Subject(s)
Drugs, Generic , Education, Medical , Hospitals , Humans , Mexico , Practice Patterns, Physicians'ABSTRACT
Cavernous hemangiomas of the tympanic membrane are extremely rare. Only 9 cases have been published in the literature. We describe a case with clinical characteristics, otoscopic image and diagnostic studies. Alternatives in treatment are discussed and a review of the literature was carried out.
Subject(s)
Diagnostic Techniques, Otological , Ear Neoplasms/pathology , Hemangioma, Cavernous/pathology , Tympanic Membrane/pathology , Humans , Male , Middle AgedSubject(s)
Academies and Institutes , Education, Medical, Continuing , Mexico , Periodicals as Topic , ResearchSubject(s)
Acquired Immunodeficiency Syndrome , AIDS Vaccines , Acquired Immunodeficiency Syndrome/complications , Acquired Immunodeficiency Syndrome/economics , Acquired Immunodeficiency Syndrome/epidemiology , Acquired Immunodeficiency Syndrome/prevention & control , Acquired Immunodeficiency Syndrome/therapy , Cost-Benefit Analysis , Costs and Cost Analysis , Forecasting , Global Health , Health Care Reform , Human Rights , Humans , Latin America , Mexico/epidemiology , Public Health , Quality of Health Care , Social Security , United NationsSubject(s)
Neoplasms/prevention & control , Adolescent , Adult , Aged , Breast Neoplasms/prevention & control , Digestive System Neoplasms/prevention & control , Female , Genital Neoplasms, Female/prevention & control , Humans , Male , Mass Screening , Middle Aged , Neoplasms/genetics , Risk Factors , Vitamins/therapeutic useABSTRACT
Malignant external otitis is a life-threatening infection occurring in aging diabetic and immunocompromised patients. The development of new antimicrobial and diagnostic aids has modified the therapy and prognosis of the disease. We describe our experience in 12 cases seen between 1982 and 1991, and review the diagnostic and therapeutic criteria during this lapse. Ten cases were males and 11 were diabetics. The most common symptoms were unilateral otalgia and otorrhea. All had edema of the external auditory channel and nine, proliferation of granulation tissue. Four had cranial nerve palsy. In ten patients Pseudomonas aeruginosa was recovered. All had axial computed tomographic scans and six sequential radionuclide scanning performed at diagnosis and follow-up. Eleven patients received combined therapy with an aminoglucoside and an anti-pseudonomas beta-lactam antibiotic; in four ambulatory treatment was continued with a quinolone. Only one patient received a quinolone as only treatment due to unavailability of other drugs in the mexican market. Presentation of granulation tissue or bone sequestrum was performed in nine patients. Only three required extensive surgical debridement procedures. We conclude that a combined antimicrobial therapy and the use of quinolones has favorably modified the prognosis and avoids extensive surgery and disminishes hospital stay.
Subject(s)
Diabetes Complications , Otitis Externa/complications , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Otitis Externa/diagnosis , Otitis Externa/therapy , Retrospective StudiesABSTRACT
A synthesis of the historical background of the councils for specialty certification in Mexico is presented. A comment is made on the role of the National Academy of Medicine and on its relation to the councils. Some statistical data are given on the councils endorsed by the Academy, which up to April 1992 grouped 29,093 physicians throughout the country. Finally, a brief comment is made on the future of these organization in Mexico and the increasing influence they will exert on the regulation of specialized medical practice.
