RESUMO
BACKGROUND: The following position statement from the Union of the European Phoniatricians, updated on 25th May 2020 (superseding the previous statement issued on 21st April 2020), contains a series of recommendations for phoniatricians and ENT surgeons who provide and/or run voice, swallowing, speech and language, or paediatric audiology services. OBJECTIVES: This material specifically aims to inform clinical practices in countries where clinics and operating theatres are reopening for elective work. It endeavours to present a current European view in relation to common procedures, many of which fall under the aegis of aerosol generating procedures. CONCLUSION: As evidence continues to build, some of the recommended practices will undoubtedly evolve, but it is hoped that the updated position statement will offer clinicians precepts on safe clinical practice.
Assuntos
Audiologia/métodos , Betacoronavirus/isolamento & purificação , Infecções por Coronavirus/prevenção & controle , Otolaringologia/métodos , Pandemias/prevenção & controle , Pneumonia Viral/prevenção & controle , Audiologia/normas , COVID-19 , Criança , Pré-Escolar , Infecções por Coronavirus/epidemiologia , Infecções por Coronavirus/virologia , Transtornos de Deglutição/diagnóstico , Transtornos de Deglutição/cirurgia , Transtornos de Deglutição/virologia , Europa (Continente)/epidemiologia , Humanos , Testes Obrigatórios/normas , Otolaringologia/normas , Pediatria/normas , Equipamento de Proteção Individual/normas , Equipamento de Proteção Individual/provisão & distribuição , Pneumonia Viral/epidemiologia , Pneumonia Viral/virologia , Guias de Prática Clínica como Assunto , SARS-CoV-2 , Sociedades Médicas/organização & administração , Distúrbios da Voz/diagnóstico , Distúrbios da Voz/cirurgia , Distúrbios da Voz/virologiaRESUMO
Alcohol withdrawal symptoms in 19 male alcoholics were objectively evaluated and classified and circadian variation in their plasma 5-hydroxyindoleacetic acid (5-HIAA) concentrations was determined at 3 different intervals after cessation of drinking. Circadian variations in plasma 5-HIAA level exhibited phase advances in alcoholic patients compared with normal controls and were different depending on the severity of alcohol withdrawal symptoms. Plasma 5-HIAA in patients with delirium tremens showed significantly higher levels during the abstention period, possibly suggesting peculiarity in their serotonergic metabolism.
Assuntos
Delirium por Abstinência Alcoólica/sangue , Alcoolismo/reabilitação , Ritmo Circadiano/fisiologia , Ácido Hidroxi-Indolacético/sangue , Adulto , Alcoolismo/sangue , Humanos , Masculino , Pessoa de Meia-Idade , Valores de ReferênciaRESUMO
Alcohol withdrawal symptoms in alcoholics were objectively evaluated and classified into three groups according to the severity of their symptoms, and circadian variation in their plasma homovanillic acid (HVA) concentrations was determined at three different intervals after cessation of drinking. The subjects studied were 19 male alcoholic patients and five age-matched healthy male volunteers. Circadian variation in plasma HVA was compared between each patient group and the control group by two-way ANOVA. In the sympathetic overactivity (SO) group comprising nine patients and in the clouding of sensorium (CS) group comprising five patients, plasma HVA concentrations on the 2nd and 3rd day and on the 6th and 7th day after cessation of drinking were low but recovered almost normal levels on the 21st and 22nd postcessation day. The delirium tremens group (DT) comprising five patients, however, showed significantly higher plasma HVA than the control group except on the 6th and 7th postcessation day. The higher plasma HVA in the DT group indicates that there is some sort of preparatory state whereby dopamine metabolism is involved in the appearance of hallucinations at alcohol withdrawal and can possibly be used as a predictor of otherwise hardly predictable delirium tremens.