[Cervical emphysema after tonsillectomy. A case report]. / Enfisema cervical post amigdalectomía: reporte de un caso.

Tonsillectomy is one of the surgical procedures most frequently performed by the ENT specialist. It is considered easy and safe, but many complications have been described. Cervical subcutaneous emphysema and pneumomediastinum are immediate complications relatively infrequent. Deep dissection of the superior pharyngeal constrictor muscle creates a continuity that dries the cervicofacial planes, until it reaches the parapharyngeal, retropharyngeal and prevertebral spaces. It can even reach the mediastinum producing a pneumothorax, which is facilitated by coughing, vomiting or manual ventilation after extubating.

Enfisema cervical post amigdalectomía: reporte de un caso / Cervical emphysema after tonsillectomy. A case report

La amigdalectomía, una de las cirugías más frecuentes realizada en la otorrinolaringología se considera relativamente segura. Numerosas complicaciones han sido descritas. El enfisema cervical subcutáneo y neumomediastino son complicaciones inmediatas relativamente infrecuentes. Una disección más profunda de la normal sobre el constrictor faríngeo superior, crea una solución de continuidad que diseca los planos cervicofaciales, alcanza el espacio parafaríngeo, retrofaríngeo y puede alcanzar el mediastino produciendo neumotórax, este proceso es facilitado por la tos, vómito o ventilación manual después de la extubación

Tonsillectomy is one of the surgical procedures most frequently performed by the ENT specialist. It is considered easy and safe, but many complications have been described. Cervical subcutaneous emphysema and pneumomediastinum are immediate complications relatively infrequent. Deep dissection of the superior pharyngeal constrictor muscle creates a continuity that dries the cervicofacial planes, until it reaches the parapharyngeal, retropharyngeal and prevertebral spaces. It can even reach the mediastinum producing a pneumothorax, which is facilitated by coughing, vomiting or manual ventilation after extubating

[Monetary value of breast milk in Bolivia]. / Valor monetario de la leche materna en Bolivia.

OBJECTIVE: To estimate the volume of breast milk consumed by Bolivian children under 36 months of age, and the monetary value of replacing that volume of breast milk with commercial substitutes. METHODS: The analysis took into account the distribution of the infant population by age groups, the prevalence of breast-feeding practices (exclusive or partial) in every age group, the average volume of breast milk consumed by the infants of a given age group, and the cost of breast milk production and replacement. RESULTS: Bolivian infants annually consume more than 161 million liters of breast milk, which represents an average volume of 573 mL/day per infant under 1 year of age. The monetary value of breast milk consumed by the Bolivian infants amounts to US$ 274 million annually. The average cost of replacing breast milk with commercial substitutes for an infant adequately breast-fed for the first year of life would be US$ 407. DISCUSSION: For the formulation and consolidation of policies and programs to protect, promote, and support breast-feeding to become a reality, it is necessary that the political leaders of Bolivia be aware of the enormous monetary value of breast milk.

The treatment of nonstreptococcal pharyngitis with erythromycin: a preliminary study.

This preliminary study evaluated the effectiveness of enteric-coated erythromycin in the treatment of adults with nonstreptococcal pharyngitis. Twenty-six patients, aged 12 or older, with nonstreptococcal pharyngitis were randomly assigned in a double-blind fashion to receive either enteric-coated erythromycin or placebo for 10 days. Each day the patients rated the soreness of their throats and how sick they felt. The use of erythromycin appeared to decrease the median number of days for the feeling of sickness to improve (two days versus four days, P less than .01) as well as to decrease the median number of days for the feeling of sickness to resolve (three-and-a-half days versus five days, P less than .05). This apparent improvement in sickness occurred even though there was no significant decrease in the soreness of the throat in patients treated with erythromycin compared to those patients treated with placebo. Treatment with enteric-coated erythromycin appeared to shorten the time until improvement in this group of adults with nonstreptococcal pharyngitis.