Biomedical subjects

C Suárez Nieto

Publications and source records attributed to C Suárez Nieto.

At least 19 recordsLinked to original sources

PubMed2006

[Factors predicting Voice Handicap Index].

OBJECTIVE: To assess factors that may be predictive of patient perception of dysphonia severity, as quantified by the Voice Handicap Index (VHI) score. MATERIAL AND METHODS: A prospective study is carried out in 81 voice samples from patients diagnosed with benign vocal fold lesions. Variables assessed for predictive value to VHI score are maximum fonation time, narrow band spectrogram, jitter, shimmer, HNR, NNE, F0 and the auditory perceptual evaluation of severity of dysphonia GRABS. RESULTS: HNR, F0 and B and S parameters of GRABS were predictors of total VHI score, functional and emotional subscales. No parameter was found to predict the physical subscale. CONCLUSIONS: VHI score is correlated with the perceived breathy voice and its acoustic attributes, such as signal-to-noise ratio. In other studies, patient perception of dysphonia is independent of many factors commonly assessed during the evaluation of voice disorders. It is reasonable to assume that the severity of glottic gap caused by benign vocal folds lesions is related to a low signal-to-noise ratio and the breathy phonation as its perceptual correlate. The physical subscale appears to be an independent element in the assessment of the patient perception of dysphonia.

Adult↗

PubMed2006

[Otorhinolaryngological consultation material in PDA: SEORL-PDA].

OBJECTIVES: Occasionally, the Otolaryngologist needs to accede quickly to medical information in order to retrieve data or to solve doubts. In this way, it seems to be of interest to design a clinical guide that could be consulted as a PDA program (Pocket PC and Palm versions), in a personal computer or Internet. MATERIAL AND METHODS: Clinical contents of protocols, guides, and articles, preferably based on the evidence and the clinical experience of 102 authors. Implementation of a program that allows the guide to be used in a PDA, to update it or to add notes using tools that could be downloaded from a web page. RESULTS: A clinical practice guide SEORL-PDA version 1.1, with thirteen ENT's topics, calculation algorithms, internal links and possibility of update the content and to add notes. DISCUSSION: SEORL-PDA is a clinical guide in PDA format, with enough information and possibilities. Its downloading and installation is easily done following the instructions of the web created with these purposes.

Algorithms↗

PubMed2006

[Gastric pull-up reconstruction in hypopharyngeal and cervical oesophageal cancer].

OBJECTIVE: To determine the results of gastric pull-up reconstruction following pharyngo-laryngo-esophagectomy. METHODS: The clinical data of 12 patients who were treated with pharyngolaryngo/esophagectomy were analysed, from 1995 to 2000. All patients had advanced disease, and required a gastric pull-up reconstruction. Clinical swallowing function and morbidity were evaluated postoperatively and the survival group was studied using a Kaplan-Meier survival curve. RESULTS: Five cases of hypopharyngeal cancer and seven cases of cervical esophageal cancer were studied. In three cases a regional flap was used. A total of 16 cervical dissections were carried out. Only in 2 patients the nodes were free of metastasis. There were four hospital deaths. At discharge, 7 patients out of the 8 had a good swallowing. The most common complications were pulmonary (58%). The five years survival was 31%. CONCLUSION: Gastric pull up transposition must be used for reconstruction following pharyngolaryngoesophagectomy. Proper selection of patients may reduce considerably the morbidity and mortality of this surgical procedure.

Adult↗

PubMed2006

[Distant metastases in head and neck cancer].

INTRODUCTION: The presence of distant metastasis (DM) after the initial treatment of head and neck squamous cell carcinoma (HNSCC) is not considered a common event and it is associated to a poor outcome. PURPOSE: To investigate the prevalence and risk factors associated with the diagnosis of distant metastasis in SCC. METHODS AND MATERIALS: A retrospective study of 633 patients with HNSCC to describe the clinical characteristics of the DM. RESULTS: During the follow-up period after the initial treatment, 6.2% of the patients were diagnosed of having distant metastasis. The site of primary tumor was hypopharynx in 14.4%, unknown origin in 11.8% and oropharynx in 8.5%. The most common sites of DM were the lungs (58%) and the bone (22%). Three year overall survival in patients with DM was 2.5% (versus 49,5% in the control group). CONCLUSIONS: This study confirms that DM have an adverse impact in survival. There is a need of guidelines for screening of distant metastases in patients with HNSCC in order to get an early diagnosis and a more effective treatment. Because of the poor prognosis of DM, protocols including adjuvant chemotherapy should be investigated.

Carcinoma, Squamous Cell↗

PubMed2006

[Second primary tumors in head and neck cancer].

INTRODUCTION: The development of second primary tumors (SPT) in patients with head and neck squamous cell carcinoma (HNSCC) has become an increasingly important factor in clinical treatment decisions. PURPOSE: To define favourable clinical characteristics for overall survival, in patients with SP head and neck cancer. MATERIAL AND METHOD: Records of 633 patients with SCC treated from 1984 to 2004 were reviewed to describe clinical characteristics of the SPT. RESULTS: The overall incidence of SPT was 11%. The incidence of the index tumors was as follows: supraglottic cancer 21% and oral cancer 16%. The most common SPT occurred in head and neck area in 47%, lung in 32% and esophagus in 11%. Second primary was associated with a poor 5 years survival in patients with HN-SCC (23 versus 53% in control group). CONCLUSION: Because of the high rate of second primary tumors, protocols including chemoprophylaxis should be investigated. Prevention and early detection are indicated.

Carcinoma, Squamous Cell↗

PubMed2005

[Multimedia educational material. A tool of support to the Otolaryngology training].

Due to multimedia technologies, the medical information has taken an extraordinary growing. Nevertheless, the education at University will turn out to be a more complex pedagogic process. We present a multimedia educational material (MEM), developed as an online course to "Seminars of Otolaryngology", and available free at the University website. MEM was designed and edited by, ENT teachers, pedagogues, and image and computer experts. It has been structured as a series of modules that integrate texts, images, movie clips, video, audio and animations. The schematic presentation stands out with progressive access to the topics through internal and external links. The pedagogic resources give additional support by learning objectives, glossary, references, index and searcher. Finally, the activities and instrumental simulations complete the training in diagnosis and treatment. The MEM is an interactive useful software program for medical training in Otolaryngology, without avoiding the key figure of the teacher.

Humans↗

PubMed2005

[Endoscopic nasal surgery for pterigopalatine fossa schwannoma].

Schwannomas are tumors of nerve sheath origin, the lesion being derived from the Schwann cells surrounding neural tissue in most of the peripheral, cranial and autonomic nerves. Schwannomas occurring in the head and neck represent 25-35% of all reported schwannomas, and most commonly arise from the acoustic or the neumogastric nerves. In the nose and paranasal sinuses these tumors are very uncommon (fewer than 4% of all schwannomas). In the pterygopalatine fossa they are very rare, and arise in this case from the ophthalmic and maxillary branches of the trigeminal nerve. In this exceptional site, the tumor is classically approached through a Caldwell-Luc incision. In this case, we report the removal of a schwannoma of the pterygopalatine fossa by endoscopic sinus surgery.

Adult↗

PubMed2005

[Prognostic factors in adenoid cystic carcinoma of salivary glands].

OBJECTIVE: Adenoid cystic carcinoma (ACC) is a relatively rare tumor which is characterized by its long clinical history, with multiple recurrences and late distant metastasis. The aim of the present study is to show our experience in the management of this tumor and the relationship of different clinico-pathological parameters with its prognosis. MATERIAL AND METHODS: A retrospective study was carried out between 1984 and 2004 in 28 patients with ACC of the salivary glands, analyzing the most outstanding clinico-pathological variables in this tumor related to the prognosis of the tumor and the survival. RESULTS: The overall survival rates at 5, 10 and 15 years were 88%, 69% and 52% respectively. Ten (36%) patients presented local recurrence and 10 (36%) presented distant metastasis (four of which also have local recurrence). Although the differences were not statistically significant, the patients with solid histological subtype (p=0.17), with positive margins status (p=0.2), with perineural invasion (p=0.59), and those treated with surgery alone (p=0.19), presented a worse survival. DISCUSSION/CONCLUSION: Our study confirms that the ACC is a tumor with a high tendency to local recurrence and development of distant metastasis, even long term, which means a close follow-up for life. Nevertheless, it also demonstrates that acceptable survival rates can be obtained with aggressive treatment.

Adolescent↗

PubMed2005

[The relationship between human papillomavirus and cyclin D1 gene amplification in squamous cell carcinomas of the head and neck].

INTRODUCTION: infection by oncogenic subtypes of human papillomavirus (HPV) and cyclin D1 gene (CCND1) amplification are frequent events in head and neck squamous cell carcinomas. The objective of this paper is to establish the relationship between the presence of human papillomavirus (HPV) gene sequences and the development of CCND1 gene amplification in these tumours. MATERIALS AND METHODS: 59 squamous cell carcinomas of the head and neck were studied for HPV types 6b and 16 and CCND1 gene amplification by polymerase chain reaction. RESULTS: HPV DNA was detected in 14 tumors (24%). Ten of them were positive for the HPV type 6b and 4 for the HPV type 16. CCND1 gene amplification was found in 15 cases (25%). Although we have found a higher frequency of CCND1 amplification in the HPV-positive cases (36%, versus 22% in the HPV-negative cases), these differences were not statistically significant (P= 0,32). CONCLUSIONS: The presence of HPV gene sequences does not seem to be related to a significative higher incidence of CCND1 gene amplification in the squamous cell carcinomas of the head and neck.

Adult↗

PubMed2005

[Research in the professional practice of the medical speciality].

Research has a very important role in the financial development of countries; it improves our life quality in all aspects and helps to face unexpected happenings. In Spain science has been left to a second plane and we feel necessary to reverse this situation. Amongst the different kinds of research (basic, clinical and translational) the two last ones are most interesting for clinical doctors. Training of the doctor in the research field helps to a better practice as the advances in research can be applied to clinical practice. There is a tendency for doctors to be involved less in research and it is very important to modify this situation. Research should start in Medical school and play an important role throughout the training period. Once training has concluded, those with capacity and interest in research should follow a 3-4 years training in the field and after that period they can undertake both clinical and research roles. Finally, in Spain our speciality needs to create specific research laboratories in those ENT departments in hospitals with adequate infrastructure to develop research.

Economics, Medical↗

PubMed2004

[Laser cordectomy: oncologic outcome and functional results].

OBJECTIVE: Early glottic carcinoma can be effectively treated with radiation or endoscopic laser surgery. We evaluated our experience treating early glottic cancer with laser CO2 surgery. MATERIAL AND METHODS: 64 patients with Tis, T1 and T2 carcinoma, who underwent endoscopic CO2 laser excision between January 1999 and July 2002, were retrospectively analyzed. We performed an objective and subjective evaluation of speech, and evaluation of physical, emotional and functional well being. The mean follow-up was thirty months. RESULTS: No patient died of this laryngeal neoplasm. Local control was achieved in 96% (62/64). Two patients with recurrence required total laryngectomy as savage treatment. Cause-specific survival was 100%, and overall survival was 98% (63/64). Voice quality was affected by laser surgery but impact on the quality of life was minor. CONCLUSIONS: Laser cordectomy for treatment of early glottic cancer is a valid alternative to radiation, with good outcome for voice and minimum impact on quality of life.

Disability Evaluation↗

PubMed2004

[CCND1 gene amplification in the adenoid cystic carcinoma of the minor salivary glands].

OBJECTIVE: Adenoid cystic carcinoma (ACC) is a tumour of epithelial origin that represents the most common malignant neoplasm of the minor salivary glands. However, little is known about the genes involved in the development and progression of this tumour. Cyclin D1 gene (CCND1) plays a key role in the control of the cell cycle, and its amplification is described in numerous cancers. The aim of this study is to determine the amplification of the CCND1 gene in the ACC of the minor salivary glands. MATERIALS AND METHODS: A retrospective study was performed on 12 patients with ACC of the head and neck. The amplification of the CCND1 was determined using multiple PCR. RESULTS: Amplification of the CCND1 was found in 4 patients (33.3%). No correlation was found between CCND1 amplification and clinicopathological parameters, although disease-free survival was diminished in patients with amplification. DISCUSSION/CONCLUSIONS: Our study demonstrates for the first time the amplification of the CCND1 gene in ACC. We have found an amplification rate similar to others neoplasms. CCND1 amplification seems to be associated with a poorer prognosis in these tumours, although this needs to be confirmed in larger studies.

Adult↗

PubMed2004

[Cerebellopontine angle and internal auditory canal lipomas: report of four cases and review of the literature].

AIM: Lipomas are exceptional tumors at the Cerebellopontine Angle (CPA) or the Internal Auditory Canal (IAC). We evaluate clinical, histological and radiological characteristics of the cases diagnosed in our Hospital and the results of conservative versus surgical treatment. MATERIAL AND METHODS: We report 4 cases of CPA and/or IAC and review 99 previously reported in the literature. RESULTS: Unilateral tinnitus was the most frequent symptom (100%). All lesions showed hyperintensity on T1 and hypo/isointensity on T2--weighted MNR images. Two patients underwent a retro-sigmoidal approach without complete tumoral resection and with additional neurological consequences. Another two cases were followed up by annual MNRs. During the follow-up period (4.2 years average), neither clinical nor radiological changes were detected. CONCLUSION: The surgical resection of CPA y/o IAC lipomas is associated to a significant morbidity due to the high vascularization and the dense adherence of these lesions to the surrounding tissues. The MNR is the suitable technique for differential diagnosis between lesions at this location.

Adult↗

PubMed2004

[DNA extraction using Chelex resin for oncogenic amplification analysis in head and neck tumours].

DNA extraction from tissues can be the most laborious and complex step in amplifying DNA by PCR when phenol-choroform procedure is used. We compare this lengthy, slow and expensive extraction method with other two based in the use of Chelex-100 resin. This chelating resin has been applied for extracting DNA from different tissues to use with the PCR. These procedures are simple, rapid and do not require multiple steps. In this study we compared DNA extraction from 30 head and neck squamous cell carcinomas (HNSCC) using organic solvent precipitation, Chelex 100 resin with and without proteinase K pretreatment. The results show that proteinase K-Chelex 100 procedure is as efficient as the phenol-chloroform one.

Carcinoma, Squamous Cell↗

PubMed2004

[Paranasal sinus osteomas. Revision of 14 cases].

OBJECTIVE: To present our experience in the management of paranasal sinus osteomas. MATERIAL AND METHODS: We review 14 patients with frontoethmoidal osteomas removed in our hospital between 1988-2001. The initial symptoms, site and size of the lesions, surgical approaches and short and long term complications were assesed. RESULTS: The most common symptom in our series was headache (57%); most of the tumors were located in frontal (35%) and frontoethmoidal (35%) regions with a mean size of 4.2 cm (maximum diameter) at the time of surgery. All symptomatic osteomas were resected by classic external surgical approaches but two cases were removed by endonasal surgery. DISCUSSION: Although osteomas are benign tumors, they may enlarge progressively and produce complications. Their resection is not free of risks, so there is some controversy about the management of asymptomatic patients. Endonasal surgery reduces the morbidity of the treatment but the location and size of the lesions do not allow to employ this technique in all cases.

Adult↗

PubMed2004

[Insertion of Montgomery salivary bypass tube under local anesthesia in patients with pharyngocutaneous fistula following total laryngectomy].

Montgomery salivary bypass tube is an effective therapeutic option in the treatment of the pharyngocutaneous fistulas following laryngectomy. The original insertion technique requires general anesthesia to introduce the tube with direct vision of the hypopharynx. In this paper we present an insertion method based in the Seldinger technique that allows the placement of the tube under local anesthesia in a rapid fashion and well tolerated by the patients.

Anesthesia, Local↗

PubMed2004

[Anaplastic thyroid carcinoma. Our experience].

UNLABELLED: Anaplastic thyroid cancer ranks among the most lethal of all known human malignancies, and remains almost uniformly fatal. It represents approximately 1% of all thyroid carcinomas. MATERIALS AND METHODS: A retrospective study was performed including all anaplastic thyroid carcinoma cases diagnosed in our institution between 1989 and 2000. RESULTS: We collected 15 cases previously biopsied as anaplastic thyroid carcinoma. Three of them were treated with a curative intention; different palliative modalities were carried out for the remaining cases. None of the cases survived more than 1 year, and the median survival time was 3.5 months. DISCUSSION/CONCLUSION: This study confirms the previously known aggressiveness of this neoplasm, in which the prognosis and evolution remain to be fatal.

Aged↗

PubMed2004

[Epidermal growth factor receptor gene amplification and E-cadherin expression in head and neck carcinomas].

INTRODUCTION: The E-cadherin adhesion molecule is fundamentally involved in the maintenance of normal epithelial morphology and differentiation. The scattering and invasion of cancer cells induced by epidermal growth factor receptor (EGFR) activation has been suggested to be probably by affecting E-cadherin function. The aim of this study is to confirm whether EGFR amplification is related to E-cadherin expression in head and neck squamous cell carcinomas. MATERIAL AND METHODS: Fifty patients with head and neck squamous cell carcinoma were studied. EGFR amplification was analyzed by semiquantitative PCR. E-cadherin expressión was determined by immunohistochemistry. RESULTS: EGFR amplification was found in 9 cases (18%). E-cadherin expression was generally weaker in tumors than in adjacent normal epithelium. No relationship was found between EGFR amplification and E-cadherin expression. CONCLUSION: EGFR amplification did not affect the level of E-cadherin expression, suggesting a complementary role of both of these molecules in reduction of cellular adhesion in head and neck squamous cell carcinomas.

Adult↗