Bacteriology in burn patients undergoing mechanical ventilation.

In this paper the authors introduce a retrospective study of the incidence of infectious processes in the Burns Unit of the Cruces Hospital (Bilbao), in those patients treated between 1995 and 1998, and who needed, for different reasons, mechanical ventilatory support. The most common microorganisms found in wound cultures, plugged telescoping catheter and blood cultures and analyse variations throughout the stay in the Burns Unit are described.

[Microbiology of acute external otitis in our environment]. / Análisis microbiológico de las otitis externas agudas en nuestro medio.

The paper deals with the review done by the AA. about the microbiology of 135 acute diffuse external otitis cases, treated at their Department in one year term. In the series is emphasized the seasonal distribution, steadily uniform in the studied period, being the Pseudomonas aeruginosa and Candida albicans the paramount responsible for these otitis.

[Retropharyngeal abscess due to atypical mycobacteria. Case report]. / Absceso retrofaríngeo por micobacterias atípicas. Estudio de un caso.

It is a rare clinico-pathological infection located in the retropharyngeal space. Our contribution refer to a young man suffering this complaint caused by atypical mycobacteria, being the aim of the paper to underline the exceptional placement. The difficulties encountered in establishing the bacteriological diagnosis as well the excellent response to a combined treatment with tuberculostatics and surgery.

[Syndrome of multiple nevoid basal cell carcinoma]. / Síndrome de carcinoma basocelular nevoide múltiple.

The paramount features of the multiple nevoid basal Carcinoma, the so-called Gorlin's syndrome, are the presence of multiple maxillary cysts (odontogenic keratocysts), several nevoid basal cells carcinomata and some skeletal anomalies. Since its first description, due to Jarish (1894), at least about 250 cases have been published. The odontogenic keratocysts present themselves with ENT symptoms, specially when arising on the upper maxillary bone or on the homonymous sinus. Owing to this reason, the AA. of the paper, recall the clinic aspects of the condition.

[Kikuchi's necrotizing lymphadenitis. Clinical and pathological study of a new case]. / Linfadenitis necrotizante de Kikuchi. Estudio clínico-patológico de un nuevo caso.

Contribution to the topic with the case of a woman, 24, admitted in our ENT Department for exam and treatment of multiple right sided adenopathies of the neck. The histopathological study was consistent with diagnosis of Kikuchi's necrotizing lymphadenitis. This is a new clinicopathologic entity first described, 1972, by Kikuchi, of unknown etiology, an a picture characterized for painful cervical lymphadenitis presented in young women and healing spontaneously after 2-3 months course. We want to emphasize in this paper the scarcity of cases published and the difficulties arising when dealing with the differential diagnosis with lympho-proliferative malignancies as well.

[Malignant rhinosinusal inverted papilloma with orbital involvement]. / Papiloma invertido nasosinusal malignizado con invasión orbitaria.

Contribution with the case of a woman 55-year-old in whom was objectified the recurrence of an inverted rhinosinusal papilloma and, under the anatomopathological viewpoint, an epidermoid carcinoma on the inverted papilloma. Was treated with surgery and radiotherapy. Remarks on several clinical, pathological and therapeutic aspects about inverted rhinosinusal papillomata, underlying its uncertain course so characteristic of these neoformations.

[Cystic formations of the maxilla. Case report]. / Formaciones quísticas de los maxilares. A propósito de un caso.

The case of a man, 28, addressed to our ENT-Department complaining of pain and swelling of the left half of the face is presented. After X-Ray and tomographic study the diagnosis of an included tooth inside the maxillary sinus, accompanied by one cyst, is evidenced. In addition a canine tooth as well included on the floor of the nose and under the lower homonyme turbinate, is disclosed. Through sinusal approach, via Caldwell-Luc, are removed the lesions encountered. Then, the AA., attempt to classify the group of several cystic structures of maxillary sitting, aiming at unify the nomenclature of this pathology, and made a brief description of each type.

[Pathology of the external ear. A year's review]. / Patología del oído externo. Revisión de un año.

The purpose of this paper is to study the incidence of external ear pathology in our ENT Service in the period between November 1987 and November 1988. During this period 238 cases of this pathology were diagnosed.

[Malignant nasosinusal melanoma: apropos of a case]. / Melanoma maligno nasosinusal: a propósito de un caso.

We present a case of a nasosinusal malignant melanoma with a really fulminant evolution, as the patient died two and a half months after the diagnostic biopsy and five months after the initial symptoms. A bibliographic review of these rare tumours is realized, and those data of the world literature we could reach concerning to incidence, clinic features, histopathology, diagnosis, treatment, and prognosis, are analyzed.

[Cystic lymphangioma]. / Linfangioma quístico.

Lymphangioma is a benign, congenital type of tumour which can be classified as a malformation of the lymphatic vessels with an enlargement and a proliferation of same. It is divided, depending on the calibre of the vessels, into Capillary, Cavernous and cystic. 80% of these lesions are located in the neck; 50% of these cases are already evident at the moment of birth and 90% prior to the 2nd year of life. Its treatment is surgical but, due to the large number of digitations present, its complete removal is difficult to achieve, thereby giving rise to frequent relapses. We are submitting the case of a three and a half-year-old girl who was operated on in our department. With this, we would like to contribute to a greater knowledge of this pathology.

[Tumor of the mouth floor: submucosal schwannoma]. / Tumoración del suelo de la boca: schwannoma submucoso.

We report a 77 years old patient with a tumour of the floor of the mouth. The long clinical evolution and its big size--longest diameter: 7.5 cm.--, are the most stringling clinical characteristics of this case. The pathologic study showed a schwannoma, a very unusual neoplasm in this situation. We focus our discussion in pathological aspects and differential diagnosis.

[Crocodile tears syndrome]. / Síndrome de las lágrimas de cocodrilo.

The syndrome of crocodile tears, or Bogorad's syndrome is a rare complication of the facial paralysis. It's characterized by lachrymation on the same side of the palsy in connection with stimulation of salivation (e.g. when eating). We present a case of Melkersson's syndrome who developed a syndrome of crocodile tears.

[Pharyngeal keratosis]. / Queratosis faríngea.

A case of keratosis pharyngis is presented. This disease is infrequent, benign and of etiology unknown. Clinically present horny outgrowths in the lymphatic tissue of the pharynx, but without symptoms. The horny projections sooner or later disappear spontaneously in months or years, however tonsillectomy seems to be indicated in all cases in which the symptoms are worrying the patient, who present an evident "cancerophobia" frequent symptom of this disease.

[Sinusal cystic adenoid carcinoma. Study of a case]. / Carcinoma adenoide quístico sinusal. Estudio de un caso.

One case of adenoid cystic carcinoma of maxillary sinus is reported. Is a malignant epithelial tumor which develops in major and minor salivary glands. Is the malignant tumor most common in the minor salivary glands. Incidence in the paranasal sinuses lies between 2-5% of all malignant tumors. These tumors grow by extensive local infiltration and perineural spread is a common feature. They are very high malignancy tumors.

[Osteoma of the mastoid]. / Osteoma de mastoides.

Osteoma of the mastoid is a osseous, benign and infrequent tumour. To date approximately 50 such cases in the world, and 7 cases in Spain have been described. Clinically this tumours are asymptomatic, except by cosmetic deformities, and are usually unsuspected roentgenographic findings. Treatment is surgical through a postauricular approach. A case of osteoma of the mastoid and a review of the literature is presented.

[Serous otitis and ciliary dyskinesia syndrome]. / Otitis serosa y síndrome de disquinesia ciliar.

Ciliary dyskinesia syndrome or immotile cilia syndrome, is a congenital defect in the ultrastructure of cilia, which result in a clinical expression diverse: recurrent respiratory infections, recurrent otitis media, infertility in the adult male, and half of those situs inversus. A case of ciliary dyskinesia syndrome is presented, who suffered of recurrent pneumonia and relapsing secretory otitis media.

Use of an autologous bioengineered composite skin in extensive burns: Clinical and functional outcomes. A multicentric study.

OBJECTIVE: We report clinical and functional outcomes obtained after application of an autologous bioengineered composite skin (ABCS) produced in a single Spanish tissue-engineering unit. MATERIALS/METHODS: Twenty-five burned patients treated with ABCS from 1999 to 2007 in five burn centres were included in the study. Mean age was 29 years (SD 11), with mean total body surface area (TBSA) burned being 74% (SD 17) and mean full-thickness injury of 61% (SD 19) of TBSA. RESULTS: The mean area initially engrafted with ABCS was 24% (SD 13) of TBSA, with a final take of 49% (SD 30, range 0-100%). ABCS achieved permanent coverage of a mean of 11% (SD 8) of TBSA. In subset analyses, lack of pre- and post-application wound bed infection and lack of serious acute systemic complications at the time of engraftment were significantly associated with better ABCS take. CONCLUSIONS: Final take obtained with ABCS could be improved with the use of non-cytotoxic topical antibiotics following engraftment. The use of plasma to prepare ABCS reduces production costs: cost-effectiveness ratio is not a limitation for its use. In terms of patient satisfaction, cosmetic/functional outcomes (general appearance, texture, flexibility, sensitivity and colour) of ABCS and split-thickness autografts are not different statistically.