Can Bed-Side Grief Counseling Sessions Enhance Recovery in a Patient With Posttrauma Amputation? A Case Report.

Amputation is the surgical removal of all or part of a body part. It demands an adjustment in almost every sphere of a person's life in addition to physical disability. An amputee faces problems in almost every psychosocial sphere.1, 2 Along with physical pain in the stump, patients may experience phantom sensations.3-5 Patients may also grieve, feel depressed, and anxious3, 6, 4, 7 or have posttraumatic stress disorder symptoms.8, 9 They may be apprehensive about their future plans and inconclusive regarding life challenges. Grief is one of the most common reactions to amputation,10, 1, 7 but often gets neglected in intensive surgical units.1 Many times, grief reactions are not resolved, turning into complicated grief or prolonged grief, leading to conditions like depression, anxiety, or even suicide. This article is about an attempt to help a patient initiate the grieving process for healthy outcomes.

The frequency of change in five-point scale score with a Bayesian penalised likelihood PET reconstruction algorithm on interim FDG PET-CT and its potential implications for therapy decisions in Hodgkin's lymphoma.

AIM: To assess the effect of a Bayesian penalised likelihood (BPL) reconstruction algorithm on the five-point scale (5-PS) score, response categorisation, and potential implications for therapy decisions after interim 2-[18F]-fluoro-2-deoxy-d-glucose (FDG) positron-emission tomography (PET)-computed tomography (CT) (iPET-CT) to guide treatment in classical Hodgkin's lymphoma (HL). MATERIALS AND METHODS: The present study included new patients with HL undergoing iPET-CT from 2014-2019 after two cycles of doxorubicin (Adriamycin), bleomycin, vincristine, and dacarbazine (ABVD). Two reporters categorised response using the 5-PS and measured maximum standardised uptake values (SUVmax) of the most avid tumour residuum, mediastinal blood pool, and normal liver with ordered subset expected maximisation (OSEM) and BPL reconstructions. RESULTS: Eighty-one iPET-CT examinations were reviewed. Compared with OSEM, BPL increased the 5-PS score by a single score in 18/81 (22.2%) patients. The frequency of potential treatment intensification by changing a score of 3-4 was 13.6% (11/81) and represented 25% (11/44) of patients with a score of 3 on OSEM. All 11 patients remained in remission without a change in therapy (mean 63 months) except one who required second-line treatment for refractory disease. Median SUVmax of tumour residuum was significantly higher with BPL compared with OSEM (2.7 versus 2.4, p<<0.0001), whilst liver SUVmax was significantly lower for both reporters (up to 6.6%, p<0.0001). CONCLUSION: BPL PET reconstruction increased the 5-PS score on iPET-CT in 22% of HL patients and can potentially result in unnecessary treatment escalation in over half of these patients.

Irreversibility effects in peristaltic transport of hybrid nanomaterial in the presence of heat absorption.

The nano heat transport has gained much significance in recent era. The micro-level devices are enganged succssfully in diverse fields like electronics, biomedical, navel structures, manufacturing, transportation, and automotive industries in order to improve the heat transfer for cooling and heating. Owing to this fact, the current article illustrates the features of irreversibility and thermal jump in peristaltic transport of hybrid nanoliquid. Here, water is used as base liquid while nanoparticles include polystyrene and graphene oxide. The flow is carried out in a non-uniform channel where the walls of channel flexible nature. Additionally, magnetic field impacts on flow and Joule heating analysis are examined. The aspect featuring heat absorption is introduced. Nanoparticle's shapes effect is also incorporated in flow analysis. Under the consideration of small Rynold number and long wavelength, the relevent equations are reduced by implementing non-dimensional variables. Involved pertinent parameters influence the peristaltic flow characteristics are displayed graphically and discussed concisely. The result indicates that temperature curves are dominant for pure water as compared to P/water nanofluid and P-GO/water hybrid nanofluid. Moreover, the convergent channel shows least entropy effects and extreme effects are noted for divergent case whereas uniform channel stays behind the divergent one.

Clinical Presentation, Management and In-Hospital Outcome of Healthcare Personnel With COVID-19 Disease.

Objective Healthcare personnel (HCP) are undoubtedly one of the major frontline fighters in the coronavirus disease 2019 (COVID-19) pandemic. Therefore, it comes as no surprise that many HCP have become infected by COVID-19 globally. The infection of HCP has received great attention in social media and is frequently reported from different parts of the world. However, there are few scientific reports addressing this aspect of the COVID-19 pandemic. The aim of this study was to evaluate the characteristics of clinical presentation, treatment, and outcome of COVID-19 infection among the HCP of our setting. Methods This cross-sectional study was performed in the National Heart Foundation Hospital & Research Institute of Bangladesh from April 29 to July 20, 2020. HCP employed in this hospital who experienced fever or respiratory symptoms or came in close contact with COVID-19 patients at home or their workplace were included in this study. The presence of COVID-19 disease was confirmed by real-time reverse transcriptase-polymerase chain reaction on nasopharyngeal samples. A total of 394 HCP were sampled and 139 had a positive corona test. Structured interviews were conducted to document symptoms for all HCP with confirmed COVID-19. Data analysis was performed in July 2020. Results Out of 1,409 HCP, 139 subjects tested positive for COVID-19. Among the HCP, infection rate was 9.86%. The mean age of the study population was 34.08±11.11 years (range: 20-69 yrs), of whom 82 (59%) were female. Most of this cohort were nurses (56 [40.3%]) and physicians (25 [18%]), and the remaining 58 (41.7%) were other staff. The mean duration of onset of symptoms to test was 2.89±2.07 days. The most common symptoms were fever (84.2%), fatigue (56.1%), cough (54%), body ache (39.6%), headache, and anosmia (38.8%). Most subjects had mild disease (125 [93%]), three (2.1%) of the HCP had moderate disease and one (0.7%) had severe disease. Ten of the HCP (7.2%) were asymptomatic. Most of them were treated either by ivermectin plus azithromycin or ivermectin plus doxycycline. Only 20 (14.4%) of the HCP were hospitalized, while others were treated either in home isolation (59.7%) or in institutional isolation (25.9%). Recovery was almost uneventful except one healthcare worker who died. Conclusion Most HCP had mild symptoms and a few of them were asymptomatic also. HCP with mild COVID-19 symptoms may be treated in home or institutional isolation. As they are a vulnerable group for infection, providing adequate protection to HCP is absolutely mandatory to safeguard them from this pandemic.

Surgical Management of Freiberg Disease by Dorsal Closing Wedge Osteotomy.

INTRODUCTION: The purpose of the study was to assess the efficacy of the dorsal closing wedge osteotomy for the treatment of Freiburg's infraction. MATERIAL AND METHODS: Twenty patients with Freiburg's infraction were admitted at our hospital over a period of six years. Patients with a normal plantar contour of the metatarsal head were included. All patients underwent a dorsal closing wedge osteotomy of the metatarsal. RESULTS: The mean Leeds Movement Performance Index (LMPI) score was 84 (range 70-86). The mean metatarsal shortening was 2mm. the passive flexion restriction was 16° and extension restriction was 10°. Also, a strong negative correlation was found between Smillie classification and American Orthopaedic Foot and Ankle Score (AOFAS) final score (r's = -0.85, P < .001). CONCLUSION: The dorsal closing wedge osteotomy is an efficient and reproducible method for the management of Freiburg's infraction.

Dynamics of antibiotic resistance with special reference to Shiga toxin-producing Escherichia coli infections.

The discovery of antibiotics was paralleled by the evolution of antibiotic resistance which is probably the best example of contemporary evolution in action. The selection pressure, imposed by indiscriminate use of antibiotics, has changed the scale, mode and tempo of antibiotic resistance evolution. The presence of multidrug resistance, wide range of adaptability features and the infectivity make antibiotic resistance of Shiga toxin-producing Escherichia coli (STEC) more dangerous. The characterization, prevalence and the virulence factors of STEC have been profusely reported, whereas, the antibiotic resistance has been largely ignored because the antibiotic use in STEC infections is controversial. Thus, the current review has focussed on the source, evolution, persistence, mechanism, dissemination and control of antibiotic resistance viz-a-viz the STEC infections. The resistance development occurs by the inactivation of antibiotics, regulating the membrane permeability, modification of natural antibiotic targets or the use of efflux pumps against antibiotics. And, the dissemination of resistance genes occurs vertically by DNA replication and horizontally by conjugation, transduction and transformation. The prevention of development and dissemination of antibiotic resistance needs international public health bodies to rationalize the antibiotic use, prevent the flux of antibiotics into the environment, develop the rapid diagnostics tests, undertake proper surveillance of antibiotic resistance, promote the research on antibiotic resistance prevention, promote the research and development of novel alternative antibiotics, and encourage the widespread social awareness campaigns against the inappropriate antibiotic usage.

Use of core biopsy in diagnosing cervical lymphadenopathy: a viable alternative to surgical excisional biopsy of lymph nodes?

OBJECTIVES Lymphoma often presents with a neck mass and while fine-needle aspiration cytology may be suggestive, tissue biopsy is required for reliable diagnosis and classification of a lymphoma that is sufficient to deliver the correct treatment for the patient. Traditionally, excisional biopsy of a lymph node has been the standard method of tissue sampling, providing ample tissue for assessment. However, this requires theatre time, and preceding fine-needle aspiration cytology, which may incur a delay. With careful use of tissue, coupled with advances in immunohistochemical and molecular investigative techniques, core biopsy provides a possible alternative to traditional fine-needle aspiration and excisional biopsy. In this study, we aimed to determine the efficacy of diagnosing neck masses. METHOD A retrospective analysis was performed of patients being investigated for a neck mass who were undergoing ultrasound-guided core biopsies of cervical lymph nodes over a 17-month period. The final histology report was scrutinised to assess whether adequate tissue was obtained to allow for full tissue diagnosis. RESULTS Over the 17-month period analysed, 70 patients with cervical lymphadenopathy underwent core biopsy. Of these, 63 (90%) were diagnostic for either lymphoma or other pathology and did not require further tissue sampling. Overall, 19 patients were diagnosed with lymphoma, of which only 1 required further biopsy due to inconclusive initial core biopsy. CONCLUSIONS Current guidelines for investigating lymphomas require that excisional biopsy be performed to obtain ample tissue to allow full nodal architecture assessment and ancillary investigation to reach an accurate histological classification. Within our head and neck multidisciplinary team, however, it is considered that results from core biopsies can be obtained in a more timely fashion and with histological accuracy equal to those of open biopsy. The results obtained demonstrate that core biopsy is an effective tool for investigation. We believe this should be the first-line investigation of choice, as it reduces the need for patients to undergo surgery, is more cost effective and offers a faster diagnosis.

Safety of long-term treatment with Pegvisomant: analysis of Spanish patients included in global ACROSTUDY.

PURPOSE: To evaluate the long-term safety of Pegvisomant (PEG) in the Spanish cohort of ACROSTUDY. METHODS: As of July 2013, 199 Spanish patients were included in ACROSTUDY, a global non interventional safety PEG surveillance study. Patients were observed for safety, biochemical outcome and magnetic resonance imaging evaluations. RESULTS: PEG was administered during an average period of 6.7 ± 2.1 years and a mean daily dose of 15.5 ± 7.5 mg. 48.2% of patients received PEG monotherapy. 90.9% of patients had received other medical treatment before PEG start. 195 adverse events (AEs) were reported in 88 patients (44.2%), and serious AEs were described in 31 patients (15.6%). There were no cases of liver tests >10 ULN, or permanent liver damage. Tumor size changes were locally reported in 61 cases (33.5%), with increases observed in 11 patients (6%). In acromegalic patients with diabetes mellitus a decrease in fasting serum glucose value was reported, reaching statistical significance after 1 and 4 years of treatment (-24.6 and -25.9 mg/dl, p = 0.04). After 60 months, normal or lower limit of normal (LLN) IGF-I levels were found in 67.9% of patients. 85.5% of patients showed an IGF-I normal or

Cost-effectiveness of anidulafungin in confirmed candidaemia and other invasive Candida infections in Spain.

BACKGROUND: Candidaemia and invasive Candida infections can cause patient death and are expensive. Anidulafungin, a newly-licensed candin, has proven effective in treating candidaemia. Our study evaluates the cost-effectiveness of anidulafungin compared with fluconazole, the current standard of care, for treating invasive candidiasis and candidaemia in Spain. METHODS: A decision tree model from the hospital perspective was constructed to examine the cost-effectiveness of anidulafungin compared with fluconazole in treating confirmed candidaemia. Treatment success, patient treatment patterns, and patient survival were based on the results from a randomised, double-blind multicentre trial (Reboli et al., 2007 [41]). Only in-hospital (2011 €) direct costs per-patient obtained from a Spanish national database were considered. Renal toxicity probabilities and costs were extracted from the published literature. The incremental cost per successfully treated patient was calculated. One-way sensitivity analyses were performed to test model robustness. RESULTS: The percentage of successfully treated patients was higher with anidulafungin than with fluconazole (74% versus 57%). Treatment with anidulafungin resulted in higher antifungal drug costs (5991€ versus 3149€) but lower overall costs (40047€ versus 41350€) due to reductions in other medical costs. Univariate sensitivity analyses showed that anidulafungin was the most cost-effective. CONCLUSIONS: Anidulafungin demonstrated improved clinical efficacy versus fluconazole in treating confirmed candidaemia. Despite increased drug costs, treating confirmed candidaemia with anidulafungin is a cost-effective strategy.

Operative and non-operative management of endoscopic retrograde cholangiopancreatography-associated duodenal injuries.

INTRODUCTION: Endoscopic retrograde cholangiopancreatography (ERCP) is indispensable in everyday surgical practice. Despite this, as an invasive procedure, it has its own mortality and morbidity, the most feared of which is periduodenal perforations. Our experience with ERCP related periduodenal perforations and its treatment strategies are presented. Additionally, a rarely encountered subtype is highlighted. METHODS: Patients who underwent ERCP and sustained a periduodenal perforation between August 2008 and October 2011 were reviewed. RESULTS: During the period from August 2008 to October 2011, 597 ERCP procedures were performed in our hospital. Ten of these patients (3 male, 7 female) had a perforation. The mean patient age was 56.6 years. During the procedure, injury was suspected in four patients; it passed unnoticed in the remaining six. The decision to operate or follow a conservative policy was based on a combination of clinical and radiological findings. Operative intervention was required in three patients, with one mortality, while conservative treatment was followed in the remaining seven. A laparotomy was performed early in two patients whereas it was performed after an initial period of conservative treatment in one. The presence of periduodenal fluid collection, contrast extravasation or free intraperitoneal air were decisive factors for performing laparotomy. CONCLUSIONS: ERCP-related periduodenal perforations include different categories. Certain types require operative repair while others should be treated conservatively. The choice of the management approach should be individualised, depending on the clinical picture and radiological findings. Although rare, these are potentially serious complications that may end fatally. Early recognition and appropriate intervention is the only way to avert a fatal outcome.

Análisis de costes de tres candinas en el tratamiento de la candidiasis invasora en pacientes adultos no neutropénicos en España / Cost analysis of 3 candins in the treatment of invasive candidiasis in adult non-neutropaenic patients in Spain

Objetivo: Estimar el coste de tres candinas (anidulafungina, caspofungina, y micafungina) en el tratamiento de pacientes adultos no neutropénicos con candidiasis invasora (CI), desde la perspectiva de la Farmacia Hospitalaria en España. Métodos Para evaluar el impacto global en los costes, se han considerado diferentes escenarios posibles modificando el porcentaje de ajuste de dosis requerido con cada candina. Los precios de cada presentación (€, agosto 2010), se han obtenido del Catálogo de Medicamentos. Únicamente se han considerado los costes de adquisición del fármaco. Los resultados se expresan como coste total para cada una de las tres candinas. Resultados El coste por episodio (14días de tratamiento) de anidulafungina por paciente se mantiene constante en 5.400€. El coste de casponfungina varía de 4.281€ a 7.991€, dependiendo del peso del paciente y la disfunción hepática. El coste de micafungina osciló entre 6.000€ (100mg/día) y 9.000€ (aumento de dosis por respuesta inadecuada al tratamiento). El coste total de tratar a una hipotética cohorte de 100 pacientes con CI con anidulafungina sería de 540.000€, mientras que con caspofungina y micafungina sería de 631.459€ y 632.998€, respectivamente, dependiendo del ajuste de dosis requerido. Conclusión Los pacientes tratados con anidulafungina no requieren ajuste de la dosis, a diferencia de caspofungina y micafungina. El empleo de anidulafungina en el tratamiento de la CI en pacientes adultos no neutropénicos es una opción que conlleva un ahorro de costes, lo que permite un mejor control del presupuesto desde la perspectiva de la Farmacia Hospitalaria en España (AU)

Objective: To estimate the cost of 3 candins (anidulafungin, caspofungin and micafungin) inthe treatment of adult non-neutropaenic patients with invasive candidiasis (IC) in a Spanish hospital pharmacy setting. Methods: The overall cost impact was evaluated by varying the percentage dosage required of each candin in different possible scenarios. The prices (in euros) for each presentation wereobtained from the Drug Catalogue (in August 2010). Only drug purchase costs were considered. The results are expressed as total cost for each of the 3 candins. Results: The cost per episode (14 days) of anidulafungin was constant at D 5400 per patient. The cost of caspofungin varied from € 4281 to € 7991, depending on patient weight and liverdysfunction. The cost of micafungin varied from € 6000 (100 mg/day) to € 9000 (when increasing the dose due to inadequate response). Based on a hypothetic cohort of 100 patients with IC, the total cost of anidulafungin treatment would be € 540 000, for caspofungin it would be € 631 459,and for micafungin it would be € 632 998, depending on any dose adjustment required. Conclusion: Patients treated with anidulafungin did not require dose adjustment, unlike those treated with caspofungin or micafungin. The use of anidulafungin is a cost-saving treatment for adult non-neutropaenic patients with IC, which would result in better control of the Spanish pharmacy budget (AU)

[Cost analysis of 3 candins in the treatment of invasive candidiasis in adult non-neutropaenic patients in Spain]. / Análisis de costes de tres candinas en el tratamiento de la candidiasis invasora en pacientes adultos no neutropénicos en España.

OBJECTIVE: To estimate the cost of 3 candins (anidulafungin, caspofungin and micafungin) in the treatment of adult non-neutropaenic patients with invasive candidiasis (IC) in a Spanish hospital pharmacy setting. METHODS: The overall cost impact was evaluated by varying the percentage dosage required of each candin in different possible scenarios. The prices (in euros) for each presentation were obtained from the Drug Catalogue (in August 2010). Only drug purchase costs were considered. The results are expressed as total cost for each of the 3 candins. RESULTS: The cost per episode (14 days) of anidulafungin was constant at €5400 per patient. The cost of caspofungin varied from €4281 to €7991, depending on patient weight and liver dysfunction. The cost of micafungin varied from €6000 (100mg/day) to €9000 (when increasing the dose due to inadequate response). Based on a hypothetic cohort of 100 patients with IC, the total cost of anidulafungin treatment would be €540,000, for caspofungin it would be €631,459, and for micafungin it would be €632,998, depending on any dose adjustment required. CONCLUSION: Patients treated with anidulafungin did not require dose adjustment, unlike those treated with caspofungin or micafungin. The use of anidulafungin is a cost-saving treatment for adult non-neutropaenic patients with IC, which would result in better control of the Spanish pharmacy budget.

Laparoscopic retroperitoneal/mesenteric lymph node sampling: a safe and effective technique.

INTRODUCTION: Needle aspiration and core biopsies are commonly used to assess retroperitoneal lymph nodes. However, the tissue obtained by this method is insufficient to define and type the tumour. This article demonstrates the feasibility and safety of the laparoscopic approach in obtaining an adequate volume of lymph node tissue for typing. METHODS: Laparoscopic retroperitoneal lymph node biopsy was performed on 12 patients over a period of five years. A pneumoperitoneum was induced with a Veress needle, and an initial 10-mm trocar was inserted in the sub-umbilical region in order to carry a 30-degree telescope. Two or more 5-mm ports were inserted into the targeted areas under laparoscopic guidance to achieve optimal triangulation in order to access the nodal tissue. RESULTS: The procedure was successful in 11 out of the 12 patients. An average volume of 1.7 cm3 of tissue was harvested for each patient. In one patient with preoperatively undiagnosed portal hypertension, laparoscopy was converted to an open procedure due to bleeding. In all patients, the histology was adequate and contributed to the diagnosis, allowing rapid institution of treatment. The diagnosis was reactive lymphadenopathy in three patients and sarcoidosis in one patient. Seven others suffered from various conditions, including lymphoma, leukaemia, secondary from unknown origin and Castleman's disease. CONCLUSION: Laparoscopy allows access to perihepatic and perisplenic areas, and is a procedure of choice when needle biopsy is not possible or fails to provide an adequate sample.

Fusion of high b-value diffusion-weighted and T2-weighted MR images improves identification of lymph nodes in the pelvis.

Accurate identification of lymph nodes facilitates nodal assessment by size, morphological or MR lymphographic criteria. We compared the MR detection of lymph nodes in patients with pelvic cancers using T2-weighted imaging, and fusion of diffusion-weighted imaging (DWI) and T2-weighted imaging. Twenty patients with pelvic tumours underwent 5-mm axial T2-weighted and DWI (b-values 0-750 s/mm(2)) on a 1.5T system. Fusion images of b = 750 s/mm(2) diffusion-weighted MR and T2-weighted images were created. Two radiologists evaluated in consensus the T2-weighted images and fusion images independently. For each image set, the location and diameter of pelvic nodes were recorded, and nodal visibility was scored using a 4-point scale (0-3). Nodal visualisation was compared using Relative to an Identified Distribution (RIDIT) analysis. The mean RIDIT score describes the probability that a randomly selected node will be better visualised relative to the other image set. One hundred fourteen pelvic nodes (mean 5.9 mm; 2-10 mm) were identified on T2-weighted images and 161 nodes (mean 4.3 mm; 2-10 mm) on fusion images. Using fusion images, 47 additional nodes were detected compared with T2-weighted images alone (eight external iliac, 24 inguinal, 12 obturator, two peri-rectal, one presacral). Nodes detected only on fusion images were 2-9 mm (mean 3.7 mm). Nodal visualisation was better using fusion images compared with T2-weighted images (mean RIDIT score 0.689 vs 0.302). Fusion of diffusion-weighted MR with T2-weighted images improves identification of pelvic lymph nodes compared with T2-weighted images alone. The improved nodal identification may aid treatment planning and further nodal characterisation.

Inspirational people and care for the deprived: medical missionaries in Kashmir.

Lieutenant Robert Thorpe, a soldier in the British Army in India, visited Kashmir and witnessed the suffering and sorrows of the people there in the nineteenth century; his appeal to British soldiers raised enough funds for the Church Missionary Society to send medical missionaries to the Kashmir Valley. Thus began a process that would see the opening of a 150-bed British Mission Hospital in Srinagar and the start of a new wave of educational and healthcare reforms in the region. As the medical missionary work progressed so did the avenues of research, which led to pioneering work on skin cancer. The missionary doctors and nurses made a significant difference to the lives of the people of Kashmir and their pioneering work continues to live on.

Epistaxis and oral anticoagulant therapy.

Epistaxis in the anticoagulated patient poses a complicated management problem, which requires interdisciplinary collaboration. The aetiology of the majority of cases of epistaxis remains idiopathic, but an ageing population and the prevalence of ischaemic heart disease and peripheral vascular disease has meant that there are increasing numbers of patients on long term oral anticoagulant therapy. This has led to a concomitant increase in the incidence of complications experienced. We have reviewed the available relevant literature and guidelines in the current management practice in this scenario. In light of this, we propose a more standardised algorithm for the management of epistaxis in this challenging group of patients.

[Diagnosis of septo-pyramidal defects. Our report]. / Evaluación diagnóstica de las deformidades septopiramidales. Nuestra casuística.

OBJECTIVE: The aim of the study is to determine the characteristics of patients who are operated on because of a nasal or septal deformity: clinical features before surgery, physical examination, anterior active rhinomanometry, and computed tomography (CT). METHODS: We retrospectively reviewed prospective data collected on 372 patients operated on between January 1998 and June 2002 by means of a septoplasty or a rhinoplasty. RESULTS: Gender distribution was: 253 male, 119 female. A smaller percentage of men underwent correction of pyramidal deformities in comparison to women. Nasal endoscopic examination diagnosed associated inflammatory pathologies in 12.4% of patients. We found a significant relationship between previous nasal trauma, laterorrinia and defects of the dorsum. Anterior active rhinomanometry had a high variability between patients. CONCLUSIONS: Prospective data collected on these patients was useful to know more precisely our activities and how to adapt them to suit management decisions. Endoscopic examination proved high efficiency in the diagnosis of this pathology.

Evaluación diagnóstica de las deformidades septopiramidales. Nuestra casuística / Diagnostic evaluation of septopyramidal deformities. Our experience

Objetivo: El estudio pretende conocer las características preoperatorias de los pacientes intervenidos por deformidad septopiramidal: clínica, exploración física, rinomanometría anterior activa (RAA), tomografía computerizada (TC). Material y Método: Se trata de un análisis retrospectivo de datos recogidos prospectivamente sobre las características preoperatorias de un total de 372 pacientes que fueron intervenidos entre los años 1998 y 2002. Resultados: La distribución por sexos fue de 253 hombres y 119 mujeres. El porcentaje de hombres con deformidad piramidal fue menor que el de mujeres. La endoscopia nasal diagnosticó patología inflamatoria nasosinusal en el 12,4 por ciento de los pacientes. Se observó una relación significativa entre traumatismo nasal previo, laterorrinia y defecto de dorso. La RAA fue muy variable entre estos pacientes. Conclusiones: La protocolización y recogida de datos en estos pacientes son útiles para conocer nuestra actividad de forma más precisa y poder modular nuestra toma de decisiones. La endoscopia nasal es muy eficaz en el diagnóstico de estos pacientes (AU)

OBJECTIVE: The aim of the study is to determine the characteristics of patients who are operated on because of a nasal or septal deformity: clinical features before surgery, physical examination, anterior active rhinomanometry, and computed tomography (CT). METHODS: We retrospectively reviewed prospective data collected on 372 patients operated on between January 1998 and June 2002 by means of a septoplasty or a rhinoplasty. RESULTS: Gender distribution was: 253 male, 119 female. A smaller percentage of men underwent correction of pyramidal deformities in comparison to women. Nasal endoscopic examination diagnosed associated inflammatory pathologies in 12.4% of patients. We found a significant relationship between previous nasal trauma, laterorrinia and defects of the dorsum. Anterior active rhinomanometry had a high variability between patients. CONCLUSIONS: Prospective data collected on these patients was useful to know more precisely our activities and how to adapt them to suit management decisions. Endoscopic examination proved high efficiency in the diagnosis of this pathology (AU)

Verrucous epidermal naevus associated with woolly hair naeves.

An unusual case of verrucous epidermal naevus associated with woolly hair naevus of the scalp is being reported.