[Sjögren syndrome in ORL. Diagnostic considerations]. / Síndrome de Sjögren en O.R.L. Consideraciones diagnósticas.

A presentation the history of a 51-year-old woman with xerostomia and keratoconjunctivitis sicca (KCS), developed in 10 months, investigations revealed the presence in serum of antibodies against cytoplasmic antigens SS-A (Ac anti-Ro/SS-A), antinuclear antibodies (ANAs) and rheumatoid factor (RF). The Rose Bengal test was positive and in the salivary gammagraphy, made with pertecnate 99 mTc, it was observed a decrease of the captation and excretion of the designer for salivary glands. The histopathology and immunohistochemical study of minor salivary glands showed the presence of a focal lymphocitic sialadenitis (fsa) and a predominance of lymphocites CD4+. It was diagnosed as primary Sjögren's syndrome (PSS) and the patient treated with salivary substitutes, artificial tears and corticoids. We analyse the current diagnostic criteria of the group of study of the European Community for the Sjögren's syndrome (SS) and emphasize the importance of histologic and immunochemical studies, that together with the rest of complementary tests will led us to distinguish not only the different forms of the presentation of the illness but also those of all patients with pathologies which are nowadays very prevalent in our environment, such as the hepatitis C (HCV) an the human immune deficiency (HIV) virus infections.

[An outpatient study in ENT (otorhinolaryngology) emergencies at a general hospital]. / Estudio de las urgencias externas otorrinolaringológicas en un hospital terciario.

ORL emergencies attended at in a general hospital for a year were studied from 1-7-1990 to 30-6-1991. 168,145 emergencies were received of which 3,101 (1.8%) were attended by an otorhinolaringologist. The age, sex, arrival time, aetiology, treatment, admissions and the admissions where AEP (Appropriateness Evaluation Protocol) criteria was applied were thoroughly examined. The most numerous pathologies presented were infectious inflammations (41%), hemorrhages (21%), and foreign bodies (18.5%). But the most frequent aetiologies were epistaxis (16.3%), otitis media (14.8%) and otitis externa (14.8%). Most patients arrived generally between 9-12 hrs. (21.3%), and 17-20 hrs. (25.4%). The average age was 38.8 years old, though there was a significant difference depending on the pathology presented. Infectious inflammations emergencies were usually the youngest age group (average age 32) and tumoral processes the eldest (average age 60), 5% of the cases were admitted. These admissions accounted for only 17.9% of total admissions. Because AEP criteria was employed 97.5% of admissions presented inclusion criteria.

[Diagnostic role of the biopsy in angiofibroma of the cavum]. / Papel diagnóstico de la biopsia en el angiofibroma de cavum.

The AA. inform about the case of a child, 13, with an antro-choanal Polyp of angiofibromatous structure, diagnosed as Angiofibroma. Though in the greater number of instances the arteriography is enough to support the suspicion, the confirmation through histopathology is compulsory.