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1.
Br J Neurosurg ; : 1-7, 2022 Jun 03.
Artigo em Inglês | MEDLINE | ID: mdl-35657108

RESUMO

OBJECTIVES: Double pituitary adenoma is a rare entity that can pose a significant challenge. The incidence of double or multiple pituitary adenomas is ∼1% in autopsy cases and 0.4-1.3% in surgical series. Its definition varies, including 'double adenomas' in the literature in contrast to 'multiple adenomas', which is more specific and suitable. While some authors require separating topographically unique tumours, others have used a looser definition of separate immunohistochemistry. CASE PRESENTATION: We presented the case of a 26-year-old patient with recurrent carpal tunnel syndrome symptoms, with double pituitary adenomas secreting growth hormone (GH) and thyroid-stimulating hormone (TSH). To date, 89 patients have been reported in the literature with symptomatic carpal tunnel syndrome, but only five had GH-TSH secretion. CONCLUSIONS: Double adenoma resection is of great importance for ensuring successful biochemical treatment. To ensure a successful operation, a careful preoperative 3T MRI examination is of great importance.

2.
Acta Otolaryngol ; 141(2): 141-146, 2021 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-33151099

RESUMO

BACKGROUND: The vHIT device, which has a mechanism based on measuring the VOR gain, helps us to quickly evaluate six semicircular canals. AIMS/OBJECTIVES: The aim of this study was to establish normative values for semicircular canal function with the video head impulse test (vHIT) battery in normal adolescents. MATERIAL AND METHODS: 100 (50 females, 50 males) individuals aged 11-18 years, with a mean age of 14.99 years, were included in the study. RESULTS: As a result of the vHIT evaluations performed with vHIT Otometrics ICS Impulse A/S Taastrup, Denmark, the mean lateral canal vestibulo-ocular reflex (VOR) gain value was 0.96, the mean anterior canal VOR gain value was 0.89, and the mean posterior canal VOR gain value was 0.87, all of which were within the normal value range. CONCLUSION AND SIGNIFICANCE: While the VOR gain values and asymmetry values are within the normal value range and are similar to the literature, no statistically significant correlation was observed between these values and age. As a result, the vHIT battery is an easy, fast, and practical test method that can be used in adolescents.


Assuntos
Teste do Impulso da Cabeça , Reflexo Vestíbulo-Ocular/fisiologia , Canais Semicirculares/fisiologia , Adolescente , Criança , Feminino , Humanos , Masculino , Valores de Referência , Gravação em Vídeo
3.
Artigo em Inglês | MEDLINE | ID: mdl-30537754

RESUMO

BACKGROUND/AIMS: The aim of this study was to observe the relationship between the gene expression profiles of tumor necrosis factor (TNF)-α and endothelin (EDN)-1 and obstructive sleep apnea (OSA). METHODS: A prospective, cross-sectional study performed at a tertiary-care academic center; 108 patients with snoring and day-time sleeplessness were included in this study carried out in the Otolaryngology Department. All patients were evaluated with 1-night polysomnography (PSG). There were 63 patients with OSA and 45 patients without OSA. In the OSA group, the median apnea hypopnea index (AHI) was 29.1; in the non-OSA group, the median AHI was 2.1. Blood samples were obtained from all 108 patients for the genetic analysis of the expression of TNF-α and EDN-1. PSG findings and gene expression levels were evaluated in both groups. RESULTS: The median (range) age was 46 (20-81) years, BMI 24.9 (15-49), EDN-1 gene expression 0.45 (0.02-67.88) pg/µL, and TNF-α gene expression 1.71 (0.08-59.52) pg/µL. We found that EDN-1 and TNF-α gene expression levels were significantly higher in the OSA group than in the control group (p = 0.009 vs. p < 0.001). CONCLUSION: EDN-1 and TNF-α gene expression levels were associated with the occurrence of OSA.


Assuntos
Endotelina-1/genética , Apneia Obstrutiva do Sono/genética , Fator de Necrose Tumoral alfa/genética , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Estudos de Casos e Controles , Estudos Transversais , Endotelina-1/metabolismo , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Prospectivos , RNA Mensageiro/metabolismo , Apneia Obstrutiva do Sono/metabolismo , Fator de Necrose Tumoral alfa/metabolismo , Adulto Jovem
6.
J Oral Pathol Med ; 47(1): 40-47, 2018 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-29024069

RESUMO

BACKGROUND: Genetic factors play a large role in cancer, and thus, there is a great desire to understand the effects of different genes in cancer and to also develop gene therapy for better treatments. Therefore, the development of alternative diagnosis and therapy modalities is of utmost importance. The aim of our study was to illuminate the role of ESM1 (endothelial cell-specific molecule-1, also known as Endocan) in proliferation and migration of head and neck cancer, thus helping to pave the way for new treatment modalities and predictive biomarkers. METHODS: ESM1 expression was shown with immunofluorescence assay using confocal laser scanning microscope in primary and metastatic head and neck cancer cells. ESM1 expression was knocked down by RNA interference in head and neck cancer cells. Knockdown efficiency was evaluated by quantitative real-time RT-PCR and Western blot. Cell proliferation and migration assays were performed by xCELLigence real-time cell analysis system. RESULTS: Immunofluorescence assay showed nuclear localization and high expression of ESM1 in primary and metastatic head and neck cancer cells. ESM1 mRNA and protein levels were significantly decreased in ESM1-knockdown cells compared to control. ESM1-knockdown cells showed reduced proliferation and migration activity when compared to control cells. CONCLUSION: These findings suggest that ESM1 has roles on proliferation and migration of head and neck cancer cells.


Assuntos
Neoplasias de Cabeça e Pescoço/genética , Proteínas de Neoplasias/genética , Proteínas de Neoplasias/farmacologia , Proteínas de Neoplasias/fisiologia , Proteoglicanas/genética , Proteoglicanas/farmacologia , Proteoglicanas/fisiologia , RNA Interferente Pequeno/genética , Biomarcadores Tumorais , Linhagem Celular Tumoral , Movimento Celular/efeitos dos fármacos , Proliferação de Células/efeitos dos fármacos , Perfilação da Expressão Gênica , Regulação Neoplásica da Expressão Gênica , Técnicas de Silenciamento de Genes , Inativação Gênica , Humanos , Fatores de Transcrição
7.
JAMA Otolaryngol Head Neck Surg ; 143(5): 478-483, 2017 05 01.
Artigo em Inglês | MEDLINE | ID: mdl-28278341

RESUMO

Importance: Laryngopharyngeal reflux (LPR) is thought to be a potential exacerbating factor in upper airway diseases. Objective: To describe the effect of pharmacologic therapy of laryngopharyngeal reflux on nasal resistance. Design, Setting, and Participants: Prospective observational study performed between August 30, 2014, and October 1, 2015, at a tertiary care academic center including 50 patients with Reflux Symptom Index higher than 13 and Reflux Finding Score higher than 7 and 50 controls with no history of LPR and nasal disease. Interventions: Oral antireflux medication was given to the LPR group for 12 weeks. Main Outcomes and Measures: The measurements of total nasal resistance (TNR) were performed by means of active anterior rhinomanometry technique and Nasal Obstruction Symptom Evaluation (NOSE) was assessed. Results: The LPR group had 29 (58%) women and a median age of 41.5 years (range, 18-64 years). The control group had 27 (54%) women and a median age of 38.5 years (range, 19-63 years). After treatment, a significant decrease was observed in all parameters. The median (range) TNR scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median TNR score of the control group was 0.20 (range, 0.11-0.32). Whereas the TNR scores of the LPR group were higher than those of the control group before treatment (difference, -0.77; 95% CI, -0.10 to 0.05), they were almost the same after treatment (difference, 0.01; 95% CI, -0.01 to 0.03). The median (range) NOSE scores of the LPR group before and after treatment were 0.29 (0.12-0.36) and 0.19 (0.10-0.31), respectively. The median NOSE score of the control group was 0.20 (range, 0.11-0.32). Conclusions and Relevance: In this study, laryngopharyngeal reflux had a negative effect on nasal resistance and nasal congestion. Treatment was associated with improved subjective and objective nasal findings.


Assuntos
Resistência das Vias Respiratórias/efeitos dos fármacos , Refluxo Laringofaríngeo/tratamento farmacológico , Cavidade Nasal , Inibidores da Bomba de Prótons/uso terapêutico , Adolescente , Adulto , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Rinomanometria , Inquéritos e Questionários
8.
Eur Arch Otorhinolaryngol ; 274(1): 239-245, 2017 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-27470115

RESUMO

To compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 µg/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 µg/kg/h infusion during operation. In group R (n = 25), 1 µg/kg remifentanil IV bolus, was administered with induction of anesthesia and continued 0.25-0.50 µg/kg/min during operation. Heart rates, mean arterial pressure, end tidal CO2, end tidal sevoflurane were recorded. The amount of bleeding, surgical field condition for bleeding and the time to reach Aldrete recovery score 9-10 were recorded. Postoperative nausea, vomiting, pain, shivering, sedation were followed up over 24 h. There was no significant difference between groups according to the amount of bleeding during surgery, assessment of surgical field condition, consumption of sevoflurane, scores of postoperative VAS, rates of nausea and vomiting, shivering, demands of additional analgesic medication (P > 0.05). The time to reach Aldrete recovery score 9-10, sedation scores at the postoperative first hour were significantly higher in group D (P = 0.001). We concluded that in comparison to remifentanil, dexmedetomidine during FESS for controlled hypotension is of limited value as it has no additional benefits in terms of control of hypotension and amount of bleeding in the surgical field and it is associated with higher recovery time and first-hour postoperative sedation scores.


Assuntos
Perda Sanguínea Cirúrgica/prevenção & controle , Dexmedetomidina/uso terapêutico , Endoscopia , Hipnóticos e Sedativos/uso terapêutico , Hipotensão Controlada/métodos , Pólipos Nasais/cirurgia , Piperidinas/uso terapêutico , Adulto , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Infusões Intravenosas , Injeções Intravenosas , Masculino , Pessoa de Meia-Idade , Avaliação de Resultados em Cuidados de Saúde , Remifentanil
10.
Eur Arch Otorhinolaryngol ; 273(5): 1227-34, 2016 May.
Artigo em Inglês | MEDLINE | ID: mdl-26825802

RESUMO

UNLABELLED: The objective of this study is to evaluate and compare the long-term efficacy of the one staged multilevel surgery (MLS) with tongue suspension (TBS) surgery or one level palatal surgery for treatment of moderate and severe obstructive sleep apnea (OSA). This is a prospective cross-sectional study. SETTING: University hospital. Thirty-three patients diagnosed as moderate to severe OSA. Patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver, were treated with palatal surgeries (PS) and patients, with ≥ 50 % retropalopharyngeal obstruction on the Müller maneuver with ≥ 50 % base of the tongue collapse, were treated with palatal surgeries and tongue suspension surgery (TBS). Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Nine-teen patients with a mean age of 46.1 ± 8.3 underwent palatal surgeries (PS) and 14 patients with a mean age of 41.4 ± 8.9 underwent PS plus TBS. Success rate in TBS+PS group was 57.1 % and in PS group was 42.1 %. In both groups total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025) but there was no statistically significant difference between TBS+PS and PS groups. Supine AHI levels were reduced statistically significant in both groups postoperatively (p < 0.025). There was not any significant difference postoperatively in non-supine AHI levels in both groups (p > 0.025). There were significant postoperative changes in ODI, AVO2, MOS, ESS, Snoring VAS values in PS group (p < 0.025). In TBS+PS group there was a significant difference postoperatively only in ODI values. Treatment of OSA patients with retropalatal or retropalatal and retroglossal obstruction, in a one staged surgery, is a safe and easy procedure. We have achieved favorable long-term outcomes in moderate-severe OSA patients undergoing both palatal surgery and tongue suspension surgery.


Assuntos
Procedimentos Cirúrgicos Bucais , Palato/cirurgia , Apneia Obstrutiva do Sono , Ronco , Língua/cirurgia , Adulto , Estudos Transversais , Feminino , Hospitais Universitários , Humanos , Masculino , Pessoa de Meia-Idade , Procedimentos Cirúrgicos Bucais/efeitos adversos , Procedimentos Cirúrgicos Bucais/métodos , Medição da Dor/métodos , Polissonografia/métodos , Período Pós-Operatório , Estudos Prospectivos , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/diagnóstico , Apneia Obstrutiva do Sono/fisiopatologia , Apneia Obstrutiva do Sono/cirurgia , Ronco/diagnóstico , Ronco/cirurgia , Tempo , Resultado do Tratamento , Turquia
11.
Eur Arch Otorhinolaryngol ; 271(6): 1777-83, 2014 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-24264762

RESUMO

The aim of this prospective study was to evaluate the long-term efficacy anterior palatoplasty (AP) technique in treatment of patients with mild to moderate obstructive sleep apnea (OSA). Forty-two patients were diagnosed with mild to moderate OSA. Participants were treated with AP for mild or moderate OSA. Patients were evaluated with one night polysomnography before the surgery and 24 months after the surgery. Patients completed Epworth sleepiness scale (ESS), snoring VAS (visual analog scale) before and 24 months after the surgery. Forty two patients with a mean age of 39.2 ± 7.6 were included study. Success rate was 57.1%. Total apnea-hypopnea index (AHI) values significantly decreased after 2 years (p < 0.025). Non-REM AHI and supine AHI values significantly decreased after 2 years (p < 0.025). The oxygen desaturation index changes significantly decreased after AP (p < 0.025). Snoring VAS values significantly decreased after AP (p < 0.025). ESS scores of patients significantly decreased (p < 0.001). We believe that AP is an effective, inexpensive technique for mild and moderate OSA patients.


Assuntos
Palato Mole/cirurgia , Apneia Obstrutiva do Sono/cirurgia , Adulto , Estudos de Coortes , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Estudos Prospectivos , Índice de Gravidade de Doença , Resultado do Tratamento
12.
Turk J Med Sci ; 44(1): 133-6, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25558573

RESUMO

AIM: Epistaxis is a common emergency in otolaryngology. The aim of this study is to analyze the etiology, management, and accompanying disorders of epistaxis in geriatric patients by reviewing the literature MATERIALS AND METHODS: Data of 117 patients 65 years old and older who presented to the Department of Otorhinolaryngology with active epistaxis between 2004 and 2010 were retrospectively reviewed. Records were evaluated for age, sex, accompanying disorders, drug medication, detailed otorhinolaryngological findings, and management of epistaxis. RESULTS: There were 67 women (57.26%) and 50 men (42.74%) with a mean age of 73.51 years (range: 65-90). Ninety-four (80.34%) patients had accompanying disorders such as hypertension, diabetes mellitus, cerebrovascular disease, sinusitis, chronic obstructive lung disease, nasal polyp, and drug treatment. The bleeding site was anterior in 90 patients (76.92%) and posterior in 16 (13.67%). In 11 patients (9.4%), the bleeding site was not identified. Fifty-seven patients (48.71%) were treated with cauterization, 17 patients (14.52%) with nasal packing, 12 patients (10.25%) with medical treatment, 1 patient (0.85%) with mass excision and nasal packing, and 19 patients (16.23%) with more than 1 treatment method. Six patients (5.12%) were untreated because of the unidentified bleeding point. Bleeding control was performed under local anesthesia in 113 patients (96.58%) and under general anesthesia in 4 patients (3.41%). Twenty-one patients (17.94%) were hospitalized and 3 patients (2.56%) required a blood transfusion. CONCLUSION: Epistaxis is the most common otorhinolaryngological emergency. It must be evaluated carefully to avoid the potential complications resulting from both epistaxis and its associated disorders, especially in geriatric patients.


Assuntos
Epistaxe/terapia , Idoso , Idoso de 80 Anos ou mais , Epistaxe/complicações , Epistaxe/etiologia , Feminino , Humanos , Masculino , Estudos Retrospectivos
13.
Int J Pediatr Otorhinolaryngol ; 77(11): 1825-9, 2013 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-24041860

RESUMO

OBJECTIVE: To investigate and compare the effectiveness of preincisional peritonsillar infiltration of ketamine and tramadol for post-operative pain on children following adenotonsillectomy. STUDY DESIGN: Prospective randomized double blind controlled study. METHODS: Seventy-five children aged 3-10 years undergoing adenotonsillectomy were included in study. Patients received injections in peritonsillar fossa of tramadol (2 mg/kg-2 ml), ketamine (0.5 mg/kg-2 ml) or 2 ml serum physiologic. During operation heart rate, oxygen saturation, average mean blood pressures were recorded in every 5 min. Operation, anesthesia and the time that Alderete scores 9-10, patient satisfaction, analgesic requirements were recorded. Postoperatively nausea, vomiting, sedation, dysphagia, bleeding scores were recorded at 0, 10, 30, 60 min and 2, 4, 8, 12, 18, 24h postoperatively. Pain was evaluated using modified Children's Hospital of Eastern Ontario Pain Scale (mCHEOPS) at fixed intervals after the procedure (15 min and 1, 4, 12, 16, and 24h postoperatively). RESULTS: The recordings of heart rate, mean arterial pressure, nausea, vomiting, sedation and bleeding scores were similar in all groups (p>0.05). The mCHEOPS scores at 10 min, 30 min, 1h, 8h were significantly lower in both tramadol and ketamine group when compared with control (p<0.05). Use of additional analgesia at 10 min and 18 h were higher in control group than ketamine, tramadol group (p<0.05). Dysphagia scores were significantly lower for both ketamine and tramadol group when compared with control group (p<0.05). mCHEOPS, additional analgesia, dysphagia, patient satisfaction scores were similar in tramadol, ketamine groups (p>0.05). CONCLUSIONS: Preincisional injection of ketamine and tramadol prior to tonsillectomy is safe, effective method and equivalent for post-tonsillectomy pain, patient satisfaction, postoperative nausea, vomiting, dysphagia.


Assuntos
Adenoidectomia/métodos , Anestesia Local/métodos , Ketamina/administração & dosagem , Dor Pós-Operatória/prevenção & controle , Tonsilectomia/métodos , Tramadol/administração & dosagem , Adenoidectomia/efeitos adversos , Analgésicos/administração & dosagem , Analgésicos Opioides/administração & dosagem , Criança , Pré-Escolar , Método Duplo-Cego , Feminino , Seguimentos , Humanos , Masculino , Medição da Dor , Dor Pós-Operatória/tratamento farmacológico , Cuidados Pré-Operatórios/métodos , Estudos Prospectivos , Valores de Referência , Medição de Risco , Estatísticas não Paramétricas , Tonsilectomia/efeitos adversos , Resultado do Tratamento
14.
Artigo em Inglês | MEDLINE | ID: mdl-21822031

RESUMO

PURPOSE OF THE STUDY: The aim of this study was to investigate the impact of two different application methods (self or nurse administered) on Epworth Sleepiness Scale (ESS) scores and compare the scores according to their correlations between polysomnographic findings. PROCEDURES: 114 patients agreed to participate by completing the Turkish version of the ESS with 2 different methods of application, but the complete results of polysomnography (PSG) were available for 101 patients. RESULTS: The scores of the nurse-administered ESS were clinically significantly correlated with the apnea-hypoapnea index. Scores of the self-administered ESS were not correlated with any of the demographic and PSG parameters. In the reliability analysis, the scores of the self-administered and the nurse-administered ESS were quite consistent. CONCLUSION AND MESSAGE: We considered that to complete the ESS with the method of nurse administration could change the reliability and sensitivity. In conclusion, the ESS may be a more reliable tool for measuring the severity of excessive daytime sleepiness or obstructive sleep apnea by a change in the administration method.


Assuntos
Autoavaliação Diagnóstica , Enfermeiros Administradores , Apneia Obstrutiva do Sono/diagnóstico , Fases do Sono , Inquéritos e Questionários , Feminino , Seguimentos , Humanos , Masculino , Pessoa de Meia-Idade , Polissonografia , Reprodutibilidade dos Testes , Índice de Gravidade de Doença , Apneia Obstrutiva do Sono/fisiopatologia
15.
J Craniofac Surg ; 22(4): 1539-42, 2011 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-21778863

RESUMO

A 47-year-old woman presented with a left-sided watery nasal discharge persisting for 3 weeks after an orthopedic operation using spinal anesthesia. The testing of the nasal fluid for ß-2 transferrin confirmed that the leakage was cerebrospinal fluid (CSF). The computed tomographic cisternography revealed a left-sided bone defect in the cribriform plate. Endonasal approach was performed for closing the defect. At 3-month follow-up, CSF rhinorrhea had not recurred. In this report, we present an unexpected CSF rhinorrhea after a spinal anesthesia and discuss the reason of spontaneous leak after spinal anesthesia, as well as discuss current diagnosis and management of CSF rhinorrhea with the composite graft.


Assuntos
Raquianestesia/efeitos adversos , Rinorreia de Líquido Cefalorraquidiano/etiologia , Doenças Ósseas/cirurgia , Transplante Ósseo/métodos , Rinorreia de Líquido Cefalorraquidiano/cirurgia , Endoscopia , Osso Etmoide/cirurgia , Feminino , Adesivo Tecidual de Fibrina/uso terapêutico , Seguimentos , Humanos , Pessoa de Meia-Idade , Procedimentos de Cirurgia Plástica/métodos , Adesivos Teciduais/uso terapêutico , Tomografia Computadorizada por Raios X , Transferrina/análise , Conchas Nasais/cirurgia
16.
Otolaryngol Head Neck Surg ; 145(3): 505-10, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21613627

RESUMO

OBJECTIVE: To investigate the differences in thickness of subcutaneous fat tissue of the anterior neck and umbilicus of patients with and without obstructive sleep apnea (OSA), the relationship between thickness of subcutaneous fat tissue of the anterior neck and umbilicus and polysomnographic findings, and the influence of body mass index (BMI), anthropometric findings, and gender. STUDY DESIGN: Cross-sectional study. SETTING: Tertiary care university hospital. SUBJECT AND METHODS: Seventy-three patients with OSA and 24 non-OSA patients were evaluated with polysomnography for 1 night. Anthropometric parameters and BMI were also investigated. Subcutaneous fat tissue thickness of anterior neck and umbilicus was assessed using ultrasound. The thickness of subcutaneous fat tissue adjacent to the submandibular gland, isthmus, hyoid, suprasternal notch, and umbilicus was measured with ultrasound. Data analysis was performed using SPSS. RESULTS: Apnea-hypopnea index (AHI) was significantly and positively correlated with age (P = .016, r (2) = 0.244), BMI (P < .001, r (2) = 0.416), and anthropometric findings (waist circumference P < .001, r (2) = 0.337; hip circumference P = .008, r (2) = 0.269; neck circumference P = .002, r (2) = 0.309). Minimum oxygen saturation was significantly, negatively correlated with age (P = .002, r (2) = -0.310), BMI (P < .001, r (2) = -0.404), and anthropometric findings (waist circumference P = .005, r (2) = -0.281, hip circumference P < .001, r (2) = -0.353, neck circumference P = .010, r (2) = -0.261). There were no significant differences between the OSA and non-OSA groups with respect to age (P = .178), gender (P = .189), or ultrasonographic findings for subcutaneous fat tissue thickness adjacent to the submandibular gland (P = .480), thyroid isthmus (P = .311), suprasternal notch (P = .950), umbilicus (P = .691), or hyoid (P = .159). Neck circumference (P = .039) and BMI (P = .014) were significantly higher in the OSA group. CONCLUSION: These indicate that anterior neck and umbilical subcutaneous fat tissue thickness may not contribute to the severity of OSA.


Assuntos
Gordura Abdominal/diagnóstico por imagem , Gordura Abdominal/patologia , Índice de Massa Corporal , Apneia Obstrutiva do Sono/diagnóstico por imagem , Apneia Obstrutiva do Sono/patologia , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/patologia , Antropometria , Distribuição de Qui-Quadrado , Estudos de Coortes , Intervalos de Confiança , Feminino , Humanos , Modelos Lineares , Masculino , Análise Multivariada , Pescoço/patologia , Polissonografia , Estudos Prospectivos , Sensibilidade e Especificidade , Estatísticas não Paramétricas , Ultrassonografia , Umbigo
18.
Auris Nasus Larynx ; 38(4): 532-7, 2011 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-21236608

RESUMO

OBJECTIVE: We aimed to attract our colleagues' attention to the oropharyngeal tularemia, which has been an infrequently diagnosed disease in otolaryngology clinics also becoming widespread in Turkey. METHODS: A retrospective review of database of 3 patients was performed to find patients with Tularemia. The medical files, treatment charts, serological and PCR findings and radiological (magnetic resonance imaging), histopathological records of these patients were reviewed. RESULTS: The study group consisted of 3 oropharyngeal tularemia patients. All of them presented with tonsillopharyngitis and cervical lymphadenitis and all were resistant to beta lactam or cephalosporin group antibiotics. Two patients had magnetic resonance imaging findings. All patients had positive serological tests. Strongly positive serological tests led to the diagnosis of tularemia. All patients had positive PCR and direct fluorescent antibody (DFA) test. All patients responded to systemic streptomycin treatment. CONCLUSION: In the daily practice of an otolaryngologist, it is not usual to diagnose a patient with oropharyngeal tularemia. Tularemia should be considered in the differential diagnosis of massive adenotonsillar enlargement and extensive necrotic cervical lymphadenopathy not responding to beta lactam antibiotics as a result of the rising number of tularemia outbreaks outside the classic endemic areas.


Assuntos
Orofaringe , Otorrinolaringopatias/diagnóstico , Tularemia/diagnóstico , Adulto , Antibacterianos/uso terapêutico , Diagnóstico Diferencial , Feminino , Imunofluorescência , Humanos , Linfonodos/microbiologia , Linfadenite/microbiologia , Imageamento por Ressonância Magnética , Masculino , Pessoa de Meia-Idade , Pescoço , Otorrinolaringopatias/tratamento farmacológico , Faringite/microbiologia , Reação em Cadeia da Polimerase , Estudos Retrospectivos , Testes Sorológicos , Estreptomicina/uso terapêutico , Tonsilite/microbiologia , Turquia , Resistência beta-Lactâmica
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