Transcanal endoscopic carbon dioxide laser resection of early-stage (A1-B1) glomus tympanicum tumours: single-centre case series.

OBJECTIVE: To report a single-centre experience in the endoscopic carbon dioxide laser-assisted approach to glomus tympanicum tumours. METHODS: A retrospective case review was conducted of patients diagnosed with class A1 to B1 glomus tympanicum tumours who underwent exclusive transcanal endoscopic carbon dioxide laser surgery. RESULTS: Seven patients fulfilled the inclusion criteria. All patients (100 per cent) were women, with a mean age of 65.4 years (standard deviation, 13.6). There were five A2 tumours, one A1 tumour and one B1 tumour. One patient presented with a delayed tympanic membrane perforation needing myringoplasty on follow up. There were no substantial post-operative complications. The mean hospitalisation time was 9.5 hours (standard deviation, 9.8). The mean follow-up period was 32.7 months (standard deviation, 13.1), with all cases having resolution of pulsatile tinnitus and no tumour recurrence. CONCLUSION: The study provides further evidence on the safety and efficacy of endoscopic carbon dioxide laser surgery as a minimally invasive technique for treating early-stage glomus tympanicum tumours.

Blue laser for the exclusive endoscopic transcanal approach to middle ear paraganglioma.

BACKGROUND: The management of glomus tympanicum tumours can be challenging. Blue laser coagulation may improve bleeding control thus facilitating an endoscopic transcanal excision. The objective of this presentation is to illustrate the authors' experience using this novel tool. METHODS: Case report of a patient that underwent exclusive endoscopic transcanal blue laser surgery of a class A2 glomus tympanicum tumour in a tertiary referral center. CONCLUSION: The present study provides evidence of the safety and efficacy of endoscopic blue laser surgery, for the minimally invasive treatment of early-stage glomus tympanicum tumours.

Current opinion on laryngeal electromyography.

PURPOSE: This study evaluates expert opinion on laryngeal electromyography (LEMG). METHODS: A cross-sectional design was used to conduct an online survey of LEMG experts in 2021. They were questioned about the number LEMG performed annually, type of electrodes used, sector worked in, pain during the test, placement of the needle electrodes, interpretation of electrical muscle parameters, diagnosis of neuromuscular injury, prognostic sensitivity in vocal fold paralysis (VFP), laryngeal dystonia, tremor and synkinesis and quantifying LEMG. RESULTS: Thirty-seven professionals answered (23 Spanish and 14 from other countries), with a response rate of 21.56%. All physicians used LEMG. 91.9% had one- or two-years' experience and 56.8% performed 10-40 LEMG per year. 70.3% were otolaryngologists and 27%, neurologists. In 89.1% of cases, a team of electrodiagnostic physician and otolaryngologist performed LEMG. 91.3% of Spanish respondents worked in Public Health, 7.14% of other nationalities; 37.8% in a university department. Bipolar concentric needles electrodes were used by 45.9% and monopolar concentric by 40.5%. 57% professionals considered good patients' tolerance to the test. LEMG sensitivity was regarded as strong, median and interquartile range were 80.0 [60.0;90.0] to diagnose peripheral nerve injuries, less for other levels of lesions, and strong to evaluate prognosis, 70.0 [50.0;80.0]. Respondents believe locate the thyroarytenoid and the cricothyroid muscles with the needle, 80.0 [70.0;90.0], as opposed to 20.0 [0.00;60.0] the posterior cricoarytenoid. The interpretation of the electrical parts of the LEMG was strong, 80.0 [60.0;90.0]. LEMG identify movements disorders, 60.0 [20.0;80.0], and synkinesis, 70.0 [30.0;80.0]. The professionals prefer quantitative LEMG, 90.0 [60.0;90.0]. CONCLUSIONS: The experts surveyed consider LEMG that is well tolerated by patients. The insertional and spontaneous activity, recruitment and waveform morphology can be assessed easily. LEMG is mainly useful in the study of peripheral nerve injuries, and its value in VFP prognosis is considered strong.

Monitoring and tracking the spread of SARS-CoV-2 in Asturias, Spain.

Mutational analysis of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) can quantify the relative importance of variants over time, enable dominant mutations to be identified, and facilitate near real-time detection, comparison and tracking of evolving variants. SARS-CoV-2 in Asturias, an autonomous community of Spain with a large ageing population, and high levels of migration and tourism, was monitored and tracked from the beginning of the pandemic in February 2020 until its decline and stabilization in August 2021, and samples were characterized using whole genomic sequencing and single nucleotide polymorphisms. Data held in the GISAID database were analysed to establish patterns in the appearance and persistence of SARS-CoV-2 strains. Only 138 non-synonymous mutations occurring in more than 1 % of the population with SARS-CoV-2 were found, identifying ten major variants worldwide (seven arose before January 2021), 19 regional and one local. In Asturias only 17 different variants were found. After vaccination, no further regional major variants were found. Only half of the defined variants circulated and no new variants were generated, indicating that infection control measures such as rapid diagnosis, isolation and vaccination were efficient.

Balloon Eustachian tuboplasty for obstructive Eustachian tube dysfunction: retrospective multicentre cohort study of 248 patients.

OBJECTIVE: To present the results after balloon eustachian tuboplasty (BET) in patients with obstructive Eustachian tube dysfunction (OETD) grouped up into: baro-challenge, chronic serous otitis media and adhaesive otitis media. METHODS: A retrospective study was carried out on patients who underwent BET surgery. As outcome measures, otoscopy, tympanometry, Eustachian tube dysfunction questionnaire-7 (ETDQ-7) and ability to perform the Valsalva manoeuvre were recorded at baseline and at 3, 12 and 24 months after BET. A p value of 0.05 was used to indicate a statistically significant difference for all statistical tests. RESULTS: Three hundred and nineteen ears (248 patients) were included with a 3-month follow-up, 272 ears had a 12-month follow-up, and 171 ears had 24-month follow-up. Globally, a statistical significance improvement in all groups in all outcome measures was found. According to BET indication, in the baro-challenge group, there was no improvement in otoscopy, but ETDQ-7, Valsalva manoeuvre and tympanogram improved significantly. In the chronic serous otitis media group, otoscopy, ETDQ-7 and Valsalva manoeuvre were significantly improved in all the three timelines, including the avoidance of a new transtympanic tube after the BET in over 80% of cases. In the adhaesive otitis media group, Valsalva manoeuvre improved significantly, ETDQ-7 decreased and tympanogram improved but not significantly. Few mild complications were reported. CONCLUSIONS: BET is an effective method for the treatment of OETD in all etiologic groups. The greatest benefit was observed in patients with baro-challenge. A long-term follow-up is recommended since the benefit seems to increase over time.

Particularidades del abordaje transcanal endoscópico de los tumores benignos de oído medio en adultos / Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients

Antecedentes y objetivo: La cirugía mínimamente invasiva de tumores benignos del oído medio es posible mediante el uso del endoscopio. La mejor iluminación y la visión más amplia que ofrece permiten el abordaje transcanal de estos raros tumores. El objetivo del presente trabajo es sintetizar los puntos clave de su diagnóstico y tratamiento, a través de una serie propia de casos.Materiales y métodosEstudio retrospectivo de tumores benignos de oído medio intervenidos exclusivamente por vía transcanal endoscópica en un hospital universitario de tercer nivel, de adultos, entre junio de 2018 y junio de 2020. El seguimiento postoperatorio se realizó mediante otoendoscopia y audiometría.ResultadosFueron intervenidos durante el periodo de estudio 6 pacientes; 5 fueron mujeres y uno fue hombre, con una edad media de 57,8 años (± 21,9). Cuatro tumores estaban en el oído izquierdo y 2 en el oído derecho. Estos incluían 4paragangliomas timpánicos (3 de tipo I y uno de tipo II), un neurinoma de cuerda de tímpano y un colesteatoma congénito. No hubo complicaciones postoperatorias graves. En el momento actual no se ha constatado recidiva tumoral en ninguno de los casos, con un seguimiento mínimo de 7 meses.ConclusionesEl presente estudio añade evidencia sobre la seguridad y eficacia de la cirugía transcanal endoscópica de oído, como técnica mínimamente invasiva, para el tratamiento de tumores benignos de oído medio confinados en la cavidad timpánica. (AU)

Background and objective: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarize its key points through a case series.Materials and methodsRetrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry.ResultsSix patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (± 21.9). Four tumours were in the left ear and 2 in the right ear. These included 4tympanic paragangliomas (3 type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months.ConclusionsThe present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity. (AU)

Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients.

BACKGROUND AND OBJECTIVE: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarise its key points through a case series. MATERIALS AND METHODS: Retrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry. RESULTS: Six patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (±21.9). Four tumours were in the left ear and 2 in the right ear. These included four tympanic paragangliomas (three type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months. CONCLUSIONS: The present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity.

Nuances in transcanal endoscopic approach to benign middle ear tumours in adult patients. / Particularidades del abordaje transcanal endoscópico de los tumores benignos de oído medio en adultos.

BACKGROUND AND OBJECTIVE: Minimally invasive surgery of benign middle ear tumours is possible by using the endoscope. The optimal lighting and the broadest vision it offers, allow a transcanal approach to these rare tumours. The objective of this work is to summarize its key points through a case series. MATERIALS AND METHODS: Retrospective study of benign middle ear tumours that underwent exclusive endoscopic surgery in a third-level adult university hospital between June 2018 and June 2020. Postoperative follow-up was performed by otoendoscopy and audiometry. RESULTS: Six patients underwent surgery during the study period. Five patients were female and one male, with an average age of 57.8 years (± 21.9). Four tumours were in the left ear and 2 in the right ear. These included 4tympanic paragangliomas (3 type I and one type II), a chorda tympani neuroma, and a congenital cholesteatoma. There were no serious postoperative complications. At present, no tumour recurrence has been found in either case, with a minimum follow-up of 7 months. CONCLUSIONS: The present study adds evidence on the safety and efficacy of endoscopic transcanal ear surgery, as a minimally invasive technique, for the treatment of benign middle ear tumours confined to the tympanic cavity.

Student and Faculty Perspectives of Inclusive Teaching Practices in Teacher Training Degree Programs / Perspectivas de Alunos e Professores de Práticas de Ensino Inclusivas Em Programas de Formação de Professores

ABSTRACT: This study focuses on student and faculty perceptions about inclusive instructional practices in teacher training degree programs in three different universities (two in Spain and one in the USA). We synthetize this framework into four dimensions: (a) identifying students' needs and strengths, (b) accessibility to physical spaces and materials, (c) methodologies and strategies to engage students, and (d) valuing diversity as a resource. A mixed methodology (questionnaire and interviews) was used to collect the information. Six hundred fifty-three university students and 35 faculty from the different education colleges participated in this study. Findings reveal the perceptions of students and faculty regarding both effective practices for diverse inclusive university classrooms as well as barriers to inclusion that affect learning in the participating institutions. Results reflect serious discrepancies between students and faculty members.

RESUMO: Este estudo foca as percepções dos alunos e do corpo docente sobre práticas instrucionais inclusivas em programas de formação de professores em três universidades diferentes (duas na Espanha e uma nos EUA). Sintetizamos essa estrutura em quatro dimensões: (a) identificação das necessidades e pontos fortes dos alunos, (b) acessibilidade aos espaços físicos e materiais, (c) metodologias e estratégias para engajar os alunos, e (d) valorização da diversidade como um recurso. Uma metodologia mista (questionário e entrevistas) foi utilizada para coletar as informações. Participaram deste estudo 653 estudantes universitários e 35 professores das diferentes faculdades de educação. Os resultados revelam as percepções dos alunos e do corpo docente tanto em relação às práticas efetivas para salas de aula universitárias inclusivas diversas quanto às barreiras à inclusão que afetam a aprendizagem nas instituições participantes. Os resultados refletem sérias discrepâncias entre alunos e docentes.

Consenso sobre el tratamiento de la disfunción tubárica obstructiva mediante dilatación con balón / Consensus on treatment of obstructive Eustachian tube dysfunction with balloon Eustachian tuboplasty

OBJETIVO: Existe una gran variabilidad en el diagnóstico de la disfunción tubárica obstructiva y su tratamiento mediante la dilatación tubárica con balón (DTB). El objetivo de este trabajo es presentar unas recomendaciones de consenso sobre las indicaciones, contraindicaciones, metodología, complicaciones y resultados de la DTB. MATERIALES Y MÉTODOS: Presentamos un consenso sobre la DTB, mediante revisión sistemática de la literatura desde 1966 hasta noviembre de 2018, términos MESH Eustachian tube and (dilation or dysfunction), recogiendo un total de 1.943 artículos en español, inglés, alemán y francés. Del total de artículos revisados se seleccionaron 139 cuyo abstract era relevante, incluyendo 2 consensos internaciones sobre diagnóstico, 7 revisiones sistemáticas y 2 ensayos clínicos aleatorizados sobre la DTB. RESULTADOS: Las indicaciones de la DTB son el barotrauma, la otitis media secretora, la otitis media adhesiva, la atelectasia y el fracaso de una timpanoplastia, siempre que se haya podido demostrar una disfunción tubárica obstructiva crónica. La efectividad de la DTB es mayor en el barotrauma y la otitis media secretora. Hay estudios publicados de elevada evidencia sobre la DTB, cuyos buenos resultados se mantienen a largo plazo, frente a tratamiento médico conservador. CONCLUSIONES: La DTB es un procedimiento quirúrgico mínimamente invasivo que ha demostrado su efectividad y seguridad en el tratamiento de la disfunción tubárica crónica en adultos y en niños. Las indicaciones en las que es más efectiva son el barotrauma y la otitis media secretora

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Consensus on treatment of obstructive Eustachian tube dysfunction with balloon Eustachian tuboplasty. / Consenso sobre el tratamiento de la disfunción tubárica obstructiva mediante dilatación con balón.

OBJECTIVE: There is a great variability in diagnosis of obstructive Eustachian tube dysfunction and its treatment by balloon Eustachian tuboplasty (BET). The aim of this paper was to present a consensus on indications, contraindications, methodology, complications and results after BET. MATERIAL AND METHODS: We obtained a consensus on BET, after a systematic review of the literature on BET from 1966 to November 2018, using MESH terms «Eustachian tube and (dilation or dysfunction)¼, including a total of 1.943 papers in Spanish, English, German and French. We selected 139 papers with a relevant abstract, including two international consensuses, seven systematic revisions, and two randomised control trials on BET. RESULTS: The indications for BET are barotrauma, serous otitis media, adhesive otitis, atelectatic middle ear and failure after tympanoplasty, once obstructive Eustachian tube dysfunction is confirmed. BET is more effective in barotrauma and serous otitis media. There are high- evidence reports on BET showing good results that persist long-term, as compared to conservative medical treatment. CONCLUSIONS: BET is a surgical, minimally invasive treatment that has shown its effectiveness and safety in obstructive Eustachian tube dysfunction in adults and children. It is most effective in barotrauma and serous otitis media.

Self-reported competences and problems in Spanish adolescents: a normative study of the YSR / Competencias y problemas autoinformados por adolescentes en el YSR

The aim of the study was to provide a standardization of self-reported competences and emotional/behavioural problems in Spanish adolescents, using the Achenbach’s Youth Self-Report (YSR), and to compare our results to those from other countries. The YSR was completed by 2822 adolescents aged 11-18 years, recruited from secondary schools in two regions of Spain. There were significant differences in Total behaviour problems and in most problem scales in boys and girls, scoring boys higher on externalizing syndromes, whereas girls score higher on internalizing syndromes . Males’ mean scores were higher than females’ scores for social competence. Age effects also showed significant differences with respect to internalizing problems, thought problems, social problems and depression. Cut-off points based on the 90th and 98th percentile developed from this sample are presented for the competences and the problem scales. To test the overall range of variations across cultures, comparisons were made between broad band and narrow band measures of the YSR in Spanish adolescents and those from other countries. Gender differences in the YSR were similar to those found across different cultures; there is a consistent trend to increase behavioural problems with age; and social competence seem to be a relevant protective factor against behavioural problems

El objeto del estudio consistió en estandarizar las competencias y los problemas emocionales/comportamentales autoinformados mediante el Youth Self-Report (YSR) de Achenbach, en una muestra de 2.822 adolescentes de 11-18 años de dos regiones españolas, y comparar nuestros resultados con los observados en otros países. Se han encontrado diferencias significativas entre varones y mujeres en la puntuación total de problemas de conducta y en la mayor parte de las escalas, puntuando los varones más alto en los síndromes externalizantes y las mujeres en los síndromes internalizantes. Los varones obtuvieron puntuaciones medias más altas que las mujeres en competencia social. Se han observado también diferencias significativas en problemas internalizantes, problemas del pensamiento, problemas sociales y depresión, comparando grupos de edad. Se presentan puntos de corte basados en los percentiles 90 y 98 para las escalas de competencias y de conductas problema. Se presentan, además, comparaciones de las medidas de la psicopatología de banda ancha y banda estrecha del YSR entre los adolescentes españoles y los de otros países. Las diferencias intersexos en el YSR fueron similares a las encontradas en diferentes culturas; se ha observado una clara tendencia a aumentar los problemas de conducta con la edad; y la competencia social parece ser una protección importante frente a los problemas de conducta

Self-reported competences and problems in Spanish adolescents: a normative study of the YSR.

The aim of the study was to provide a standardization of self-reported competences and emotional/behavioural problems in Spanish adolescents, using the Achenbach's Youth Self-Report (YSR), and to compare our results to those from other countries. The YSR was completed by 2822 adolescents aged 11-18 years, recruited from secondary schools in two regions of Spain. There were significant differences in Total behaviour problems and in most problem scales in boys and girls, scoring boys higher on externalizing syndromes, whereas girls score higher on internalizing syndromes . Males' mean scores were higher than females' scores for social competence. Age effects also showed significant differences with respect to internalizing problems, thought problems, social problems and depression. Cut-off points based on the 90th and 98th percentile developed from this sample are presented for the competences and the problem scales. To test the overall range of variations across cultures, comparisons were made between broad band and narrow band measures of the YSR in Spanish adolescents and those from other countries. Gender differences in the YSR were similar to those found across different cultures; there is a consistent trend to increase behavioural problems with age; and social competence seem to be a relevant protective factor against behavioural problems.

Marcadores de membrana linfocitaria en pacientes con fiebre hemorrágica por dengue / Surface markers for lymphocytes in patients with dengue hemorrhagic fever

Se investigan los marcadores de membrana en 78 pacientes (28 adultos y 50 niños) que presentan fiebre hemorrágica por dengue (FHD), durante la epidemia ocurrida en Cuba en el año 1981. El grupo de adultos está formado por 15 hombres y 13 mujeres. La edad promedio es de 32 años con un rango de 16 a 75 años. La distribución por sexo de los niños es de 24 varones y 26 hembras. En ellos da edad promedio es de 9 años, con un rango de 4 a 14 años. De acuerdo con los resultados serológicos, estos enfermos se consideran casos de reinfección. El agente etiológico identificado es el serotipo 2 del virus dengue. Con vistas a correlacionar las pruebas de laboratorio con el cuadro clínico los enfermos se clasifican en: leves, moderados, severos y graves. En los niños se encuentra correlación entre el estado de gravedad y el número de linfocitos T, medidos por la técnica de roseta espontánea total. Se sugiere que la cuantificación de los linfocitos T de la sangre periférica de los pacientes con FHD puede considerarse como un indicador del estado de gravedad de esta enfermedad

Marcadores de membrana linfocitaria en pacientes con fiebre hemorrágica por dengue

Se investigan los marcadores de membrana en 78 pacientes (28 adultos y 50 niños) que presentan fiebre hemorrágica por dengue (FHD), durante la epidemia ocurrida en Cuba en el año 1981. El grupo de adultos está formado por 15 hombres y 13 mujeres. La edad promedio es de 32 años con un rango de 16 a 75 años. La distribución por sexo de los niños es de 24 varones y 26 hembras. En ellos la edad promedio es de 9 años, con un rango de 4 a 14 años. De acuerdo con los resultados serológicos, estos enfermos se consideran casos de reinfección. El agente etiológico identificado es el serotipo 2 del virus dengue. Con vistas a correlacionar las pruebas de laboratorio con el cuadro clínico los enfermos se clasifican en: leves, moderados, severos y graves. En los niños se encuentra correlación entre el estado de gravedad y el número de linfocitos T, medios por la técnica de roseta espontánea total. Se sugiere que la cuantificación de los linfocitos T de la sangre preiférica de los pacientes con FHD puede considerarse como un indicador del estado de gravedad de esta enfermedad(AU)