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evidence. Am J Med., 2003;115 Suppl 3A:97S-104S. 11. Richter J.E. - Extraesophageal presentations of gastroesophageal reflux disease. Semin Gastrointest Dis., 1997;8(2):75-89. 12. Wong R.K., Hanson D.G., Waring P.J., Shaw G. - ENT manifestations of of gastroesophageal reflux. Am J Gastroenterol., 2000;95(8 Suppl):S15-S22. 13. Vaezi M.F. - Laryngeal manifestations of gastroesophageal reflux disease. Curr Gastroenterol Rep., 2008;10(3):271-277. 14. Carr M.M., Nagy M.L., Pizzuto M.P., Poje C.P., Brodsky L.S. - Correlation of findings at direct laryngoscopy and bronchoscopy

inmmunocompetent patient. A case report. N Dermatol Online. 2011;2(3):130-4. 4. Branco C, Subtil J, Tomas L, Pereira AM. Tuberculose ganglionar cervical: a propósito de um caso clínico. Tuberculosis lymphadenitis: case report. Rev Port ORL. 2005;43(3):257-64. 5. Costache A, Dumitru M, Anghel I, Cergan R, Anghel AG, Sarafoleanu C. Ultrasonographic anatomy of head and neck – a pictorial for the ENT specialist. Med Ultrason. 2015;17(1):104-8. DOI : 10.11152/ 6. Deveci HS, Kule M, Kule ZA, Habesoglu TE. Diagnostic challenges in cervical tuberculous lymphadenitis

Romanian Journal of Rhinology, Vol. 7, No. 26, April-June 2017 DOI: 10.1515/rjr-2017-0014 Corresponding author: Oana Musteata email: Oana Musteata ENT&HNS Department, “Sfanta Maria” Hospital, Bucharest, Romania Romanian ENT residency program - expectations and real facts LETTER TO THE EDITOR In Romania, after completion of the Faculty of Medicine, the next step in the training of future doc- tors is passing the residency exam. Once they have ac- quired the status of resident physician, they receive all necessary information


Background: Stapedectomy and stapedotomy are the standard techniques for stapes fixation surgery. Both techniques depend on the size of window opening (total, partial stapedectomy and small-hole stapedotomy) and the type of prosthesis used. Outcome of technique and prosthesis are controversy. Objective: Evaluate the outcomes of the two surgical techniques (stapedectomy/stapedotomy) and two sizes of prosthesis (Cawthorn 0.6mm/0.3mm) in terms of effectiveness and safety. Material and methods: Sixty-four medical records of patients undergoing stapedectomy or stapedotomy between the year 1995 and 2005 were reviewed. The subjects were classified into three groups including 0.6-mm stapedectomy, 0.6-mm and 0.3-mm stapedotomy group. The pre and post operative air-conduction threshold (AC) and air-bone gap (A-B gap) were compared for each group. The pre-and post-operative differences in pure tone average of AC, pure tone average of bone conduction threshold (BC), AB gap, AC at 4KHz, BC at 4KHz, AC at 8KHz, and speech discrimination score (SDS) were analyzed. The surgical complications were also compared. Results: Means of post-operative AC, and A-B gap were significantly better in all three groups. The mean of postoperative AC at 4KHz was significantly improved only in stapedotomy groups (0.6-mm and 0.3-mm stapedotomy). To compare the hearing outcomes among the three groups, there were no statistically significant differences between 0.6-mm stapedectomy vs. 0.6-mm stapedotomy, and between 0.6- mm vs. 0.3-mm stapedotomy. The complications were found in all three groups. The 0.3-mm stapedotomy had the lowest rate. Conclusion: Stapedectomy versus stapedotomy yields comparable hearing outcomes but stapedotomy results had a better success rate than the stapedectomy. For 0.6-mm stapedotomy vs. 0.3-mm stapedotomy, the overall results in both groups are not significantly different, in terms of both the hearing outcomes and the success rate. In terms of complication rate, 0.6-mm stapedectomy had the highest rate, while 0.3-mm stapedotomy had the lowest.


This study used Maximum Entropy (MaxEnt) to explore potential environmental determinants of Fusarium wilt occurrence on banana in south-central part of the Philippines. Different variables representing topographic, bioclimatic, and edaphic features of an area were tested against data of Fusarium wilt occurrence. Based on the results, precipitation during the driest month, precipitation during the wettest month, precipitation of the warmest quarter, slope, and elevation were the most important variables for predicting the probability of Fusarium wilt occurrence on banana. Results also suggest that among the variables tested, precipitation had the major contribution to the occurrence of Fusarium wilt.


Hemorrhagic Hereditary Telangiectasia (HHT) disease, also called Osler-Weber-Rendu (OWR) disease, is a rare and underdiag-nosed genetic disorder characterized by a multisystemic vascular dysplasia. Nosebleeds, acute or chronic digestive tract bleeding and various problems due to the involvement of major organs (liver, lungs, brain) characterize the disease.

Although it was described at the beginning of the 20th century, many patients, GPs and specialists still ignore the disease, its morbidities and the modalities of the treatment.

That is the reason why the authors have decided to publish this review on this familiar, evolving and potentially life-threatening disease, whose management can be sometimes a real nightmare for the clinician.


Background: The diagnosis of tuberculous lymphadenitis (TBLN) ranges from therapeutic diagnosis to open biopsy with tissue culture. The open biopsies are accepted as the gold standard to diagnose TBLN, but it requires skin incision that leaves unwanted scars. Objective: Test the sensitivity and specificity of fine needle aspiration (FNA) using tissue culture in mycobacteria growth indicator tube (MGIT) and tissue polymerase chain reaction (PCR) for comparison with open biopsy using tissue culture. Subject and methods: Forty patients with clinically suspected cervical tuberculous lymphadenitis were recruited at King Chulalongkorn Memorial Hospital. The patients underwent FNA followed by open biopsies either excisional or incisional. Specimens from FNA were collected for tissue culture in MGIT and for tissue PCR. The specimens from open biopsies were divided into two portions for tissue culture in MGIT (the gold standard) and for hispathology. Results: FNA for tissue culture in MGIT had a moderate sensitivity (65%) but high specificity (83%) (73% positive and 76% negative predictive value). FNA for tissue PCR had a moderate sensitivity (53%) but very high specificity (96%) (90% positive and 73% negative predictive values). Combination of either FNA for tissue culture or FNA tissue PCR revealed an increase in sensitivity and specificity to 83.6% and 80.0%, respectively. However, a combination of both FNA for tissue culture and FNA tissue PCR revealed a decrease in sensitivity (34.5%) but a highly increase in specificity (99.0%). Conclusion: Either the FNA using tissue culture in MGIT or tissue PCR had a moderate sensitivity but high specificity. FNA using tissue culture or FNA tissue PCR may be used as an alternative test for diagnosis TBLN. The techniques may replace the open biopsies because of its effectiveness and low complication rate.


Using 35 presence-only data samples and five uncorrelated bioclimatic variables, we made species distribution models (SDMs) for 4 species of critically endangered (CR) liverworts from genus Jungermanniales and Marchantiales (Cephaloziella elegans, Leiocolea heterocolpos, Lophozia wenzelii and Riccia papillosa) using the maximum entropy modelling method (MaxEnt). Since we were modelling CR species, only one model proved to be strong enough to be used in the field. However, SDMs can serve as effective and fast tools for acceleration of the discovery of the rare and endangered species. The final model presented in this study can serve as a guide to future survey expeditions, the conservation of the target species and also to help understand their ecology.


On the verge of technological breakthroughs, which define and revolutionize our understanding of intelligence, cognition, and personhood, especially when speaking of artificial intelligences and mind uploads, one must consider the legal implications of granting personhood rights to artificial intelligences or emulated human entities


The association between patch metrics and roosting site (n = 31) suitability of Lyle’s flying fox (Pteropus lylei) in 26 Central Eastern and Western provinces of Thailand was quantified. Land use classes with 90-m resolution were identified based on various vegetation and land cover types to calculate patch metrics using FRAGSTATS. Then, Maximum Entropy Modeling (MaxEnt) was performed using patch metrics covariates to produce a predictive potential distribution map. The results indicated that patch contiguity (contiguity index, 63.7%), patch area (29.3%), and patch shape complexity (shape index, 5.7%) are the most influential patch metrics, all of which have negative effects on roosting site suitability. In total, 13,222 small patches were considered highly suitable patches, with a mean area of 0.921 ± 0.698 (SD) ha, which accounted for 122,090 ha (2.04%) of the study area. Roosting sites predicted from the model were consistently associated with occurrences of roosting sites observed in temples; such habitats likely provide shelter from external threats for colonies roosting in a human-dominated landscape.