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1.
Medicine (Baltimore) ; 99(24): e20394, 2020 Jun 12.
Artículo en Inglés | MEDLINE | ID: mdl-32541459

RESUMEN

INTRODUCTION: Hyaluronic acid injections is relatively safe with little risk of complications. Although herpes reactivation after the injection of hyaluronic acid is rare, it produces quite a huge pressure and panic on patients. Quite a lot cosmetic practitioners have no awareness of preventing, diagnosing, and giving correct treatment in time due to lack of experience. PATIENT CONCERNS: A 24-year-old woman presented with erythema, crusted papules, pain and swelling on the nose after receiving the injection of hyaluronic acid. A swab of the discharge fluid was obtained for bacterial and viral culture, showing positive for herpes simplex virus. DIAGNOSIS: The patient was diagnosed as herpes reactivation after the injection of hyaluronic acid. INTERVENTIONS: The patient underwent antiviral therapy with acyclovir 400 mg, 3 times daily for seven days. OUTCOMES: After a week of antiviral treatment, the clinical signs improved. CONCLUSION: Herpes reactivation after the injection of hyaluronic acid is quite rare but needed sufficient attention of cosmetic practitioners to make the proper diagnosis, prevention and treatment.


Asunto(s)
Rellenos Dérmicos/efectos adversos , Herpes Simple/inducido químicamente , Ácido Hialurónico/efectos adversos , Nariz/virología , Simplexvirus/aislamiento & purificación , Aciclovir/administración & dosificación , Aciclovir/uso terapéutico , Administración Oral , Adulto , Antivirales/administración & dosificación , Antivirales/uso terapéutico , Rellenos Dérmicos/administración & dosificación , Femenino , Herpes Simple/patología , Herpes Simple/prevención & control , Humanos , Ácido Hialurónico/administración & dosificación , Nariz/patología , Resultado del Tratamiento , Adulto Joven
2.
Eur Rev Med Pharmacol Sci ; 24(10): 5769-5771, 2020 May.
Artículo en Inglés | MEDLINE | ID: mdl-32495913

RESUMEN

OBJECTIVE: Coronavirus disease 2019 (COVID-19) related coagulopathy may be the first clinical manifestation even in non-vasculopathic patients and is often associated with worse clinical outcomes. CASE PRESENTATION: A 78 years old woman was admitted to the Emergency Unit with respiratory symptoms, confusion and cyanosis at the extremity, in particular at the nose area, hands and feet fingers. A nasal swab for COVID-19 was performed, which resulted positive, and so therapy with doxycycline, hydroxychloroquine and antiviral agents was started. At admission, the patient was hemodynamically unstable requiring circulatory support with liquids and norepinephrine; laboratory tests showed disseminated intravascular coagulation (DIC). During hospitalization, the clinical condition worsened and the cyanosis of the nose, fingers, and toes rapidly increased and became dried gangrene in three days. Subsequently, the neurological state deteriorated into a coma and the patient died. DISCUSSION: In severe cases, COVID-19 could be complicated by acute respiratory disease syndrome, septic shock, and multi-organ failure. This case report shows the quick development of dried gangrene in a non-vasculopathic patient, as a consequence of COVID-19's coagulopathy and DIC. CONCLUSIONS: In our patient, COVID-19 related coagulopathy was associated with poor prognosis.


Asunto(s)
Infecciones por Coronavirus/diagnóstico , Gangrena/diagnóstico , Neumonía Viral/diagnóstico , Enfermedad Aguda , Anciano , Antivirales/uso terapéutico , Betacoronavirus/aislamiento & purificación , Infecciones por Coronavirus/tratamiento farmacológico , Infecciones por Coronavirus/patología , Infecciones por Coronavirus/virología , Coagulación Intravascular Diseminada/diagnóstico , Coagulación Intravascular Diseminada/etiología , Doxiciclina/uso terapéutico , Femenino , Dedos/patología , Gangrena/patología , Humanos , Hidroxicloroquina/uso terapéutico , Cavidad Nasal/virología , Nariz/patología , Pandemias , Neumonía Viral/tratamiento farmacológico , Neumonía Viral/patología , Neumonía Viral/virología , Índice de Severidad de la Enfermedad
3.
Zhonghua Kou Qiang Yi Xue Za Zhi ; 55(4): 249-252, 2020 Apr 09.
Artículo en Chino | MEDLINE | ID: mdl-32268624

RESUMEN

Objective: To evaluate the changes of nasalance when cleft palate patients examined using nasometer and nasopharyngeal fiberscopy simultaneously. Methods: A total of 33 cleft palate patients from August 2004 to August 2010 were examined by nasopharyngeal fiber endoscopy and nasometer simultaneously. The nasalance of 33 voice samples was compared under two situations only nasometer and nasometer with nasopharyngeal fiberscopy. Results: The statistics showed that the nasalance value of 33 voice samples of 33 participants under different situations were no significant difference through paired t-test (P>0.05). Conclusions: Nasopharyn fiber endoscopy had no influence to the results of the nasalance value under simultaneous condition. The nasometer and nasopharyn fiber endoscopy can be applied to evaluate the velopharyngeal function of cleft palate patients simultaneously.


Asunto(s)
Fisura del Paladar , Endoscopía/métodos , Tecnología de Fibra Óptica , Insuficiencia Velofaríngea , Fisura del Paladar/diagnóstico , Fisura del Paladar/patología , Endoscopía/instrumentación , Humanos , Nariz/patología
4.
Pan Afr Med J ; 34: 49, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31762915

RESUMEN

Massive and severe epistaxis is an uncommon event in pregnancy. It could be life threatening and could affect the normal pregnancy course. The best management is still on debate; it could be medical, conservative or surgical. Pregnancy termination often is problem solving. Hormonal changes during pregnancy affects nasal physiology. Vaginal delivery, labour induction or cesarean section are all suitable, after hemodynamic stabilization of pregnant woman. We report a case and review the available literature.


Asunto(s)
Epistaxis/complicaciones , Nariz/patología , Complicaciones del Embarazo/patología , Adulto , Epistaxis/terapia , Femenino , Humanos , Embarazo , Complicaciones del Embarazo/terapia , Recurrencia , Índice de Severidad de la Enfermedad
5.
Actas dermo-sifiliogr. (Ed. impr.) ; 110(9): 759-762, nov. 2019. graf, ilus
Artículo en Español | IBECS | ID: ibc-185568

RESUMEN

La reparación de los defectos nasales distales producidos durante la cirugía micrográfica de Mohs representa un desafío para el cirujano. Existen múltiples técnicas por las cuales se puede optar para el cierre del defecto. Presentamos 3 casos en los que se realizó el colgajo este-oeste, un colgajo de avance, de fácil diseño, que consiste en un triángulo que cubre el defecto y un segundo triángulo de descarga con sus bases en la línea de desplazamiento. Con este colgajo se obtiene un óptimo resultado estético con un movimiento mínimo de los tejidos, preservando la arquitectura nasal y con líneas de sutura bien disimuladas


Repair of distal nasal defects resulting from Mohs micrographic surgery is a challenge, but surgeons can choose from a number of techniques. We present 3 cases in which an east-west flap was used to close the defect. The east-west flap is an easily conceived advancement flap that consists of a superior triangle used to cover the defect and an inferior triangle whose base is located along the advancement line. The flap results in an optimal cosmetic outcome and involves minimum movement of tissue (preserving the nasal architecture) and well-camouflaged suture lines


Asunto(s)
Humanos , Masculino , Femenino , Adulto , Anciano , Colgajos Quirúrgicos , Cirugía de Mohs/métodos , Neoplasias Nasales/cirugía , Cirugía de Mohs/tendencias , Procedimientos Quirúrgicos Dermatologicos/métodos , Nariz/patología , Nariz/cirugía
7.
An Bras Dermatol ; 94(4): 476-478, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31644626

RESUMEN

Pemphigus vulgaris is chronic bullous disease that manifests as bullae and erosions of skin and mucosas, with intraepidermal suprabasal cleft formation seen in the histological examination. It has a rare variant called pemphigus vegetans, where vesicles and bullae are replaced by pustular, verrucous and hyperpigmented lesions, mainly in skin folds. The treatment is similar to that for classic pemphigus vulgaris. The authors present an exuberant case of pemphigus vegetans, covering the nose and chest exclusively, without oral or flexural lesions.


Asunto(s)
Nariz/patología , Pénfigo/patología , Tórax/patología , Anciano de 80 o más Años , Biopsia , Glucocorticoides/uso terapéutico , Humanos , Masculino , Pénfigo/tratamiento farmacológico , Prednisona/uso terapéutico , Piel/patología , Resultado del Tratamiento
8.
Vet Dermatol ; 30(6): 511-e155, 2019 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-31486556

RESUMEN

BACKGROUND: Dermal arteritis of the nasal philtrum (DANP) is a cutaneous vascular condition that selectively targets large vessels of the nasal philtrum of dogs; little information is published about this disease. OBJECTIVE: The aim of this study was to report the signalment, clinical signs, treatment options and outcome of dogs with DANP, and to propose a rationale for the clinical diagnosis. ANIMALS: Twenty-three dogs from four referral veterinary clinics from January 2002 to July 2018. METHODS AND MATERIALS: Retrospective analysis of medical records of dogs with diagnosis of DANP. RESULTS: The mean age at disease onset was 5.3 years. Nineteen dogs were pure-bred (11 different breeds) and four were mixed breed. Twenty-three dogs had a clinical diagnosis of DANP and three of these had histopathological confirmation. Eight dogs had episodes of profuse arterial bleeding from the lesion, nine had minor bleeding and six no bleeding. Twenty dogs were managed medically with monotherapy or combined therapy of topical tacrolimus, prednisolone, doxycycline and niacinamide, and/or pentoxifylline. Long-term tacrolimus was prescribed for 15 cases, eight of those cases as sole therapy. Treatment was declined for three dogs and four dogs were lost to follow-up. The lesion was satisfactorily controlled in 12 dogs and well-controlled in four dogs. CONCLUSIONS AND CLINICAL IMPORTANCE: The distinctive presentation of DANP substantiates the clinical diagnosis. Medical treatment seems to be effective in controlling DANP and tacrolimus used as sole or adjunctive therapy appears to manage the disease satisfactorily.


Asunto(s)
Arteritis/veterinaria , Enfermedades de los Perros/diagnóstico , Enfermedades de los Perros/inmunología , Labio/patología , Nariz/inmunología , Animales , Arteritis/diagnóstico , Arteritis/inmunología , Enfermedades de los Perros/patología , Perros , Femenino , Masculino , Nariz/patología , Estudios Retrospectivos , Piel
9.
Genetics ; 213(2): 685-703, 2019 10.
Artículo en Inglés | MEDLINE | ID: mdl-31420322

RESUMEN

Structural maintenance of chromosomes flexible hinge domain-containing 1 (SMCHD1) is an architectural factor critical for X-chromosome inactivation (XCI) and the repression of select autosomal gene clusters. In mice, homozygous nonsense mutations in Smchd1 cause female-specific embryonic lethality due to an XCI defect. However, although human mutations in SMCHD1 are associated with congenital arhinia and facioscapulohumeral muscular dystrophy type 2 (FSHD2), the diseases do not show a sex-specific bias, despite the essential nature of XCI in humans. To investigate whether there is a dosage imbalance for the sex chromosomes, we here analyze transcriptomic data from arhinia and FSHD2 patient blood and muscle cells. We find that X-linked dosage compensation is maintained in these patients. In mice, SMCHD1 controls not only protocadherin (Pcdh) gene clusters, but also Hox genes critical for craniofacial development. Ablating Smchd1 results in aberrant expression of these genes, coinciding with altered chromatin states and three-dimensional (3D) topological organization. In a subset of FSHD2 and arhinia patients, we also found dysregulation of clustered PCDH, but not HOX genes. Overall, our study demonstrates preservation of XCI in arhinia and FSHD2, and implicates SMCHD1 in the regulation of the 3D organization of select autosomal gene clusters.


Asunto(s)
Atresia de las Coanas/genética , Proteínas Cromosómicas no Histona/genética , Microftalmía/genética , Distrofia Muscular Facioescapulohumeral/genética , Nariz/anomalías , Inactivación del Cromosoma X/genética , Animales , Cadherinas/genética , Atresia de las Coanas/patología , Codón sin Sentido/genética , Femenino , Genes Letales/genética , Humanos , Ratones , Microftalmía/patología , Distrofia Muscular Facioescapulohumeral/patología , Nariz/patología , Transcriptoma/genética
10.
J Vet Med Sci ; 81(10): 1419-1423, 2019 Oct 18.
Artículo en Inglés | MEDLINE | ID: mdl-31391384

RESUMEN

In July 2017, twenty cattle of a free-grazing herd were found to be infested with leeches in the mouth. Main signs were bloody sialorrhea and/or a purple-red colour of the lower lip. Leeches, in a variable number (1 to 3) per animal, were found at the lingual frenulum or on the sublingual vestibular mucosa and were morphologically identified as Limnatis nilotica. To the best of our knowledge, this is the first report of cattle infestation by L. nilotica in Italy. Besides recalling the attention to leech infestation and suggesting its inclusion in the differential diagnosis of animals with suggestive signs, this short report also provides practitioners with easy-going morphological keys for proper diagnosis and discrimination among species.


Asunto(s)
Infestaciones Ectoparasitarias , Sanguijuelas/parasitología , Animales , Bovinos , Diagnóstico Diferencial , Italia , Boca/parasitología , Boca/patología , Nariz/parasitología , Nariz/patología
11.
An. bras. dermatol ; 94(4): 476-478, July-Aug. 2019. graf
Artículo en Inglés | LILACS | ID: biblio-1038309

RESUMEN

Abstract: Pemphigus vulgaris is chronic bullous disease that manifests as bullae and erosions of skin and mucosas, with intraepidermal suprabasal cleft formation seen in the histological examination. It has a rare variant called pemphigus vegetans, where vesicles and bullae are replaced by pustular, verrucous and hyperpigmented lesions, mainly in skin folds. The treatment is similar to that for classic pemphigus vulgaris. The authors present an exuberant case of pemphigus vegetans, covering the nose and chest exclusively, without oral or flexural lesions.


Asunto(s)
Humanos , Masculino , Anciano de 80 o más Años , Tórax/patología , Nariz/patología , Pénfigo/patología , Piel/patología , Biopsia , Prednisona/uso terapéutico , Pénfigo/tratamiento farmacológico , Resultado del Tratamiento , Glucocorticoides/uso terapéutico
12.
Indian J Dermatol Venereol Leprol ; 85(6): 597-604, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31293275

RESUMEN

Background: Facial papules are a feature of several clinical conditions and may present both diagnostic and therapeutic challenges. Aim: To describe a grouped papular eruption on the nose and adjoining cheeks that has not been well characterized previously. Materials and Methods: A series of consecutive patients with a papular eruption predominantly involving nose and cheeks were evaluated, treated and followed up prospectively at tertiary care centers. Demographic details, clinical features, histopathology and response to treatment were recorded. Results: There were five men and six women (mean age 29.9 ± 6.9 years) who had disease for a mean duration of 17.3 ± 11.1 months. All patients presented with a predominantly asymptomatic eruption of monomorphic, pseudovesicular, grouped, skin colored to slightly erythematous papules prominently involving the tip of nose, nasal alae, philtrum and the adjoining cheeks. A total of 15 biopsies from 11 patients were analyzed and the predominant finding was a dense, focal lymphoid infiltrate restricted to the upper dermis with basal cell damage and atrophy of the overlying epidermis. The eruption ran a chronic course from several months to years. Limitations: Direct immunofluorescence could not be performed except in one case. Immunohistochemical stains for CD4 and CD8 could not be done owing to nonavailability. Phototesting was undertaken in one patient only. Conclusion: Small grouped papules on the nose and adjoining skin with a lichenoid histopathology appear to represent a distinct clinicopathological entity. It may be related to actinic lichen nitidus/micropapular variant of polymorphous light eruption.


Asunto(s)
Fármacos Dermatológicos/uso terapéutico , Dermatosis Facial/diagnóstico , Liquen Nítido/diagnóstico , Erupciones Liquenoides/diagnóstico , Nariz/patología , Adulto , Dermatosis Facial/complicaciones , Dermatosis Facial/terapia , Femenino , Humanos , Liquen Nítido/complicaciones , Liquen Nítido/terapia , Erupciones Liquenoides/complicaciones , Erupciones Liquenoides/terapia , Masculino , Fototerapia/métodos , Adulto Joven
13.
Vet Parasitol Reg Stud Reports ; 17: 100290, 2019 08.
Artículo en Inglés | MEDLINE | ID: mdl-31303238

RESUMEN

Feline leishmaniasis (FeL) is an emerging infectious disease of cats caused by Leishmania infantum with global distribution. This study investigated the cause of chronic progressive cutaneous lesions in two cats from Central-west Brazil by using cytological, histopathologic, and immunohistochemical (IHC) analyses. Clinically, both cats had ulcerative cutaneous lesions at the nasal planum and ear resulting in a tentative diagnosis of squamous cell carcinoma (SCC). Moreover, both cats had varying degrees of onychogryphosis. However, cytology revealed chronic inflammatory reactions associated with intralesional amastigotes; histopathology confirmed chronic ulcerative dermatitis associated with intralesional and intracytoplasmic parasitic organisms consistent with amastigotes of Leishmania spp. within histiocytes. The IHC assay demonstrated that the intralesional parasitic structures identified by cytology and histopathology were immunoreactive to antigens of Leishmania spp., confirming the participation of this infectious disease agent in the development of the cutaneous lesions of these cats. The observation of onychogryphosis must be highlighted, since this lesion is frequently observed in dogs with visceral leishmaniasis but is underreported in FeL. Collectively, the pathologic and IHC findings of the chronic cutaneous disease confirmed active infections due to Leishmania spp. in these cats. Additionally, FeL with associated lesions to the ear and nasal planum must be considered as differential diagnosis for SCC in cats.


Asunto(s)
Enfermedades de los Gatos/parasitología , Leishmania infantum/aislamiento & purificación , Leishmaniasis Cutánea/veterinaria , Animales , Biopsia con Aguja Fina/veterinaria , Brasil/epidemiología , Carcinoma de Células Escamosas/diagnóstico , Carcinoma de Células Escamosas/veterinaria , Enfermedades de los Gatos/diagnóstico , Enfermedades de los Gatos/epidemiología , Gatos , Ciudades , Diagnóstico Diferencial , Oído Externo/patología , Femenino , Miembro Anterior/patología , Miembro Posterior/patología , Inmunohistoquímica/veterinaria , Leishmaniasis Cutánea/diagnóstico , Leishmaniasis Cutánea/epidemiología , Leishmaniasis Cutánea/parasitología , Nariz/patología , Neoplasias Cutáneas/diagnóstico , Neoplasias Cutáneas/veterinaria
14.
Indian J Pathol Microbiol ; 62(3): 451-453, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31361238

RESUMEN

Rhabdomyosarcoma (RMS) is a tumor arising from primitive mesenchymal cell with tendency for myogenesis. WHO classification categorizes this entity as embryonal, alveolar, spindle cell/sclerosing, and pleomorphic subtypes removing botryoid as a separate entity. The alveolar variant has worse prognosis and the cytological features of this entity are similar to embryonal type with little variations. This case report describes the cytohistological features of alveolar RMSfrom a 9-year-old child with nonparameningeal location.


Asunto(s)
Nariz/patología , Rabdomiosarcoma Alveolar/diagnóstico , Biopsia , Biopsia con Aguja Fina , Niño , Cara/patología , Técnicas Histológicas , Humanos , Masculino , Nariz/citología , Rabdomiosarcoma Alveolar/terapia
15.
Artículo en Inglés | MEDLINE | ID: mdl-31343132

RESUMEN

Trichorhinophalangeal syndrome (TRPS) is rare genetic disorder with autosomal dominant inheritance. The TRPS1 gene is located on the long arm of the eighth chromosome (8q24.12). The phenotype is variable and presents a wide clinical spectrum. Most cases are characterised by thin, sparse scalp hair, distinctive facial dysmorphism, and various skeletal abnormalities, especially of the hands and feet. Characteristic facial features may include a "pear-shaped" nose, micrognathia, dental anomalies, prominent ears, elongated philtrum, and thin upper vermillion border. In most cases, affected individuals exhibit skeletal abnormalities including brachydactyly and clinodac-tyly, short metacarpals phalanges, short feet and metatarsals, and pectus carinatum and hip joint malformations. Additionally, patients may exhibit short stature. This report presents four cases of TRPS (three sporadic and one familial). Clinical presentation included typical facial features and vari-ous skeletal abnormalities. Some TRPS symptoms may mimic growth hormone deficiency and other endocrine disturbances. The aim of this article is to deliver TRPS symptomatology. The treatment of TRPS is symptomatic and supportive and requires the coordination of several specialists, including paediatricians, endocrinologists, orthopaedic surgeons, dermatologists, and medical rehabilitation and den-tal specialists. In some cases, recombinant growth hormone therapy may be necessary. Genetic counselling may be of benefit for affect-ed individuals and their families.


Asunto(s)
Dedos/anomalías , Enfermedades del Cabello/diagnóstico , Síndrome de Langer-Giedion/diagnóstico , Nariz/anomalías , Adolescente , Niño , Preescolar , Femenino , Dedos/patología , Enfermedades del Cabello/genética , Enfermedades del Cabello/patología , Enfermedades del Cabello/terapia , Humanos , Síndrome de Langer-Giedion/genética , Síndrome de Langer-Giedion/patología , Síndrome de Langer-Giedion/terapia , Masculino , Mutación , Nariz/patología , Fenotipo , Polonia , Proteínas Represoras/genética
16.
Rom J Morphol Embryol ; 60(1): 255-259, 2019.
Artículo en Inglés | MEDLINE | ID: mdl-31263853

RESUMEN

Basal cell carcinoma (BCC) is a frequent form of skin cancer, which usually affects people that have been exposed to the sunlight for longer periods of time. The cells of the lower part of the epidermis are called the basal cell layer. These cells constantly divide to form new cells to replace the squamous cells that wear off the skin's surface. As these cells move up in the epidermis, they get flatter, eventually becoming squamous cells. Therefore, the BCC develops from these cells. Most BCCs have indolent behavior, with cure rates very high after low-complexity treatment. However, some lesions are very aggressive and there are only a few papers focusing on the subtype of this skin cancer known with the name ulcus rodens or giant BCC. In this study, we evaluate a case of ulcus rodens or giant BCC, subtype of the BCC skin cancer located in the area of the nasal pyramid, stage III, TxNxMx, with lymphatic and vascular invasion present.


Asunto(s)
Carcinoma Basocelular/diagnóstico , Neoplasias Nasales/diagnóstico , Nariz/patología , Carcinoma Basocelular/patología , Humanos , Masculino , Persona de Mediana Edad , Neoplasias Nasales/patología
18.
BMJ Case Rep ; 12(6)2019 Jun 22.
Artículo en Inglés | MEDLINE | ID: mdl-31229987

RESUMEN

The majority of epistaxes are anterior in nature, resolve with simple first aid measures and require no further follow-up. However, some cases pose more of a diagnostic challenge and prove resistant to standard investigation and treatment. We present a case of recurrent epistaxis, refractory to multiple treatment modalities and with CT imaging suggestive of a vascular aetiology which was ultimately disproved. The case highlights the shortcomings of CT imaging and importance of thorough examination technique. Nasal haemangiomas are a rare but recognised cause of epistaxis and should be considered in refractory cases.


Asunto(s)
Epistaxis/etiología , Hemangioma/complicaciones , Nariz/patología , Anciano , Aneurisma , Arteria Carótida Interna/diagnóstico por imagen , Arteria Carótida Interna/patología , Angiografía por Tomografía Computarizada/métodos , Angiografía por Tomografía Computarizada/estadística & datos numéricos , Diagnóstico Diferencial , Femenino , Hemangioma/diagnóstico por imagen , Hemangioma/cirugía , Humanos , Nariz/irrigación sanguínea , Nariz/diagnóstico por imagen , Resultado del Tratamiento
20.
Ann Emerg Med ; 74(1): 72-78, 2019 07.
Artículo en Inglés | MEDLINE | ID: mdl-31080025

RESUMEN

STUDY OBJECTIVE: The primary objective of this study is to compare the effectiveness of 3 treatment protocols to stop anterior epistaxis: classic compression, nasal packing, and local application of tranexamic acid. It also aims to determine the frequency of rebleeding after each of these protocols. METHODS: This single-center, prospective, randomized controlled study was conducted with patients who had spontaneous anterior epistaxis. The study compared the effect of 3 treatment options, tranexamic acid with compression but without nasal packing, nasal packing (Merocel), and simple nasal external compression, on the primary outcome of stopping anterior epistaxis bleeding within 15 minutes. RESULTS: Among the 135 patients enrolled, the median age was 60 years (interquartile range 25% to 75%: 48 to 72 years) and 70 patients (51.9%) were women. The success rate in the compression with tranexamic acid group was 91.1% (41 of 45 patients); in the nasal packing group, 93.3% (42 of 45 patients); and in the compression with saline solution group, 71.1% (32 of 45 patients). There was an overall statistically significant difference among the 3 treatment groups but no significant difference in pairwise comparison between the compression with tranexamic acid and nasal packing groups. In regard to no rebleeding within 24 hours, the study found rates of 86.7% in the tranexamic acid group, 74% in the nasal packing group, and 60% in the compression with saline solution group. CONCLUSION: Applying external compression after administering tranexamic acid through the nostrils by atomizer stops bleeding as effectively as anterior nasal packing using Merocel. In addition, the tranexamic acid approach is superior to Merocel in terms of decreasing rebleeding rates.


Asunto(s)
Antifibrinolíticos/administración & dosificación , Epistaxis/tratamiento farmacológico , Nariz/patología , Ácido Tranexámico/administración & dosificación , Anciano , Antifibrinolíticos/uso terapéutico , Femenino , Formaldehído/administración & dosificación , Formaldehído/uso terapéutico , Hemostáticos/administración & dosificación , Hemostáticos/uso terapéutico , Humanos , Masculino , Persona de Mediana Edad , Nariz/irrigación sanguínea , Nariz/efectos de los fármacos , Alcohol Polivinílico/administración & dosificación , Alcohol Polivinílico/uso terapéutico , Estudios Prospectivos , Tampones Quirúrgicos/efectos adversos , Tampones Quirúrgicos/normas , Ácido Tranexámico/uso terapéutico
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