCIQ domains improved following surgery, and all patients had a positive overall GBI score. The mean HISQUI19 score was 97 in both age groups. AMEIs are an effective hearing restoration method for older adults suffering from conductive or mixed hearing loss.
ABSTRACT
We realize the growth of self-catalyzed core-shell GaAs/GaAsP nanowires (NWs) on Si substrates using molecular-beam epitaxy. Transmission electron microscopy of single GaAs/GaAsP NWs demonstrates their high crystal quality and shows domination of the GaAs zinc-blende phase. Using continuous-wave and time-resolved photoluminescence (PL), we make a detailed comparison with uncapped GaAs NWs to emphasize the effect of the GaAsP capping in suppressing the nonradiative surface states. Significant PL enhancement in the core-shell structures exceeding 3 orders of magnitude at 10 K is observed; in uncapped NWs PL is quenched at 60 K, whereas single core-shell GaAs/GaAsP structures exhibit bright emission even at room temperature. From analysis of the PL temperature dependence in both types of NW we are able to determine the main carrier escape mechanisms leading to the PL quench.
ABSTRACT
Strained semiconductor nanostructures can be used to make single-photon sources, detectors and photovoltaic devices, and could potentially be used to create quantum logic devices. The development of such applications requires techniques capable of nanoscale structural analysis, but the microscopy methods typically used to analyse these materials are destructive. NMR techniques can provide non-invasive structural analysis, but have been restricted to strain-free semiconductor nanostructures because of the significant strain-induced quadrupole broadening of the NMR spectra. Here, we show that optically detected NMR spectroscopy can be used to analyse individual strained quantum dots. Our approach uses continuous-wave broadband radiofrequency excitation with a specially designed spectral pattern and can probe individual strained nanostructures containing only 1 × 10(5) quadrupole nuclear spins. With this technique, we are able to measure the strain distribution and chemical composition of quantum dots in the volume occupied by the single confined electron. The approach could also be used to address problems in quantum information processing such as the precise control of nuclear spins in the presence of strong quadrupole effects.
Subject(s)
Magnetic Resonance Spectroscopy , Quantum DotsABSTRACT
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
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
Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results.
Subject(s)
Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Laryngeal/epidemiology , Adult , Aged , Antitubercular Agents/therapeutic use , Female , Humans , Incidence , Laryngoscopy , Male , Treatment Outcome , Tuberculosis, Laryngeal/diagnosis , Tuberculosis, Laryngeal/drug therapyABSTRACT
La tuberculosis es la infección crónica granulomatosa más común de la laringe. Aparece, generalmente a partir de una tuberculosis pulmonar. Predomina en hombres. La sintomatología más habitual incluye disfonía, odinofagia, otalgia referida ya veces disnea. La mayoría de los pacientes suelen tener afectación pulmonar radiológica al diagnóstico. Las lesiones nodulares exofiticas o ulcerosas pueden confundirse con carcinoma, por lo que en estos casos es imprescindible el estudio anatomopatológico. El diagnóstico se hace mediante muestras de esputos positivos, características específicas de la radiografia de tórax y las biopsias positivas de bacilos ácido-alcohol resistentes. Se presentan los pacientes diagnosticados de tuberculosis laríngea en nuestro hospital entre 1994 y 2004. Se describen las pruebas diagnósticas realizadas así como la actitud terapéutica adoptada en cada uno de ellos y sus resultados
Tuberculosis is the chronic granulomatose most common infection of the larynx. It appears generally from pulmonary tuberculosis. It prevails in men. The most habitual symptomatology includes dysphony, odinophagy, referred otalgy and sometimes dispnea. The majority of patients use to have radiological pulmonary affectation to the diagnosis. The nodular exophitic or ulcerous lesions can be confused with carcinoma, therefore in these cases the anatomopathologic study is essential. The diagnosis is made with positive spit samples, specific characteristics of the thorax radiography and the positive biopsies of acid-alcohol resistant bacillus. We present the patients diagnosed with laryngeal tuberculosis in our hospital between 1994 and 2004. We describe the diagnostic procedures realised and the adopted therapeutic attitude in every case and results
Subject(s)
Male , Adult , Aged , Humans , Mycobacterium tuberculosis/isolation & purification , Tuberculosis, Laryngeal/epidemiology , Antitubercular Agents/therapeutic use , Laryngoscopy , Treatment Outcome , Tuberculosis, Laryngeal/diagnosis , Tuberculosis, Laryngeal/drug therapySubject(s)
Back Pain/epidemiology , Adolescent , Adult , Age Factors , Aged , Back Pain/complications , Back Pain/psychology , Child , Chile , Female , Humans , Male , Middle Aged , Obesity/complications , Occupational Diseases/epidemiology , Sex FactorsSubject(s)
Child , Adolescent , Adult , Middle Aged , Humans , Male , Female , Endoscopy , Gastrointestinal Hemorrhage , Diagnosis, DifferentialABSTRACT
En la experiencia que se presenta, la frecuencia de la peritonitis apendicular fue del 9,70%. Se observo un retardo notable en el diagnostico y tratamientos de los cuadros apendiculares agudos y en un elevado porcentaje de casos la falla fue medica
