[The clinical and bacteriological study of the effectiveness of the application of silver nanoparticle for the treatment of tuberculosis]. / Kliniko-bakteriologicheskoe issledovanie éffektivnosti ispol'zovaniia nanochastits serebra dlia lecheniia tuberkuleza verkhnikh dykhatel'nykh putei.

The objective of the present study was to evaluate the expediency of the application of nano-scale silver preparations, argovit-C and vitargol, differing in concentration for the treatment of tuberculosis of the upper respiratory tract. The study was carried out based at the Karachaevo-Cherkessian TB dispensary. It has been demonstrated that the 3.3% solution of argovit-C possessed of the 100% bactericidal activity with respect to the medically-resistant mycobacteria at both maximum and minimal concentrations of isoniazid. Based on these findings, this preparation was chosen for the clinical study. It was shown to exhibit a higher therapeutic effectiveness in comparison with the standard anti-tuberculosis treatment. The authors conclude that the inhalation of the 3.3% argovit-C solution twice daily for 10 minutes during 2 months can be recommended for the local treatment of laryngeal tuberculosis.

Appearance and morphologic features of laryngeal tuberculosis using laryngoscopy: A retrospective cross-sectional study.

ABSTRACT: Laryngeal tuberculosis (LTB) is highly contagious and can cause permanent laryngeal damage. Therefore, correctly identifying laryngoscopic LTB lesion locations, sizes, and morphologic features are essential for LTB diagnoses. This study aimed to explore the appearance and morphologic features of LTB and correlated these features with clinical symptoms.We retrospectively analysed 39 LTB patients in our hospital between January 2013 and December 2019. Medical records, including clinical presentation, lesion appearance (locations, sizes, and morphology), complementary examination results, and histopathologic features were summarized and analysed.In this patient cohort, dysphonia and sore throat were the two most common clinical symptoms. In LTB patients with extensive lesions, ulcerative lesions were most common, and the proportion of cases with concurrent pulmonary tuberculosis (86.4%, P = .033) infection was higher, as were the positive rates of sputum smears (72.7%, P = .011) and cultures (86.4%, P = .002) than patients without concurrent pulmonary TB and with more localized and exophytic lesions. The histopathologic features of LTB-related ulcerative lesions included fewer granulomas and more areas with caseous necrosis. These lesions were more likely to have acid-fast bacilli detected with a Ziehl-Neelsen stain than exophytic lesions that rarely showed detectable bacilli.A complete knowledge regarding the visual and morphologic features of LTB on laryngoscopy is needed for the early detection and diagnosis of LTB. Our study revealed the lesion sites, sizes, and morphologic features of LTB. These parameters were also correlated with patient clinical symptoms. Future studies are needed to support and expand the results of this retrospective study.

A 51-Year-Old Man With Hoarseness of Voice.

CASE PRESENTATION: A 51-year-old nonsmoking man presented to his general practitioner with a primary complaint of 4 months of progressive hoarseness, and was subsequently referred to an otolaryngologist. He had no relevant medical or surgical history. He did not take any chronic medications or supplements. He was born in the Dominican Republic and moved to New York City when he was 36 years old. He worked in construction. In his spare time, he would return to his home country. The patient was a lifelong nonsmoker and reported no alcohol consumption. He denied shortness of breath, cough, sputum expectoration, fevers, chills, and night sweats.

Primary Laryngeal Tuberculosis: Our Experiences at a Tertiary Care Teaching Hospital in Eastern India.

INTRODUCTION: Primary laryngeal tuberculosis is a chronic bacterial infection of the larynx by Mycobacterium tuberculosis without affecting the lungs. It is a rare type of extrapulmonary tuberculosis seen in clinical practice. OBJECTIVES: This study aimed to evaluate the clinical presentation, diagnosis, and treatment of primary laryngeal tuberculosis at a tertiary care teaching hospital in eastern India. MATERIALS AND METHODS: This is a retrospective study of 11 cases of primary laryngeal tuberculosis managed between December 2013 and January 2018. The detailed clinical presentations, investigations, and treatment of primary laryngeal tuberculosis of the patients were studied. RESULTS: Primary laryngeal tuberculosis is common in men with mean age of 38.63 years. Hoarseness of the voice is the most common symptom, and the most common site for primary laryngeal tuberculosis is the vocal fold with ulcerative lesion. Endoscopic examinations of the larynx in laryngeal tuberculosis are nonspecific and are to be confused with laryngeal cancer. Histopathological and bacteriological examinations are confirmatory tests for the diagnosis. After confirmation of the diagnosis, all patients had taken antitubercular therapy for 6 months, which gave excellent outcome. CONCLUSIONS: Delayed diagnosis or untreatable laryngeal tuberculosis will lead to high morbidity and mortality of the patient. Although primary laryngeal tuberculosis has nonspecific clinical presentations, it is very important to have a high index of suspiciousness to rule out tubercular lesion in the larynx as this disease is curable.

Flow-volume loops: clinical correlation.

Flow volume loops are an essential part of spirometry testing. Their appearance can give information that can be helpful in the differential diagnosis of a patient's clinical condition. We present two clinical scenarios in which careful evaluation of the flow-volume loop gives an insight into the cause of the disease process.

Laryngeal tuberculosis. A cause of stridor in children.

The number of tuberculosis (TB) cases reported in the United States has been on the decline for the last three decades. This trend has been dramatically reversed in the past few years, largely owing to the human immunodeficiency virus epidemic. Laryngeal TB, while well recognized in the adult population, is a rare disease in children. Only six cases have been described in the world literature since 1960. We describe three children with laryngeal TB who presented with stridor. One child required an emergency tracheotomy for control of the airway. The pathogenesis of laryngeal TB in children is postulated to differ from that in adults. In children primary infection of the larynx occurs, while in adults, laryngeal infection is secondary to pulmonary disease. All patients had triple anti-TB chemotherapy for 1 year. Laryngeal TB, although rare, may be seen more frequently in the near future and the diagnosis should always be considered.

Laryngeal tuberculosis: a case report.

A case of laryngeal tuberculosis, in a 21-year-old female, is presented. The pathophysiology and natural course of the disease are discussed. The incidence of apical tuberculosis and associated laryngeal spread is noted.

A clinical and videostroboscopic evaluation of laryngeal tuberculosis.

A series of 31 cases of tuberculous laryngitis is reviewed to assess the diagnostic features of the disease. The condition generally presents in males of late middle age who have pulmonary tuberculosis. It presents in a manner similar to laryngeal carcinoma except that painful dysphagia is a prominent symptom. Histological examination of biopsy material is usually the diagnostic procedure. Stroboscopy was able to document a number of abnormalities which included abnormalities of laryngeal configuration, vibratory asymmetry, reduction of amplitude and mucosal wave. Symptoms responded well to antituberculous chemotherapy.

[Rare case of laryngeal tuberculosis]. / Rzadki przypadek gruzlicy krtani.

In this work was described one case tuberculosis of the larynx. Provisional diagnosis was tumor of the larynx, because of similar symptoms. Authors described diagnostic and treatment which should be carry out in the similar cases.

[Tuberculosis of the larynx in patients treated in laryngological clinic No. 2 in Zabrze]. / Gruzlica krtani u chorych leczonych w II Klinice Laryngologii Sl. AM w Zabrzu.

3 cases of tuberculosis of the larynx were presented in this paper. Provisional diagnosis was tumor of the larynx. Further specialistic investigations e.g. MDL and biopsy were done and revealed proper diagnosis tuberculosis of the larynx.

Vocal quality of patients treated for laryngeal tuberculosis, before and after speech therapy.

OBJECTIVES: To evaluate dysphonia in patients treated for laryngeal tuberculosis, and to assess the effect of speech therapy on patients' vocal quality. MATERIALS AND METHODS: Seven of 23 patients with a confirmed diagnosis of laryngeal tuberculosis, treated at the Evandro Chagas Institute of Clinical Research, Oswaldo Cruz Foundation, underwent speech therapy for six months. These seven patients were evaluated by videolaryngoscopy and vocal acoustic analysis, before, during and after a course of speech therapy. RESULTS: The 23 patients with laryngeal tuberculosis comprised five women and 18 men, with ages ranging from 25 to 83 years (mean 41.3 years). Dysphonia was present in 91.3 per cent of these laryngeal tuberculosis patients, being present as the first symptom in 82.6 per cent. In laryngeal tuberculosis patients with dysphonia, laryngeal tuberculosis treatment resulted in dysphonia resolution in only 15.8 per cent. After speech therapy, dysphonia patients had better vocal quality, as demonstrated by statistical analysis of jitter, shimmer, fundamental frequency variability, maximum phonation time, and the ratio between maximum phonation time for voiceless and voiced fricative sounds. CONCLUSIONS: Following treatment of laryngeal tuberculosis, the incidence of dysphonia was very high. Speech therapy improved patients' vocal quality.

Intervenção fonoaudiológica precoce nos distúrbios vocais em pacientes com tuberculose laríngea / Early intervention speech therapy in in voice disorders in patients with laryngeal tuberculosis

INTRODUÇÃO: Embora possa ser tratada clinicamente com sucesso, a tuberculose laríngea (TBL) pode causar mudanças irreversíveis na qualidade da voz. Raros estudos relatam intervenções fonoaudiológicas para tratar a disfonia na TBL. OBJETIVO: Avaliar a qualidade vocal dos pacientes com TBL em atividade e os efeitos da intervenção fonoaudiológica precoce na reabilitação das funções vocais alteradas nesses indivíduos. MÉTODO: Esta dissertação é composta por dois artigos desenvolvidos com dados de pacientes com TBL atendidos no Instituto de Pesquisa Clínica Evandro Chagas, Fundação Oswaldo Cruz, no período de 2010 a 2013. No primeiro foram relatadas as alterações anatômicas e vocais de três pacientes com TBL ativa antes de iniciar o tratamento. No segundo artigo foi realizado um estudo longitudinal para avaliar o impacto da terapia fonoaudiológica na recuperação das alterações vocais diagnosticadas ao início do tratamento da TBL em 11 pacientes. As avaliações fonoaudiológicas iniciais e finais foram comparadas através dos testes de McNemar, T de Student, sinal de Wilcoxon, Friedman e do Chi quadrado, considerando-se significativos os valores de p<0,05. RESULTADOS: No primeiro artigo, entre os indivíduos avaliados, observou-se que os principais sítios afetados foram as pregas vocais, pregas ariepiglóticas, aritenóides e epiglote e os principais sintomas foram disfonia, disfagia e odinofagia. No segundo artigo, foram avaliados 11 pacientes com uma média de idade 56,55 anos (±18,31), 2 eram do sexo feminino e 9 do sexo masculino, 4 pacientes eram tabagistas e 7 etilistas. A TBL e tuberculose pulmonar estavam associadas em 9 indivíduos. Nestes, encontrou-se inicialmente 100 por cento de disfonia, 54,5 por cento de disfagia e 45,5 por cento de odinofagia...

INTRODUCTION: Although it can be treated medically with success, laryngeal tuberculosis (LT) can cause irreversible changes in voice quality. Few studies report speech therapy interventions to treat dysphonia in LT. OBJECTIVE: To evaluate the vocal quality of patients with LT in activity and the effects of early languageintervention in the rehabilitation of vocal functions altered in these individuals. METHOD: This dissertation consists of two papers developed with data from patients with TBL that were treated at Clinical Research Institute Evandro Chagas, Oswaldo Cruz Foundation, in the period 2010-2013. In the first anatomical changes andvocals from three patients with active LT were reported before starting treatment. In the second article, a longitudinal study was conducted to evaluate the impact of speech therapy in the recovery of vocal disorders diagnosed at initiation of treatmentof LT in 11 patients. The initial and final speech evaluations were compared using the McNemar test , Student t, Wilcoxon sign , Friedman and Chi square and p values < 5 percent were considered significant. RESULTS: In the first article the main sites affected were the vocal folds, aryepiglottic folds, arytenoids and epiglottis and the main symptoms were dysphonia, dysphagia and odynophagia. In the second article we evaluated 11 patients with a mean age of 56.55 years (± 18.31), 2 females and 9 males, 4 patients were smokers and drinkers 7. The LT were associated with pulmonary tuberculosis and 9. These patients initially find 100 percent of dysphonia, dysphagia 54.5 percent and 45.5 percent of odynophagia. The most affected sites were the larynx: vocal folds in 81.8 percent, 63.6 percent in vestibular folds, epiglottis in 36.4 percent, 27.3 percent arytenoids, aryepiglottic folds in 36.4 percent, and interarytenoid space 9.1 percent...

Flow-volume loops: clinical correlation

Flow volume loops are an essential part of spirometry testing. Their appearance can give information that can be helpful in the differential diagnosis of a patient's clinical condition. We present two clinical scenarios in which careful evaluation of the flow-volume loop gives an insight into the cause of the disease process.