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Elena Patrascu and Claudiu Manea

Abstract

Obstructive sleep apnea is a chronic disease characterized by the appearance of apnea or hypopnea episodes during sleep. This condition is associated with several risk factors. Among them, the most important is obesity and it is the only potentially curable. The treatment is polimodal and it involves several therapeutic directions. The purpose of this paper is to establish the role of obesity in the etiology of sleep apnea, as well as the role of the weight loss in its management, both through intensive lifestyle interventions and surgical therapy.

Open access

Krishnamoorthy Madhusudhan, Nor Eyzawiah binti Hassan, Norasnieda binti Md Shukri, Shahrul bin Hitam and Ikmal Hisyam bin Bakrin

Abstract

Small cell neuroendocrine carcinoma (SCNEC) of the nasopharynx and nasal cavity is a rare condition. It is an aggressive malignancy with a high recurrence rate. Despite its rarity in the sinonasal region, it may occur as a second primary malignancy. Patients with cancer of the head and neck region are more prone to develop a second primary tumor due to the field cancerization phenomenon, and a higher incidence is seen in those who have previously received radiation therapy. A detailed clinical and histopathological examination is pivotal to diagnose SCNEC as a second primary malignancy. We wish to highlight such a peculiar case from our center.

Open access

Georgi Petrov Kukushev and Dilyana Vicheva

Abstract

BACKGROUND. The rigid endoscope developed by Karl Storz in 1961 led to a great advance in diagnosis and surgery and nowadays it is the gold standard in routine ENT practice. In addition, the development of video cameras has enhanced the surgical abilities as well as teaching opportunities in endoscopic sinus surgery.

OBJECTIVE. We developed a new prototype endoscope using the “chip-on-the-tip” technology. The aim of our non-clinical study was to observe and discuss the experimental data collected from laboratory tests on plastic models.

MATERIAL AND METHODS. The prototype rigid chip-on-the-tip endoscope has two parts - inner and outer. The inner part includes the chip-on-the-tip camera, light source and the cable. The outer part is a metal tube ending with a 0-degree lens. We performed laboratory tests of the rigid chip-on-the-tip endoscope for rhinosurgery and diagnosis.

RESULTS. We have observed technical parameters of the rigid chip-on-the-tip in order to compare them to conventional endoscopes connected with camera head units that are standard equipment for rhinosurgery and diagnosis.

CONCLUSION. Its advantages compared to the conventional Hopkins endoscope, connected to a standard camera head, are the smaller size, weight and the necessity of only one cable instead of two, allowing easy handling.

Open access

Codrut Sarafoleanu and Raluca Enache

Abstract

Dysphagia is a common disorder associated with a large number of etiologies like aging, stroke, traumatic brain injury, head and neck cancer, neurodegenerative disorders, structural changes or congenital abnormalities. The type of the treatment and its results depend on the type, severity and the cause of dysphagia. The primary goal of dysphagia treatment is to improve the swallowing process and decrease the risk of aspiration.

Along with the existing rehabilitation swallowing treatments, new adjunctive therapy options developed, one of them being the neuromuscular electrical stimulation (NMES).

The authors present the principles of NMES, a small literature review about the results of this therapy and their experience in using transcutaneous NMES in dysphagia patients.

Open access

Daniela Vrinceanu, Ana Maria Oproiu, Mihai Dumitru, Madalina Georgescu and Mariana Costache

Abstract

BACKGROUND. Excision of facial cutaneous carcinomas requires further reconstruction in a combined team with plastic surgeons. Among the traditional risk factors, the unprotected occupational exposure to sunlight can be identified. Giant masses at the level of the nose are frequently squamous carcinomas in origin. Moreover, repeated tumor trauma favours local-regional and remote extension.

MATERIAL AND METHODS. We present step by step the surgical management of an old woman with a nasal mass of 58/36/20 mm. Also, the patient presented right genian tumefaction of approximately 6 months in evolution.

RESULTS. The patient was submitted to surgical resection with free margins, leaving a considerable nasal and genian groove defect. Teaming up with the plastic surgeon, we applied complex reconstruction techniques with a satisfactory aesthetic and functional result. The histopathologic diagnosis confirmed our suspicion of an acantholytic squamous cell carcinoma with lymph nodes metastasis.

CONCLUSION. Our case exhibited traditional risk factors, living in a rural environment. The tumor degree of aggressiveness was increased by repeated self-inflicted trauma. Late presentation to healthcare services implied complex facial reconstruction for the combined resection of the nasal tip and genian lymph node.

Open access

Klaus Vogt, Inese Daine-Loza and Maris Sperga

Abstract

BACKGROUND. Radiofrequency reduction and Coblation are widely used procedures for the treatment of functionally enlarged turbinates with an appropriate outcome. Bleeding and crusting are postoperative complications for Coblation. Thermographic measurements and histological analyses were used to elucidate the causes.

MATERIAL AND METHODS. In a porcine turbinate model, double-needle electrodes of different lengths were tested using a 4MHz radiofrequency current with either automatic energy limitation or a predetermined energy amount of 200 J. Coblation, according to the manufacturer’s instructions, was carried out with a Reflex Ultra 45 wand. The generated temperature was measured with thermo-probes at the tip of the electrodes. The mucosa was subsequently investigated histologically.

RESULTS. Without preoperative saline injection, all procedures generate temperatures < 100° C. After saline injection, excessive temperatures are reached by Coblation after the release of plasma in a closed system. The follow-up is a severe deterioration of the microscopic structures of the mucosa. The low-temperature advantages of Coblation are only effective if the mandatory saline solution rinses the surface. The Radiofrequency applications deliver more predictable results.

CONCLUSION. For the treatment of the functional enlargement of the turbinates, Radiofrequency current with proofed settings should be chosen.

Open access

Andreea Marza and Claudiu Manea

Abstract

We report a case of a 47-year-old patient recently diagnosed with left abducens nerve palsy, who was admitted in our clinic with diplopia. The cranio-facial CT scan revealed left sphenoid fungal rhinosinusitis and the patient underwent endoscopic surgery with complete removal of the fungal material. The immediate postoperative evolution of the patient was favourable, with partial improvement of diplopia. The first month follow-up visit revealed the recurrence of the diplopia, so the patient performed an MRI scan of the brain that showed a cavernous sinus meningioma. The patient was referred to a neurosurgeon who choose a “wait-and-see” strategy instead of surgery.

The paper presents the limits of computed tomography versus magnetic resonance imaging in the radiologic diagnosis of intracranial tumors.

Open access

Túrós János Levente, Kiss Szilárd-Leó, Bereczky Lujza-Katalin, Bartha Edina, Lészai Lehel, Szabó Tamás, Györfi Imola and Szabó Béla

Abstract

Thrombophilia refers to a coagulation disorder that predisposes to thrombosis and thus increases the risk of thrombotic events. Both inherited and acquired thrombophilia are associated with vascular thrombosis and pregnancy-related complications, including infertility, recurrent miscarriage, and premature birth.

Recently, thrombophilia has been increasingly encountered as an infertility factor, which gives the clinical relevance of the disease.

The aim of the study was to investigate the prognostic role of thrombophilia in the treatment of infertility and the pregnancy of thrombophilic women during assisted reproduction procedures.

Frequency of abortions increases and effectiveness of in vitro fertilization (IVF) decreases with age. Normal weight has a positive effect on assisted reproduction techniques (ART’s) outcome. Repeat IVF failure is more common in thrombophilia than in healthy women, and the “take home baby” ratio for IVF is 24%. Spontaneous abortion was most commonly observed in the PAI homozygous group followed by MTHFR homozygous mutation, MTHFR heterozygous mutation, and Factor V (Leiden) mutation. The most effective treatment was concomitant therapy with low molecular weight heparin and aspirin.

Open access

Ábrám Zoltán

Abstract

Fodor József (1843–1901) is the founder of Hungarian hygiene who established the second hygiene department and hygiene institute in the world; he was a member of the Hungarian Academy of Sciences. He lived in the era of great microbiological discoveries, and his rich and multidisciplinary work has opened up new directions and approaches in science. For a short period of time he was professor at the newly established university from Cluj (Kolozsvár), later he had important contributions to the Hungarian public health act of 1876. His entire professional career represents a very special model by the messages left behind. He was proposed for Nobel Prize in medical (biological) sciences, but he suddenly died on 20 March 1901.

Open access

Péter H. Mária

Abstract

On 31st of December 1895 Gyula Wlassics (1852-1937), minister of religion and education, published his Decree No 72 039, which allowed women to study medical science, pharmacy and humanities at universities. In Kolozsvár Gizella Kárpáti was the first woman who registered at the Faculty of Medicine of Ferenc József University.

Gizella Kárpáti was born in Kolozsvár on 3rd August 1884. After finishing secondary school in June 1902, in the autumn of the same year she registered at the Faculty of Medicine. The marks she got at the university examinations in the following 10 semesters proved that she could cope with her task. In the years spent at the university she met medical student József Szabó (born in 1882) whom she married later. They both started their medical career at Károly Lechner’s Neuro-Psychiatry Institute. From 1909 Gizella Kárpáti was a payed assistant, from 1911 she became assistant lecturer. Her husband became an assistant lecturer from the year 1908, then he was appointed lecturer and then honorary lecturer. Meanwhile he had to go to the front where he was followed by his wife. In 1919, after the professors of the university refused the act of swearing the oath of allegiance, they both made their escape from Kolozsvár together with the greater part of their fellow professors. After a short time they settled in Szeged, where József Szabó was appointed university professor. Here he published his book „Elmekórtan” in 1925. In the 1927-28 academic year he became dean, then vice-dean of the Faculty of Medicine, but in the year 1929 he died unexpectedly. In Szeged, Gizella Kárpáti being engaged in bringing up her two children, did not work as a physician. One of her children, Miklós, continued his parents’ profession, and became a physician. Gizella and her children returned to Kolozsvár for a short time, between 1940-1944, then they moved to Budapest and finally they settled in Szeged again. In 1929 József Szabó and in 1953 Gizella Kárpáti were entombed in one of the graves of honour of the Szeged central cemetery.