DYMUS-Hr self-assessment questionnaire (Croatian version) for dysphagia in multiple sclerosis-validity, reliability, and cross-cultural adaptation.

BACKGROUND: The prevalence of dysphagia in the early phases of multiple sclerosis is 30-40%, with an estimated of 30% of cases going undiagnosed cases. Such complications can lead to malnutrition, dehydration, and aspiration pneumonia and have a great impact on the quality of life and psychosocial status of a person with MS. The aim of this study was the validation of dysphagia in multiple sclerosis self-assessment questionnaire (DYMUS) in the Croatian language. METHODS AND PATIENTS: The cross-cultural adaptation process included a back-forward translation technique of the English language version of DYMUS to the Croatian language, with pilot testing on 30 participants. The validity and reliability of the Croatian version of DYMUS (DYMUS-Hr) was applied to 106 MS patients, with comparison to the Eating Assessment Tool (EAT10), the Water Swallowing Test (WST), and a dichotomous self-assessment question. In the assessment of test-retest reliability, 99 MS patients were included. RESULTS: Internal consistency of DYMUS-Hr was very good (Cronbach's alpha-0.837); Cronbach's alpha was 0.819 for the "dysphagia for solids", and 0.562 for "dysphagia for liquids" subscale. A significant correlation (p < 0.001) was found between DYMUS-Hr and EAT10 (Spearman's rho-0.787), and WST (Spearman's rho-0.483). Construct validity was assessed with the self-assessment question and interpreted with the Mann-Whitney U test. Test-retest reliability showed moderate to substantial Cohen's Kappa reliability for each item. CONCLUSION: DYMUS-Hr is a valid and reliable screening assessment tool for patients with MS. There is a general lack of awareness about dysphagia symptoms among patients with MS; consequently, this disorder receives inadequate attention and often goes untreated.

Poorly differentiated sarcoma of the maxillary sinus: a histopathology dilemma of a rare tumor.

Sarcomas are a rare heterogeneous group of neoplasms of mesenchymal origin. In the redistribution of all head and neck malignancies, sarcomas are represented by only 1%. Herein, we report a case of a 66-year-old patient with right maxillary sinus sarcoma that spread through the ostiomeatal complex, infiltrated the septum, all ethmoid cells, frontal sinus, involved the entire right nasal cavity and penetrated to the nasopharynx. Patient was treated with neoadjuvant chemotherapy, surgery and adjuvant radiotherapy. The histopathology indicated poorly differentiated sarcoma with elements of Ewing's sarcoma, but also with elements consistent with osteosarcoma. Molecular pathological analysis excluded Ewing's sarcoma. Samples were also sent for review to the other Pathology Clinics. They suggested poorly differentiated high-grade pleomorphic sarcoma with elements of osteosarcoma. The accurate diagnosis of the head and neck sarcoma type can be a histopathology dilemma posing a great challenge in the choice of therapeutic approach, and thus the treatment outcome.

Redefining Pregnancy-Induced Rhinitis.

BACKGROUND: Pregnancy-induced rhinitis (PIR) is a form of chronic non-allergic rhinitis not present before pregnancy that manifests itself during pregnancy with complete resolution of symptoms after delivery. OBJECTIVE: The objective of this ambidirectional longitudinal cohort study is to evaluate the prevalence of PIR and to investigate the appearance and character of its symptoms, and its impact on the quality of life.Methodology: Six hundred eighty-one (681) women were recruited in the study. They completed questionnaires about nasal symptoms a day after delivery and each woman with nasal symptoms was interviewed 30 days later and data on symptom duration and quality were recorded. RESULTS: The prevalence of PIR was 31.86% (N = 217), 47.14% (N = 321) women had no nasal symptoms and 21% (N = 143) of participants had prior sinonasal disease. The clinical presentation of pregnancy rhinitis included nasal obstruction as the most common symptom, followed by rhinorrhea, postnasal secretion, nose itching, sneezing, and hyposmia. The median duration of PIR was 4 months with their complete resolution of symptoms between 2th and 16th day after delivery in the majority of respondents. PIR was diagnosed significantly more often if the women carried a female child. PIR affected their quality of life during pregnancy in 53,9% women (N = 117), with an average VAS score of 8. It seems that pregnancy may affect the course of previously present sinonasal disease (allergic rhinitis, chronic rhinosinusitis, nonallergic rhinitis, or non-infectious rhinitis prior to the pregnancy). CONCLUSIONS: PIR is a common clinical entity with a wide range of symptoms with a direct impact on the quality of life in pregnancy. We propose a new definition of pregnancy-induced rhinitis.

An unusual case of hyalinizing clear cell carcinoma in a sinonasal cavity and cranial base.

Hyalinizing clear cell carcinoma (HCCC) is a rare, predominantly minor salivary gland tumor. Most of these tumors occur in the oral cavity, mainly the palate and tongue. Primary localization of the tumor in the region of the nasal cavity and paranasal sinuses is extremely rare and, with only a few cases reported in the literature so far. We present an extremely rare case of a 61-year-old woman with hyalinizing clear cell carcinoma (HCCC), occupying the left posterior nasal and nasopharyngeal cavity, as a primary tumor location. The patient total recovery was uneventful, and she is now free of disease at three years postoperative follow-up.

Injury patterns in synchronized skating: a growing and evolving sport.

BACKGROUND: Data about injuries among synchronized skating athletes are lacking while physical demands in this sport discipline continue to grow. No injury data among junior synchronized skaters exist. The purpose of this study was to investigate the frequency and pattern of injuries in junior and senior synchronized skaters. METHODS: In this descriptive epidemiology study anonymous questionnaires were distributed to synchronized junior and senior skaters. 708 synchronized skaters (393 juniors and 315 seniors) completed the questionnaire. Male skaters were excluded from analysis. RESULTS: Spinal conditions were reported by 148 (37.7%) juniors compared to 149 (47.3%) of senior skaters with statistically significant cumulative incidence (P=0.01); 23% of juniors and 30.2% of senior skaters reported problems with more than one spinal region; 64.4% juniors and 72.1% senior skaters reported at least one non-spinal injury during their synchronized skating career. There were 380 unique injuries reported by junior skaters and 363 by senior skaters. Lower extremity injuries were the most common injuries in both groups of skaters, followed by upper extremity, head and trunk injuries. From all the anatomical regions mentioned, there was only statistically significant difference between the groups in the occurrence of head injuries with senior skaters having 1.9 greater odds ratio to have head injury. CONCLUSIONS: This study presents new data on the current injury pattern seen in synchronized skating since the inclusion of new skills. The number of head injuries and spinal conditions show statistically significant cumulative incidence in senior compared to junior skaters.