RESUMEN
Primary laryngeal aspergillosis is exceptionally rare, and only five cases have been reported in the literature. We present here two cases of invasive laryngeal aspergillosis without tracheobronchopulmonary extension and without any generalized immune deficit. Aspergillosis developed after local radiotherapy for a squamous cell carcinoma and preceded a recurrence of the tumor. The relationships between the clinical features, the histopathology, and the etiology of laryngeal aspergillosis and squamous cell carcinoma are discussed. We recommend that following treatment of laryngeal aspergillosis, these rare patients should systematically be investigated for a squamous cell carcinoma or a recurrence thereof.
Asunto(s)
Aspergilosis/patología , Carcinoma de Células Escamosas/patología , Neoplasias Laríngeas/patología , Recurrencia Local de Neoplasia/patología , Biopsia , Carcinoma de Células Escamosas/radioterapia , Humanos , Neoplasias Laríngeas/radioterapia , Laringe/patología , Laringe/efectos de la radiación , Masculino , Persona de Mediana Edad , NecrosisRESUMEN
Cannot simply be considered as a nociception phenomenon: it is more complex than a simple transmission system that conveys this information to the cerebral cortex. It is mainly a psychological event. Numerous regulating and inhibiting effects on incoming pain signals exist, for the most part located in spinal and thalamic areas; only half of these are morphine-dependent. Knowledge of these allows a better approach to chronic pain, using not only medication but also other techniques such as physiotherapy and music therapy analgesia.
Asunto(s)
Dolor/fisiopatología , Humanos , Nociceptores/anatomía & histología , Nociceptores/fisiología , Médula Espinal/anatomía & histología , Médula Espinal/fisiología , Tractos Espinotalámicos/anatomía & histología , Tálamo/anatomía & histología , Tálamo/fisiologíaRESUMEN
After recalling the components and the factors influencing the pain, are stated the main reasons which needs for the evaluation of the pain. The different methods allowing an evaluation of the pain are then described with their advantages and disadvantages. These methods are based on, on one hand on questonary with as a support the use of different mono or multidimensional scales and on the other hand a clinical examination. The goal of this proceeding is to elaborate a scale of the pain for a better adaptation of it's therapy.