Differences in acute external injuries of the larynx and cervical trachea between peace-time and war trauma were studied. Twenty-six patients with peace-time injuries and 39 patients with war injuries were retrospectively analyzed. The incidence of peace-time laryngotracheal injuries was 0.91% of the total number of patients hospitalized for head and neck injuries. In the groups of wounded in action (WIA) and killed in action (KIA) with head and neck war injuries, the incidence of laryngotracheal injuries was 4.8 and 6.2%, respectively. According to the type of the wound, blunt injuries were most common among peace-time and penetrating wounds among war injuries. There was no difference between peace-time and war injuries according to the wound localization. War wounds were more severe, caused more extensive local tissue and organ defects, were associated with a greater number of lesions to the neck and other body regions and more often required reconstructive surgical procedures than peace-time injuries. The mortality of war laryngotracheal injuries was two times greater than that of peace-time lesions (9 vs. 3.8%).
The aim of this study was the determination of bacteria present in maxillary and ethmoid cavities in patients with chronic sinusitis and to correlate these findings with bacteria simultaneously present in their nasopharynx. The purpose of this correlation was to establish the role of bacteria found in chronically inflamed sinuses and to evaluate if the bacteria present colonized or infected sinus mucosa. Nasopharyngeal and sinus swabs of 65 patients that underwent functional endoscopic sinus surgery were cultivated and at the same time the presence of leukocytes were determined in each swab. The most frequently found bacteria in nasopharynx were Staphylococcus aureus, Staphylococcus epidermidis, Streptococcus spp., Streptococcus viridans and Streptococcus pneumoniae. Maxillary or ethmoidal sinus swabs yielded bacterial growth in 47 (72.31%) patients. The most frequently found bacteria in sinuses were Staphylococcus epidermidis, Staphylococcus aureus, Klebsiella spp. and Streptococci (pneumoniae, viridans and spp.). The insignificant number of leukocytes was present in each sinus and nasopharyngeal swab. Every published microbiology study of chronic sinusitis proved that sinus mucosa were colonized with bacteria and not infected, yet antibiotic therapy was discussed making no difference between infection and colonization. Chronic sinusitis should be considered a chronic inflammatory condition rather than bacterial infection, so routine antibiotic therapy should be avoided. Empiric antibiotic therapy should be prescribed only in cases when the acute exacerbation of chronic sinusitis occurs and the antibiotics prescribed should aim the usual bacteria causing acute sinusitis. In case of therapy failure, antibiotics should be changed having in mind that under certain circumstances any bacteria colonizing sinus mucosa can cause acute exacerbation of chronic sinusitis.
Relapsing polychondritis is an autoimmune disease that primarily manifests as cartilaginous tissue destruction. However, the immune impairment may also involve noncartilaginous tissues such as kidneys, blood vessels, etc. The disease may occur as a primary disorder or in association with other diseases. The case of a female patient with concurrent manifestation of myelodysplastic syndrome-refractory anemia with excess blasts, and relapsing polychondritis, is presented. The diagnosis of relapsing polychondritis was established ten months after the diagnosis of myelodysplastic syndrome, when the criteria for the former were met. Total hearing loss and blindness developed soon thereafter.
Background. Ultrasound energy during phacoemulsification can cause mechanical trauma to corneal endothelium which leads to prolonged postoperative recovery. Several studies have reported conflicting results of corneal changes after phacoemuslification in diabetic versus non-diabetic patients. We aimed to assess corneal edema recovery and compare best corrected visual acuity (BCVA) after phacoemulsification in patients with diabetes mellitus type 2 versus patients without type 2 diabetes. Methods. The study included type 2 diabetic and nondiabetic patients who underwent phacoemulsification between November 2018 and May 2019. Assessments of corneal edema recovery were done preoperative and on postoperative day 1, after 1 week and after two months. BCVA were taken preoperative and postoperative after 1 week and 2 months after the surgery. Results. There was no significant difference between groups in corneal status on checkup examinations. Corneal edema recovery was equal between the patients with and without diabetes mellitus type 2. No significant difference in mean BCVA was observed between the studied groups after the operation. Conclusion. Considering the use of modern technology in cataract surgery, there was no difference in postoperative results between non-diabetic and type 2 diabetic patients.
Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis. Th e study included 176 patients with acute facial palsy divided into three groups based on serologic testing: borreliosis, Bell's palsy, and facial palsy caused by herpes simplex virus type 1 (HSV-1). Study patients underwent baseline audiometry with tympanometry and acoustic reflex, whereas current state of facial palsy was assessed by the HB scale. Subsequently, the same tests were obtained on three occasions, i.e. in week 3, 6 and 12 of presentation. Th e patients diagnosed with borreliosis, Bell's palsy and HSV-1 differed according to the time to acoustic refl ex recovery, which took longest time in patients with borreliosis. Th ese patients had the highest percentage of suprastapedial lesions at all time points and recovery was achieved later as compared with the other two diagnoses. Th e mean score on the HB scale declined with time, also at a slower rate in borreliosis patients. Th e prognosis of acoustic refl ex and facial palsy recovery according to HB scale was not associated with the length of elapsed time. The results obtained in the present study strongly confirmed the role of acoustic reflex and HB grading scale as prognostic indicators of facial palsy in neuroborreliosis.
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