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INTRODUCTION: Thyroid gland fibrosarcomas are extremely rare tumors, and only very few cases have been described in the literature. There are no set recommendations along with follow-ups regarding the treatment of these tumors. Moreover, the prognosis is poor with a very short life expectancy. CASE REPORT: We present an 81-year-old patient who was suffering from increasing dysphagia and dysphonia related to a painless giant cervical mass, which presented with progressive growth for the preceding months. After a core needle biopsy with a suspicion of a solitary fibrous tumor, total excision of the tumor was successfully performed, and the pathology examination revealed a fibrosarcoma. Following surgery, radiotherapy was decided in the oncological multidisciplinary meeting; however, the patient refused it. There were neither new clinical symptoms nor tumor recurrence after an 18-month follow-up. CONCLUSION: Although it is a very rare tumor, primary fibrosarcoma of the thyroid gland should be kept in mind in the differential diagnosis of neck tumors.
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Background. Vertical facial growth has a high prevalence. Nonspecialized professionals have shown low sensitivity to identify patients at risk. In the face of this difficulty, we designed and validated a screening checklist for vertical facial growth. Methods. A multidisciplinary team of 5 members developed the Vertical Facial Growth Screening Test. A sample of 160 evaluations was obtained. We consider as the gold standard the evaluation of 2 specialists in dentofacial orthopedics. Results. Consistency measured with Cronbach α was .675 for 10 items. Test-retest reliability was .956. The interobserver concordance was .886. The receiver operating characteristic curve has .987 area under the curve. Conclusion. This is the first study to design and validate a screening checklist for vertical facial growth for nonexpert evaluators. We think that given its good performance, ease of use, inexpensiveness, and availability, the test could be useful for nontrained professionals dealing with children.
Subject(s)
Growth Disorders/diagnosis , Mass Screening/methods , Maxillofacial Development , Child , Child, Preschool , Female , Growth Disorders/etiology , Humans , Male , Mouth Breathing/complications , Reproducibility of ResultsABSTRACT
INTRODUCCIÓN: El tratamiento con hipotermia ha mejorado el pronóstico de los neonatos con asfixia perinatal. Ampliamente utilizado, este tratamiento ha probado ser seguro sin efectos adversos graves. No descrito en los estudios multicéntricos iniciales, el estridor se ha reportado recientemente como un efecto secundario de este tratamiento. El objetivo de este artículo es revisar la incidencia de estridor respiratorio entre los neonatos con encefalopatía hipóxico-isquémica (EHI) sometidos a tratamiento con hipotermia en nuestra unidad. MÉTODOS: Estudio retrospectivo revisando las historias de todos los pacientes sometidos a hipotermia en nuestra unidad. RESULTADOS: Siete de 75 (9,3%) pacientes presentaron estridor; 3 recibieron hipotermia corporal total, 3 cerebral selectiva y un caso recibió ambas técnicas. Todos los casos requirieron aumento del soporte respiratorio. CONCLUSIÓN: Diferentes mecanismos pueden estar implicados con la aparición de estridor en los pacientes con EHI sometidos a hipotermia, en nuestra serie de casos no encontramos relación ni con el método de hipotermia activa empleado ni con la fase del tratamiento. Para intentar comprender mejor este posible efecto adverso de la hipotermia es necesario desarrollar estudios prospectivos que incluyan laringoscopia
INTRODUCTION: Hypothermia treatment has improved the prognosis of asphyxiated neonates. Widely used, it has demonstrated to be safe without severe side effects. The aim of this article is to review the incidence of stridor amongst asphyxiated newborns treated with hypothermia in our unit. METHODS: Retrospective chart review of our patients. RESULTS: Stridor was presented in 7/75 (9.3%) of patients during hypothermia. Three received whole body hypothermia, 3 selective cerebral, and in one case both techniques were used. All cases required increased respiratory support. CONCLUSIONS: Different mechanisms may be responsible for the appearance of stridor in patients with hypoxic-ischaemic encephalopathy (HIE). In our series the incidence of stridor was similar for the two hypothermia devices. To better understand these possible side effects of hypothermia, further prospective studies (which should include laryngoscopy) are needed
Subject(s)
Humans , Male , Female , Child , Respiratory Sounds/radiation effects , Brain Ischemia/complications , Brain Ischemia , Hypothermia/complications , Hypothermia , Retrospective Studies , Laryngoscopy/methods , Laryngoscopy , Phenobarbital/therapeutic use , Respiration, Artificial/methodsABSTRACT
INTRODUCTION: Hypothermia treatment has improved the prognosis of asphyxiated neonates. Widely used, it has demonstrated to be safe without severe side effects. The aim of this article is to review the incidence of stridor amongst asphyxiated newborns treated with hypothermia in our unit. METHODS: Retrospective chart review of our patients. RESULTS: Stridor was presented in 7/75 (9.3%) of patients during hypothermia. Three received whole body hypothermia, 3 selective cerebral, and in one case both techniques were used. All cases required increased respiratory support. CONCLUSIONS: Different mechanisms may be responsible for the appearance of stridor in patients with hypoxic-ischaemic encephalopathy (HIE). In our series the incidence of stridor was similar for the two hypothermia devices. To better understand these possible side effects of hypothermia, further prospective studies (which should include laryngoscopy) are needed.
Subject(s)
Hypothermia, Induced , Hypoxia-Ischemia, Brain/complications , Hypoxia-Ischemia, Brain/therapy , Respiratory Sounds/etiology , Female , Humans , Hypothermia, Induced/methods , Infant, Newborn , Male , Retrospective StudiesABSTRACT
OBJECTIVES/HYPOTHESIS: Current knowledge of the functional role of human laryngeal nerves is based on traditional laryngeal neuroanatomic descriptions or contradictory electromyographic studies. The aim of this study was to clarify the functional role of neural connections between laryngeal nerves by correlating the different electromyographic patterns observed after laryngeal stimulation and the existence of different neural connections. STUDY DESIGN: Descriptive. METHODS: Electromyographic and morphologic study in 13 patients during total laryngectomy procedure. RESULTS: Seven patients showed an additional evoked response from the cricothyroid muscle after recurrent laryngeal nerve stimulation. External laryngeal nerve stimulation resulted in additional responses from the posterior cricoarytenoid muscle in three cases and from the arytenoid muscle in one. The presence of a neural connection was confirmed in all patients who showed an unexpected electromyographic response. CONCLUSIONS: The different connections between laryngeal nerves are at least partially of motor nature and play a role in the mobility of vocal folds.
