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2.
Rev. esp. patol ; 55(3): 192-196, jul.-sep. 2022. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-206794

RESUMO

Paciente mujer de 54 años que acude a consulta por un cuadro de obstrucción nasal. En la exploración física se observa una lesión rosada, bien delimitada, en la fosa nasal izquierda. Se realiza TAC de macizo facial en la que se observa una masa expansiva a nivel del tercio anterosuperior de la fosa nasal izquierda. Se realiza resección endoscópica. Histológicamente se observa una proliferación mesenquimal atípica constituida por células que forman haces largos desorganizados y entrecruzados. Las células tumorales presentan un citoplasma amplio eosinófilo y núcleo ovalado, vesiculoso e hipercromático. Se aprecian frecuentes figuras mitóticas, muchas de ellas atípicas. No se observa necrosis. En el estudio inmunohistoquímico se evidenció inmunorreactividad de las células tumorales frente a calponina, actina muscular específica, caldesmón y miosina específica de músculo liso. El índice de proliferación frente a KI-67 fue de un 30%. Con todos estos hallazgos se estableció el diagnóstico de leiomiosarcoma de fosa nasal.(AU)


A 54-year-old female patient presented with a left nasal obstruction. On physical examination a pink delimited mass in the left nostril was observed. A cranial computed tomography scan revealed an expansive mass in the upper anterior third of the left nasal fossa, partially obstructing it. Endoscopic resection of the mass was performed. Histopathology revealed an atypical mesenchymal proliferation formed by cells disposed in disorganized and interconnected long bundles. Tumor cells had abundant eosinophilic cytoplasm and an oval, vesicular and hyperchromatic nucleus. Frequent mitotic figures were observed, many of them atypical. Necrosis was not observed. Immunohistochemistry showed tumor cells to be positive for calponin, muscle specific actin, caldesmon and smooth muscle specific myosin. Ki-67 index proliferation was 30%. A diagnosis of leiomyosarcoma of the nasal fossa was established.(AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , Leiomiossarcoma , Cavidade Nasal , Músculo Liso/patologia , Neoplasias , Imuno-Histoquímica , Antígeno Ki-67
4.
Rev. patol. respir ; 24(2): 83-85, abr.- jun. 2021. ilus, tab
Artigo em Espanhol | IBECS | ID: ibc-228299

RESUMO

Se describe el caso de una paciente de 50 años que fue ingresada durante la pandemia de SARS-CoV-2 (COVID-19) por neumonía bilateral, atribuida a la infección por dicho virus. Sin embargo, tras realizar pruebas complementarias, se diagnostica una pieza dentaria localizada en fosa nasal como foco infeccioso del proceso. Se concluye con la necesidad de efectuar una correcta anamnesis para valorar otras posibles causas de neumonía durante la pandemia por SARS-CoV-2 (AU)


We describe the case of a 50-year-old patient who was admitted during the SARS-Cov-2 (COVID-19) pandemic for bilateral pneumonia, attributed to infection by this virus. However, after complementary tests, a tooth located in the nostril is diagnosed as an infectious focus of the process. It concludes with the need to carry out a correct anamnesis to assess other possible causes of pneumonia during the SARS-CoV-2 pandemic (AU)


Assuntos
Humanos , Feminino , Pessoa de Meia-Idade , /diagnóstico , Pneumonia/diagnóstico , Pneumonia/etiologia , Erupção Ectópica de Dente/complicações , Cavidade Nasal , Diagnóstico Diferencial
5.
Neurocirugía (Soc. Luso-Esp. Neurocir.) ; 32(3): 153-156, mayo- jun. 2021. ilus
Artigo em Inglês | IBECS | ID: ibc-222562

RESUMO

We report the surgical management of a spontaneous and recurrent nasal fistula using a temporoparietal fascial flap for definitive treatment after several failed attempts to close the fistula by conventional approaches. Two formalin-fixed cadaveric human heads were also dissected to study the anatomy and surgical technique involved in the design of the temporoparietal fascial flap (AU)


Reportamos el manejo quirúrgico de una fístula nasal espontánea y recurrente utilizando un colgajo de fascia temporoparietal para el tratamiento definitivo después de varios intentos fallidos de cerrar la fístula mediante abordajes convencionales. También se diseccionaron 2 cabezas de cadáver humano y fijadas con formol para estudiar la anatomía y la técnica quirúrgica que intervienen en el diseño del colgajo de fascia temporoparietal (AU)


Assuntos
Humanos , Feminino , Adulto , Fístula/diagnóstico por imagem , Fístula/cirurgia , Cavidade Nasal/cirurgia , Retalhos Cirúrgicos , Fossa Craniana Anterior
6.
Rev. esp. patol ; 54(1): 59-64, ene.-mar. 2021. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-202491

RESUMO

El carcinoma epidermoide sarcomatoide es una entidad rara en la fosa nasal. Presentamos el caso de un varón de 50 años con una masa polipoide en la cavidad nasal izquierda. En el estudio anatomopatológico, se observa una histología bifásica de nidos escamosos no queratinizantes y un estroma sarcomatoide con positividad para AE1-AE3. El paciente presentó metástasis cervicales ipsilaterales, tratándose con vaciamiento cervical, radioterapia y cisplatino adyuvante. Dos años después se encuentra libre de enfermedad


Spindle cell carcinoma of the nasal cavity is a rare variant of squamous cell carcinoma. We report a case of a 50 year-old male presenting with a polypoid mass in the left nasal cavity. Histologically, the tumor was biphasic, composed of non-keratinizing squamous nests and a sarcomatoid stroma with positivity for CKAE1-AE3. Metastatic ipsilateral lymph nodes were present and the patient underwent radical neck dissection, followed by adjuvant radiotherapy and cisplatin. Two years after diagnosis the patient is free of disease


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Carcinossarcoma/patologia , Neoplasias Nasais/patologia , Cavidade Nasal/patologia , Metástase Neoplásica/patologia , Carcinossarcoma/diagnóstico , Metástase Neoplásica/tratamento farmacológico , Metástase Neoplásica/radioterapia , Intervalo Livre de Doença , Imuno-Histoquímica
8.
Rev. esp. patol ; 53(4): 257-263, oct.-dic. 2020. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-200573

RESUMO

Extraosseous (extramedullary) plasmacytomas are rare plasma cell neoplasms that can result in an erroneous and/or delayed diagnosis as often they are not considered in the differential diagnosis due to their rarity. Furthermore, the anaplastic type is one of the most difficult to recognize in biopsies. We report the case of a patient with an extraosseous plasmacytoma occluded in the right nostril. Its prompt and accurate diagnosis resulted in early treatment and a good outcome, despite the tumour being anaplastic with the risk of progressing into a plasma cell myeloma. The patient shows no recurrence or disease progression after 10 years of follow-up. Our case highlights the clinical and pathological characteristics of this rare disorder that should be considered in order to improve diagnostic criteria and thus early treatment. We also reviewed the pertinent literature


Los plasmocitomas extraóseos (extramedulares) son neoplasias de células plasmáticas que a menudo resultan en diagnósticos erróneos y/o retrasados, debido a que con poca frecuencia se consideran dentro del diagnóstico diferencial y donde el tipo anaplásico es una de las formas más difíciles de reconocer en las biopsias. Aquí describimos el caso de un paciente con un plasmocitoma extraóseo ocluido en la fosa nasal derecha, donde el diagnóstico oportuno y adecuado permitió proporcionar un tratamiento temprano con buenos resultados a pesar de ser un tipo anaplásico con riesgo de progresar a mieloma de células plasmáticas. El seguimiento de 10 años después del diagnóstico mostró que el paciente experimentó una respuesta completa sin recurrencia o progresión de la enfermedad. Nuestro caso destaca las características clínicas y patológicas que los médicos deben considerar al tratar a pacientes con esta enfermedad infrecuente para mejorar los criterios de diagnóstico y proporcionar un tratamiento más oportuno


Assuntos
Humanos , Masculino , Adulto , Plasmocitoma/patologia , Neoplasias Nasais/patologia , Cavidade Nasal/patologia , Neoplasias de Plasmócitos/patologia , Recidiva Local de Neoplasia/patologia , Plasmocitoma/radioterapia
9.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 38(10): 466-470, dic. 2020. tab, graf
Artigo em Inglês | IBECS | ID: ibc-200775

RESUMO

INTRODUCTION: Nasal swab culture is used to identify Staphylococcus aureus colonization, as this is a major risk factor for surgical site infection (SSI) in patients who are going to undergo major heart surgery (MHS). We determined nasal carriage of S. aureus in patients undergoing MHS by comparing the yield of a conventional culture with that of a rapid molecular test (Xpert(R) SA Nasal Complete, Cepheid). METHODS: From July 2015 to April 2017, all patients who were to undergo MHS were invited to participate in the study. We obtained two nasal cultures from each patient just before entering the operating room, independently of a previous test for the determination of nasal colonization by this microorganism performed before surgery. One swab was used for conventional culture in the microbiology laboratory, and the other was used for the rapid molecular test. We defined nasal colonization as the presence of a positive culture for S. aureus using either of the two techniques. All patients were followed up until hospital discharge or death. RESULTS: Overall, 57 out of 200 patients (28.5%) were colonized by S. aureus at the time of surgery. Thirty-three patients had both conventional culture- and PCR-positive results. Twenty-four patients had a negative culture and a positive PCR test. Only twenty-one percent (12/57) of colonized patients had undergone an attempt to decolonise before the surgical intervention. CONCLUSION: A significant proportion of patients undergoing MHS are colonized by S. aureus in the nostrils on entering the operating room. New strategies to prevent SSI by this microorganism are needed. Rapid molecular tests immediately before MHS, followed by immediate decolonisation, must be evaluated


INTRODUCCIÓN: Los cultivos nasales se usan para identificar colonización por Staphylococcus aureus, ya que la colonización es un factor de riesgo para la infección de la herida quirúrgica en pacientes que van a ser sometidos a cirugía cardiaca mayor (CCM). En este trabajo, identificamos portadores de S. aureus en el momento quirúrgico en pacientes que van a ser sometidos a CCM, comparando el resultado del cultivo convencional con un test molecular rápido (Xpert(R) SA Nasal Complete, Cepheid). MÉTODOS: Desde julio del 2015 hasta abril del 2017, a todos los pacientes que iban a ser intervenidos con CCM se les invitó a participar en el estudio. Se obtuvieron 2 cultivos nasales de cada paciente, justo antes de entrar en el quirófano, independientemente de si había un test previo de colonización nasal realizada. Una torunda fue usada en el laboratorio de microbiología para cultivo convencional y la otra para el test molecular rápido. Se definió colonización nasal como la positividad para S.aureus por cualquiera de las 2 técnicas. Todos los pacientes fueron seguidos hasta el alta hospitalaria o éxitus. RESULTADOS: Un total de 57 de 200 pacientes (28,5%), estaban colonizados por S. aureus en el momento de la cirugía. En total, 33 pacientes tuvieron ambas muestras positivas (convencional y PCR); 24 pacientes tuvieron cultivo negativo y PCR positiva. Solo el 21% (12/57) de los pacientes colonizados habían tenido un intento de descolonización antes de la cirugía. CONCLUSIÓN: Un porcentaje alto de pacientes están colonizados por S. aureus en el momento de ser sometidos a CCM. Son necesarias nuevas estrategias para prevenir la infección de la herida quirúrgica por este microorganismo. Un test molecular rápido inmediatamente antes de la CCM y descolonización posterior inmediata debe ser evaluado


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Cavidade Nasal/microbiologia , Procedimentos Cirúrgicos Cardíacos , Infecção da Ferida Cirúrgica/prevenção & controle , Infecção da Ferida Cirúrgica/microbiologia , Staphylococcus aureus/isolamento & purificação , Patologia Molecular/métodos , Reação em Cadeia da Polimerase/métodos , Técnicas de Laboratório Clínico/métodos , Estudos Prospectivos , Infecções Estafilocócicas/prevenção & controle , Clorexidina/uso terapêutico , Sensibilidade e Especificidade , Curva ROC
10.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 38(1): 16-20, ene. 2020. graf
Artigo em Inglês | IBECS | ID: ibc-200428

RESUMO

INTRODUCTION: Livestock are known reservoirs of methicillin-resistant Staphylococcus aureus (MRSA) and this constitutes an important public health issue. The prevalence of nasal MRSA carriers in swine housed indoors in Galicia, Spain, was studied. METHODS: 197 samples from swine aged three, eight, 12, 16 and 24 weeks, and from adult pigs, were obtained from four farms. The cleaning procedures implemented to clean the barns and antimicrobial consumption were analyzed. Antimicrobial susceptibility and antimicrobial resistance genes were studied. PFGE, spa typing and MLST were used to classify the isolates. SCCmec, agr and pvl were analyzed. RESULTS: MRSA prevalence was 12.7%. Swine younger than 16 weeks had a higher colonization rate; 22.9% vs 3.5% (OR, 8.16; 95% CI, 2.47-29.79; p < 0.01). The only farm found to be MRSA-free used disinfectants as part of its cleaning procedure. All MRSA were tetracycline-resistant (identifying the tetK and tetM genes), 80% were resistant to erythromycin and clindamycin and 16% were only clindamycin-resistant. The ermC and vgaA genes were identified in these two phenotypes. A single genotype (PFGE type A) and ST398 - spa t011 (84%) and t1451 (16%) were identified. SCCmec type V and agrI were identified in all isolates, and all were pvl-negative. CONCLUSION: A correlation between swine age and MRSA colonization was observed. Appropriate cleaning procedures could have an impact on MRSA colonization in farming. Resistance to antibiotics used in human health was identified. Clinicians should be aware if their patients have come into contact with farm animals


INTRODUCCIÓN: Los animales de granja son reservorios de Staphylococcus aureus resistente a la meticilina (SARM), y constituyen un problema de salud pública. Se estudia la prevalencia de portadores nasales de SARM en cerdos estabulados en Galicia, España. MÉTODOS: En 4 explotaciones se obtuvieron 197 muestras de cerdos con edades en semanas de 3, 8, 12, 16, 24 y adultos. Se analizaron los métodos empleados para limpiar los establos y el consumo de antimicrobianos. Se estudió la resistencia a antimicrobianos, y los genes involucrados en esta. Los aislamientos fueron clasificados mediante PFGE, spa y MLST. Se analizaron SCCmec, agr y pvl. RESULTADOS: La prevalencia de SARM fue del 12,7%. Los cerdos de <16 semanas presentaron las frecuencias de colonización más elevadas 22,9 vs. 3,5% (OR: 8,16; IC 95%: 2,47-29,79; p < 0,01). En la única explotación libre de SARM se empleaban desinfectantes en la limpieza. Todos los SARM fueron resistentes a tetraciclina identificándose los genes tetK y tetM, el 80% fueron resistentes a eritromicina y clindamicina, y el 16% fueron únicamente resistentes a clindamicina. Se identificaron los genes ermC y vgaA en estos 2 fenotipos. Se identificó un único genotipo (PFGE-A) y ST398, siendo spa t011 (84%) y t1451 (16%). En todos los aislamientos se identificó SCCmec V y agrI, siendo estos pvl negativos. CONCLUSIONES: Se observó la asociación entre edad y colonización SARM. La limpieza adecuada podría modificar la colonización por SARM. Se detectaron resistencias a antibióticos empleados en humanos. Los médicos deberían conocer si los pacientes tienen contacto con animales de granja


Assuntos
Staphylococcus aureus Resistente à Meticilina/isolamento & purificação , Suínos/microbiologia , Reservatórios de Doenças/microbiologia , Cavidade Nasal/microbiologia , Portador Sadio/epidemiologia , Indústria Agropecuária , Ambiente Controlado , Espanha/epidemiologia , Prevalência
11.
Med. oral patol. oral cir. bucal (Internet) ; 25(1): e124-e130, ene. 2020. tab, ilus
Artigo em Inglês | IBECS | ID: ibc-196204

RESUMO

BACKGROUND: The aim of this study is to describe the presence, to reveal the frequency and characteristics of accessory canals (ACs) of the canalis sinuosus (CS) by cone beam computed tomography (CBCT). MATERIAL AND METHODS: A total of 326 CBCT examinations were scanned retrospectively. The anatomical views were evaluated on sagittal, axial, coronal and cross sectional imaging. The following parameters were recorded: age, sex, presence or absence of ACs, location in relation to the adjacent teeth and distance to the nasal cavity floor (NCF), alveolar ridge crest (ARC) and buccal cortical bone (BCB), and incisive canal. All the collected data were statistically analyzed. RESULTS: 113 patients (34,7%); presented ACs in total 214 foramina of the sample. There were no statistically sig-nificant changes in the presence of ACs regarding age groups excluding 80-89 years. But there is a statistically significant difference regarding the frequency of ACs and the gender. The prevalence for male patients was higher than female patients. Curved-shape configuration of CS prevalence is found as 69,15%. The prevalence of vertical tracing is 26,16% and Y-shape configuration of CS prevalence is 4,67%. Diameter of the foramens of the CS branches was 1.30 mm. The mean distance of the AC to the NCF, BCB, and ARC were found 13,83 mm, 6,60 mm and 5,32 mm, respectively. CONCLUSIONS: In the anterior palatal region, ACs are mostly related to CS's branches. So; knowing the course of CS branches in surgical planning and radiographic evaluations in this region is extremely important for preventing complications and avoiding misdiagnosis


No disponible


Assuntos
Humanos , Masculino , Feminino , Criança , Adolescente , Adulto Jovem , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Maxila/anatomia & histologia , Maxila/diagnóstico por imagem , Nervo Maxilar/anatomia & histologia , Nervo Maxilar/diagnóstico por imagem , Tomografia Computadorizada de Feixe Cônico/métodos , Osso Cortical/anatomia & histologia , Osso Cortical/diagnóstico por imagem , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/diagnóstico por imagem , Fatores Etários , Fatores Sexuais , Padrões de Referência , Pontos de Referência Anatômicos , Estudos Retrospectivos
16.
Enferm. infecc. microbiol. clín. (Ed. impr.) ; 37(1): 41-44, ene. 2019. tab, graf
Artigo em Inglês | IBECS | ID: ibc-177000

RESUMO

Introduction: Streptococcus pneumoniae (Sp) is the main cause of community-acquired pneumonia in the elderly, hence the importance to establish the prevalence of nasopharyngeal colonization by different Sp serotypes in adults. Methods: from December 2009 to June 2010, nasopharyngeal cultures were taken from adults living in rural communities in Mexico for the isolation and serotyping of Sp by the Quellung reaction. Penicillin and ceftriaxone susceptibility tests were performed by the microdilution method. Results: two hundred and thirty-six adults over 50 years old, were included. The prevalence of colonization by Sp was 21.6%. The most frequent serotypes were 19A (21%), 6A (13%), 6B and 11A (11%). All isolates were susceptible to ceftriaxone, and 52.8% of the isolates showed penicillin minimal inhibitory concentrations ≥0.12 mg/L. Conclusion: this is the first study analyzing the nasopharyngeal colonization by Sp in adults in Mexico. Serotypes not included in any of the pneumococcal vaccines were frequently identified


Introducción: Streptococcus pneumoniae (Sp) es la principal causa de neumonía adquirida en la comunidad en ancianos, de ahí la importancia de conocer la prevalencia de colonización nasofaríngea y los serotipos de Sp. Métodos: De diciembre de 2009 a junio de 2010 se realizaron cultivos nasofaríngeos en mayores de 50 años de comunidades rurales de México para la detección y serotipificación de Sp (reacción de Quellung). Se determinó la sensibilidad a penicilina y ceftriaxona mediante la técnica de microdilución. Resultados: Se incluyeron 236 sujetos. La prevalencia de colonización por Sp fue del 21,6%. Los serotipos más frecuentes fueron 19A (21%), 6A (13%), 6B y 11A (11%). El 100% eran sensibles a ceftriaxona y en el 52,8% la concentración mínima inhibitoria de penicilina fue ≥ 0,12 mg/l. Conclusión: Este es el primer estudio de colonización nasofaríngea por Sp en adultos realizado en México. Se identificaron con frecuencia serotipos circulantes no incluidos en ninguna de las vacunas neumocócicas


Assuntos
Humanos , Streptococcus pneumoniae/isolamento & purificação , Infecções Pneumocócicas/epidemiologia , Infecções Pneumocócicas/microbiologia , Cavidade Nasal/microbiologia , Faringe/microbiologia , Penicilinas/farmacologia , Ceftriaxona/farmacologia , Portador Sadio/microbiologia , Streptococcus pneumoniae , Testes de Sensibilidade Microbiana , População Rural , México/epidemiologia , Prevalência , Estudos Transversais
17.
Eur. j. anat ; 22(5): 411-413, sept. 2018. ilus
Artigo em Inglês | IBECS | ID: ibc-179811

RESUMO

The vomeronasal system is comprised of the nasopalatine duct and the vomeronasal organ. While this system functions in chemodetection in mammals, its presence and function in adult humans remains to be clearly elucidated. Here, a case of asymptomatic, bilateral, patent nasopalatine ducts is presented. We postulate that the presence of these patent structures represents persistence of the embryological nasopalatine duct component of the vomeronasal organ into adult life


No disponible


Assuntos
Humanos , Feminino , Adolescente , Cavidade Nasal/fisiopatologia , Órgão Vomeronasal , Palato/anatomia & histologia , Fístula Bucal/diagnóstico , Fístula do Sistema Respiratório , Radiografia Dentária/métodos
18.
Acta otorrinolaringol. esp ; 69(4): 208-213, jul.-ago. 2018. tab, graf
Artigo em Inglês | IBECS | ID: ibc-180485

RESUMO

INTRODUCTION AND OBJECTIVES: Olfactory neuroblastoma (ONB) is a rare entity that constitutes less than 5% of nasosinusal malignancies. Mainstream treatment consists in surgical resection+/-adjuvant radiotherapy. By exposing results observed with apparition of new therapeutic options as neoadjuvant chemotherapy, the objective is to evaluate a series and a review of the current literature. METHODS: A retrospective review was conducted including patients diagnosed and followed-up for ONB from 2008 to 2015 in our institution. RESULTS: 9 patients were included. Mean follow-up of 52.5 months (range 10-107). Kadish stage: A, 1 patient (11.1%) treated with endoscopic surgery; B, 2 patients (22.2%) treated with endoscopic surgery (one of them received adjuvant radiotherapy); C, 6 patients (66.7%), 4 patients presented intracranial extension and were treated with neoadjuvant chemotherapy followed by surgery and radiotherapy. The other 2 patients presented isolated orbital extension, treated with radical surgery (endoscopic or craniofacial resection) plus radiotherapy. The 5-year disease free and overall survival observed was 88.9%. CONCLUSION: Neoadjuvant chemotherapy could be an effective treatment for tumor reduction, improving surgical resection and reducing its complications


INTRODUCCIÓN Y OBJETIVOS: Elneuroblastoma olfatorio es una entidad rara que se corresponde con menos del 5% de las neoplasias nasosinusales. El tratamiento principal consiste en la resección quirúrgica ± radioterapia adyuvante. El objetivo es evaluar la sobrevida en una serie de casos y la literatura actual, mostrando resultados observados con la aparición de nuevas opciones terapéuticas como la quimioterapia neoadyuvante. MÉTODOS: Se realizó un estudio retrospectivo incluyendo pacientes tratados y seguidos en nuestro centro desde 2008 a 2015. RESULTADOS: Dentro del estudio fueron incluidos 9 pacientes. El seguimiento medio fue de 52,5 meses (rango 10-107). Estadio Kadish: A) un paciente (11,1%) fue tratado con resección endoscópica; B) 2 pacientes (22,2%) tratados con resección endoscópica (uno de ellos recibió radioterapia adyuvante); C) 6 pacientes (66,7%), de los cuales 4 presentaron extensión intracraneal y fueron tratados con quimioterapia neoadyuvante, cirugía y radioterapia adyuvante. Los otros 2 pacientes presentaron invasión intraorbitaria aislada, tratados con cirugía radical y radioterapia adyuvante. La sobrevida y periodo libre de enfermedad a 5 años fue del 88,9%. CONCLUSIÓN: La quimioterapia neoadyuvante puede ser un tratamiento efectivo para la reducción del tamaño tumoral, mejorando la resección quirúrgica y reduciendo sus complicaciones


Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Estesioneuroblastoma Olfatório/tratamento farmacológico , Estesioneuroblastoma Olfatório/cirurgia , Cavidade Nasal , Neoplasias Nasais/tratamento farmacológico , Neoplasias Nasais/cirurgia , Quimioterapia Adjuvante , Seguimentos , Terapia Neoadjuvante , Estudos Retrospectivos
19.
J. investig. allergol. clin. immunol ; 28(2): 67-90, 2018. tab, ilus, graf
Artigo em Inglês | IBECS | ID: ibc-173566

RESUMO

Nasal obstruction (NO) is defined as the subjective perception of discomfort or difficulty in the passage of air through the nostrils. It is a common reason for consultation in primary and specialized care and may affect up to 30%-40% of the population. It affects quality of life (especially sleep) and lowers work efficiency. The aim of this document is to agree on how to treat NO, establish a methodology for evaluating and diagnosing it, and define an individualized approach to its treatment. NO can be unilateral or bilateral, intermittent or persistent and may be caused by local or systemic factors, which may be anatomical, inflammatory, neurological, hormonal, functional, environmental, or pharmacological in origin. Directed study of the medical history and physical examination are key for diagnosing the specific cause. NO may be evaluated using subjective assessment tools (visual analog scale, symptom score, standardized questionnaires) or by objective estimation (active anterior rhinomanometry, acoustic rhinometry, peak nasal inspiratory flow). Although there is little correlation between the results, they may be considered complementary and not exclusive. Assessing the impact on quality of life through questionnaires standardized according to the underlying disease is also advisable. NO is treated according to its cause. Treatment is fundamentally pharmacological (topical and/or systemic) when the etiology is inflammatory or functional. Surgery may be necessary when medical treatment fails to complement or improve medical treatment or when other therapeutic approaches are not possible. Combinations of surgical techniques and medical treatment may be necessary


La obstrucción nasal (ON) se define como la percepción subjetiva de disconfort o dificultad en el paso del aire a través de las fosas nasales. Es un motivo de consulta frecuente en atención primaria y especializada, que puede afectar hasta un 30-40% de la población. Repercute en la calidad de vida (especialmente con alteración del sueño) y disminuye la eficiencia laboral. El objetivo de este documento es consensuar el manejo de la ON, estableciendo una metodología para su evaluación y diagnóstico y un abordaje individualizado para el tratamiento. La ON puede ser uni o bilateral, intermitente o persistente y debida a factores locales o sistémicos, ya sean anatómicos, inflamatorios, neurológicos, hormonales, funcionales, ambientales o medicamentosos. La anamnesis dirigida y la exploración física son claves para el diagnóstico diferencial. La evaluación de la ON puede realizarse con herramientas de valoración subjetiva (escala visual analógica, puntuación de síntomas, cuestionarios estandarizados) o por estimación objetiva (rinomanometría anterior activa, rinometría acústica, flujo máximo nasal inspiratorio). Aunque existe poca correlación entre ellas, sus resultados pueden considerarse complementarios y no excluyentes. También es aconsejable valorar el impacto en la calidad de vida mediante cuestionarios estandarizados. El tratamiento de la ON se establece en función de la causa. Es fundamentalmente farmacológico (tópico y/o sistémico) cuando la etiología es inflamatoria o funcional. El tratamiento quirúrgico estará indicado tras el fracaso del tratamiento médico, para complementarlo o mejorarlo. Puede ser necesaria la combinación de varias técnicas quirúrgicas y/o la asociación de un tratamiento médico pre/post cirugía


Assuntos
Humanos , Criança , Adolescente , Adulto Jovem , Adulto , Obstrução Nasal/diagnóstico , Obstrução Nasal/cirurgia , Atenção Primária à Saúde , Qualidade de Vida , Cavidade Nasal/fisiopatologia , Transtornos do Sono-Vigília/complicações , Rinometria Acústica/métodos , Rinomanometria/métodos , Obstrução Nasal/epidemiologia , Obstrução Nasal/fisiopatologia
20.
Eur. j. anat ; 21(4): 305-307, oct. 2017. ilus
Artigo em Inglês | IBECS | ID: ibc-168647

RESUMO

The foramen caecum is located on the midline between the crista galli and the crest of the frontal bone. The vein of the foramen caecum (VFC) is described as a vein that connects the nasal cavity to the superior sagittal sinus through the foramen caecum. In the literature, the foramen caecum has been found to be filled with fibrous tissue and is considered that vessels cannot pass through it. Although the VFC is observed in lower mammals, the existence of the VFC in humans is still under debate because the VFC has not been confirmed even in cadavers. In some recent reports, enhanced structures resembling a vascular structure within the foramen caecum on CT and MRI have been reported but not really proven to be the VFC. Here we report a case of a VFC confirmed by digital subtraction angiography. To the best of our knowledge, this is the first VFC confirmed in humans by angiography. From embryologic and clinical point of view, the VFC is a venous remnant, although rare, we should keep this in mind to avoid some complications when treating lesions around this area


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Assuntos
Humanos , Masculino , Adulto , Seio Sagital Superior/anatomia & histologia , Seio Sagital Superior/diagnóstico por imagem , Osso Frontal/diagnóstico por imagem , Variação Anatômica , Veias Cerebrais/diagnóstico por imagem , Angiografia Cerebral/métodos , Osso Frontal/anatomia & histologia , Veias Cerebrais/anatomia & histologia , Veias Cerebrais/anormalidades , Cavidade Nasal/anatomia & histologia , Cavidade Nasal/diagnóstico por imagem
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