Problem-solving self-appraisals of obese patients.

OBJECTIVE: It has been reported that for obesity patients, improved problem-solving skills have a positive impact on losing weight and treatment adherence. The aims of our study, by describing the problem-solving self-appraisal of obese patients applied to our center, were to provide data in enriching the obesity management, to facilitate weight loss and improve long-term goals for patients. PATIENTS AND METHODS: The study design was cross-sectional and descriptive. There were no sampling methods, all patients registered to the center program and passed the health screening module were asked to be included. The data collection was performed via "Socio-demographic information form" and "Problem-Solving Inventory" (PSI) forms. Quantitative data were compared by Student's t-test, Mann-Whitney U test, One-way Anova, post-hoc test, and correlation analysis. RESULTS: The total average of the PSI scores of 87 patients was 122.33±20.25. There was no statistical significance between the inventory scores and gender, marital status, financial state, smoking, and alcohol consumption (p>0.05). Physical activity and education were correlated with the PSI scores (p˂0.05). CONCLUSIONS: The study showed that participants had low problem-solving self-appraisals. Providing an additional perspective on problem-solving skills may help to promote the psychological and physical well-being of obesity patients.

The role of Helicobacter pylori infection in the cause of squamous cell carcinoma of the larynx.

OBJECTIVE: Helicobacter pylori can cause chronic infection that has been linked to the development of both benign and malignant disease of the aerodigestive tract. The purpose of this study was to determine the link between H pylori infection and squamous cell carcinoma of the larynx (SCCL). METHODS: We estimated the presence of IgG antibodies against H pylori antigens by using ELISA technique in the sera of 26 patients with SCCL and 32 matched controls without carcinoma of the larynx. RESULTS: The incidence of seropositivity of patients with SCCL was 73.07% and of controls was 40.62%. These data support an etiologic role for H pylori infection on development of SCCL (chi(2) = 4.85, P< 0.05). CONCLUSION: H pylori infection of the upper aerodigestive tract might result in mucosal disruption, allowing for subsequent transformation by known carcinogens such as tobacco and alcohol.

Pentoxifylline effects on acute and late complications after radiotherapy in rabbit.

Soft tissue damages after radiotherapy are an uncommon but serious complication. Late damage after radiation is the principal dose-limiting factor in radiation therapy today and is dependent on vascular pathology as a result of radiation. Pentoxifylline is a methylxanthine derivative that produces dose-related improvement in blood flow, lower blood viscosity, improved erythrocyte flexibility, and increased tissue oxygen levels. An agent that increases blood flow and tissue oxygen content may contribute to enhanced healing of soft tissue pathology. Sixteen adult New Zealand rabbits were separated into 2 groups and inspected for 30 weeks after radiation. We noted acute and chronic reactions and pathologic changes in different regions of the head and neck of rabbits. The prophylactic administration of pentoxifylline in the postirradiation period can reduce late soft tissue pathology, but it does not affect acute radiation reactions.

Pneumatization in otosclerosis.

In this study, degrees of mastoid pneumatization in otosclerotic and normal patients were compared on CT scan and plain X-rays. This study was prospective, conducted on inpatients and outpatients at a large community hospital. Patients were consecutively evaluated with no sex or age predilection. Each patient had a CT scan and a Schuller graph. Temporal bone volumetric and planimetric measurements were done respectively on CT scans and Schuller graphs. Statistically no significant variations were observed between groups. No correlation could be established between the degree of pneumatization and otosclerosis. Neither imaging technique is superior to the other when they are compared.

Isolated sphenoid sinusitis.

Isolated sphenoid sinusitis is a relatively rare clinical entity and can cause severe complications. Diagnostic nasal endoscopy using Hopkins telescopes and coronal and axial paranasal-sinus CT made the diagnosis of the sphenoid sinus disease easier. Eight out of 221 patients with paranasal sinus infection refractory to medical treatment--and treated surgically at the 2nd ENT Clinic of Ankara Numune Hospital between 1990-1995--had isolated sphenoid sinus infection. The most common symptom was headache felt in the retro-orbital region. Surgical procedure was intranasal endoscopic approach to the sphenoid sinus. The symptoms of the patients with isolated sphenoid sinusitis were completely resolved after surgery. As the literature is reviewed, it is concluded that endoscopic approach to the sphenoid sinus disease is the most appropriate method of surgery in order to reduce intra-operative morbidity and mortality.

Role of suprahyoid neck dissection in the treatment of squamous cell carcinoma of the lower lip.

Treatment of squamous cell carcinoma of the lip is primarily surgical. Unlike other oral lesions, lower lip cancers do not metastasize to lower cervical lymph nodes without invading submental and submandibular lymph nodes. This study presents 30 patients with N0 lower lip carcinoma who were treated by en bloc resection of the tumor with suprahyoid neck dissection. Occult metastasis was found in 4 patients (13%). Four patients, 3 of whom had no occult metastases, died of local or regional uncontrollable disease. Suprahyoid or modified radical neck dissection appears to be beneficial, even in small tumors of the lower lip, in detecting occult metastases.

Postoperative hypertension after radical neck dissection.

Postoperative hypertension after radical neck dissection was detected in 20.2% of 109 neck dissections in our department between 1989 and 1993. It was probably caused by carotid sinus denervation and appeared after the vasodilation generated by anesthesia had subsided. If postoperative hypertension was encountered after the first operation, the risk of such hypertension after surgery on the contralateral side significantly increased.

Rhinolithiasis.

Rhinoliths are mineralized masses located in the nasal cavity. In this report, 12 patients with rhinolithiasis who were operated at the 2nd ENT Clinic of Ankara Numune Hospital are presented. The most frequently seen symptom is nasal obstruction, which has been seen in 9 patients. The disease most frequently seen in association with rhinolithiasis is chronic sinusitis. All masses have been extracted intranasally.

Diagnosis and treatment of lingual thyroid: a review.

Lingual thyroid is a rare developmental anomaly. It occurs because of the defective descent of thyroid tissue through the thyroglossal duct to its normal pretracheal position. In this study, two patients who presented with a mass in the oropharynx, finally diagnosed as lingual thyroid are presented, and the literature is reviewed. The masses were 3 x 2.5 x 1.5 cm and 3.5 x 3 x 3 cm in size. The diagnosis was based on the clinical features, fine needle aspiration biopsy, laboratory tests and radiographic imaging studies. The first case was treated medically with thyroxine. No treatment was given for the second case because of the patient's refusal. Both cases have not required additional therapy so far.

Mastoidectomy in noncholesteatomatous chronic suppurative otitis media: is it necessary?

Chronic suppurative otitis media (CSOM) without cholesteatoma, the surgical treatment of which is still controversial, is a common diagnosis in otologic practice. A retrospective analysis of 323 patients who underwent surgery for noncholesteatomatous chronic otitis media in the Gruppo Otologica, Piacenza, Italy, between April 1983 and December 1993 is presented. Cases were separated into three groups according to different surgical treatment modalities and conditions of the ears at the time of operation. Group I (n = 53) consisted of cases of CSOM treated by tympanoplasty without mastoidectomy (TLWOM). Group II (n = 28) included cases of CSOM treated by tympanoplasty with mastoidectomy (TLWM). Intact canal wall technique was used in these cases. The ears in both these groups were discharging severely at the time of surgery. Group III (n = 242) included patients whose ears were dry at the time of surgery but who had had previous recurrent episodes of suppuration and who were treated by TLWOM. At the last follow-up, graft success rates for groups I, II, and III were 90.5%, 85.7%, and 89.2%, respectively, and mean residual gaps were 17.2 dB, 20.1 dB, and 19.4 dB, respectively. There was no statistically significant difference between the three groups either on graft success rates (p > 0.05) or on final functional hearing outcome (p > 0.05). TLWM is the preferable treatment modality for most surgeons in noncholesteatomatous CSOM. Nevertheless, in our experience TLWOM yields comparable results for this group of patients. In addition, we could not find any significant difference in results of graft success and final functional hearing rates between dry and discharging ears (p > 0.05).

Effect of blood transfusion on tumor recurrence and postoperative pharyngocutaneous fistula formation in patients subjected to total laryngectomy.

Some surgical oncologists and otolaryngologists have reported that transfusion-induced immunosuppression may increase the incidence of recurrence and infectious complications in patients subjected to head and neck surgery for carcinoma. The relationship between intra-operative blood transfusion and postoperative pharyngocutaneous fistula formation and/or tumor recurrence is controversial. In a retrospective study of 110 total laryngectomized patients, we found no statistically significant differences between the transfused and nontransfused groups in terms of tumor recurrence and fistula formation.

Cerebrospinal fluid leak after translabyrinthine acoustic neuroma surgery.

Cerebrospinal fluid leakage is the most common complication of translabyrinthine acoustic neuroma surgery. This retrospective study reviews patients who had translabyrinthine acoustic neuroma surgery at the Gruppo Otologico, Piacenza, Italy, and ENT Department of Bergamo General Hospital, Bergamo, Italy, during the last 6 years. The incidence of postoperative cerebrospinal fluid leakage was 6.2%, and 75% of these patients underwent another surgery to control the cerebrospinal fluid leakage. A modification of translabyrinthine approach was used in patients with highly pneumatized temporal bones to prevent cerebrospinal fluid leakage in these high-risk patients.

Early oral feeding after total laryngectomy.

Following total laryngectomy, 110 patients were orally fed on the first/second postoperative day without using a nasogastric (NG) tube. Pharyngo-cutaneous fistula was observed in 23 patients (21%) only nine of which (8%) needed surgical intervention to close the fistula. Early postoperative oral feeding of laryngectomized patients does not increase the fistula rate but decreases postoperative hospitalization time and eliminates the disadvantages of the NG tube.