Biomedical subjects

G Trinidad Ruiz

Publications and source records attributed to G Trinidad Ruiz.

At least 19 recordsLinked to original sources

PubMed2006

[Utility of the surgical treatment for severe epistaxis by endoscopic approach of sphenopalatine and ethmoidal arteries].

INTRODUCTION: To evaluate the efficacy and cost-effectiveness of the treatments used for controlling epistaxis, particularly compared with the surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoid (AE) arteries, a intervention prospective-retrospective study is presented with the aim of assessing the feasibility of these surgical techniques as an alternative to conventional treatments. PATIENTS AND METHODS: 184 consecutive patients admitted in the ENT ward between the years 1997 and 2005 were included in the study, and distributed into three groups depending on the last treatment applied to control their bleeding: AP group.- anterior packing (n=98); PP group.- posterior packing (n=66), and ES group.- endoscopic ligation and/or cauterization of SP or AE (n=20). RESULTS: Highly significant differences were found between the groups, not only regarding the efficacy (90% for surgical treatment compared with 41.3% for AP and 63.1% for PP), but also the length of postreatment hospital stay (AP.- 4.92 days; PP.- 6.3 days; ES.- 2.15 days). DISCUSSION AND CONCLUSIONS: The lack of efficacy of conventional treatment and the increasing risk factors that condition nasal bleeding, together with the advance of endoscopic and anesthesic procedures have brought along the possibility of a surgical solution for these patients. Our results demonstrate the feasibility of these techniques as alternative for nasal packing in the treatment of posterior epistaxis, and even its ethical and economical convenience as a substitutive to posterior packing.

Aged↗

PubMed2006

[Practical aspects regarding endoscopic treatment for epistaxis].

INTRODUCTION: A prospective study is presented to evaluate some practical and financial aspects regarding surgical endoscopic ligation or cauterization of sphenopalatine (SP) and anterior ethmoidal (AE) arteries performed to control posterior nasal bleeding. PATIENTS AND METHODS: 35 patients admitted at the ENT ward between 2004 and 2006 were included in the study, and distributed into two groups depending on the protocol applied in each case. Until March 2005 the surgery was performed if there was failure or insecurity of the posterior packing, and since that date a substitutive surgical protocol (not including posterior packing) was applied. RESULTS: 82.9% of the patients were male, with a mean age of 55.74 years and a left bleeding in a 60% of the cases. Ligature/cauterization was performed on SP in 28 (80%) patients, on AE in 4 (11.4%), and on both arteries in 3 cases (8.6%). 38.7% of the SP approach only one sphenopalatine foramen was observed, through which an only branch of the artery passed; 42% of the cases two branches passed through an only foramen, and in 19.3% two or more branches were present, breaking into the nose through two or more independent clefts. AE was intradural in 3 cases, intranasal attached to the cranial base in other 3 and intranasal detached to the cranial base in 1 patient. Besides, highly significant differences were found between the two protocols, observing a mean reduction of hospital stay of 3.1 days, which throws up savings of 939.3 euros per patient. DISCUSSION AND CONCLUSIONS: Surgical treatment for epistaxis has proved to be effective (91.2% in our experience) and safe, determining an important reduction in hospital stay and avoiding the morbility of posterior packing. Accurate knowledge of the anatomy of the arteries implied and specific actuation upon the correct bleeding territory are essential to perform this surgery.

Adult↗

PubMed2006

[Advantages of the determination of parathyroid hormone (PTH) intraoperatively in hyperparathyroidism surgery].

OBJECTIVE: To evaluate the utility of rapid or turbo intraoperative parathyroid (PTH) assay in the surgery of hyperparathyroidism. Since 2000 to july 2004 we have used this test on 39 patients. 24 of them corresponded to primary hyperparathyroidisms and 15 to secondary forms. Our results showed a PTH decreasing percentage >70% at 15 minutes in 92.3% of the cases. Only in two patients (5.1%) persisted the hypercalcemia after the surgery and one was reoperated with good clinic evolution. As advantages we stand out the reduction of surgical time, permitting unilateral parathyroid exploration instead a bilateral in primary HPT, and the prediction of success by confirming the excision of all hyperfunctionating parathyroid tissue in patients with multiple gland hyperplasia.

Female↗

PubMed2005

[Value of nutritional support in patients with pharingocutaneous fistula].

INTRODUCTION: A prospective and statistic study is presented to evaluate the efficacy of nutritional support in the postoperative care of patients with pharyngocutaneous fistula after laryngectomy. PATIENTS AND METHODS: All patients who developed pharyngocutaneous fistula after total o partial laryngectomy between 2001 and 2004 were included and assigned to the study group if a supplementary and enteral nutrition was started through the nasogastric tube, and to the control group if a conventional liquid diet was given. Nutrition of patients in the study group was controlled by an Endocrinologist. RESULTS: 32 patients were included (14 in the study group and 18 in the control group). Both groups were similar for all variables measured except for the length of hospital stay (mean difference 31.02 days) and the need for surgical closure (33% in the control group and 0% in the study group). These differences were found statistically significant. DISCUSSION AND CONCLUSIONS: Postoperative supplementary enteral nutrition controlled by the Endocrinologist reduced the need for surgical treatment of pharyngocutaneous fistula and shortened the stay in hospital of these patients. More studies are needed to prove the efficacy of preoperative nutrition in reducing the incidence of fistula after laryngectomy.

Aged↗

PubMed2005

[Controlling retests in a universal hearing screening program].

INTRODUCTION: To evaluate the influence of several factors in the need for retesting in the first stage of a universal auditory screening program, a prospective and statistic study is presented, specially remarking the differences found between two health systems (public and private). PATIENTS AND METHODS: 18,073 children born in the 1999-2004 period were included in the study, in the context of a universal screening protocol based on Otoacoustic emissions and ABR, and distributed into three groups depending on their place of birth (A: public hospital; B: private hospital; C: children from other region). RESULTS: Significant differences were found between the groups (7.3% retesting in the public system and 2.4% in the private), explained by the fact that in the first group the test was performed in 74.9% of cases within 3 days after birth (when the need for repetition was 7,7%), and in the other groups the exploration was delayed up to 4-10 days in most cases (when retesting was performed only in 4.9%). DISCUSSION AND CONCLUSIONS: Proportion of retesting in the first stage of a universal screening program is an important factor for the cost estimation of these protocols. We assume that the age at testing varies significantly this factor, and on the contrary, we know that precocious exploration (before the child leaves the hospital) increases the program covering. Therefore we conclude that the test should be delayed only in health systems needing to save resources or not able to test before discharge, and not in those wanting to guarantee the maximum covering.

Female↗

PubMed2005

[Considerations about ENT emergencies. Analysis of 30000 patients assisted in 10 years].

OBJECTIVE: To know those pathologies that require more frequently urgent medical assistance and what percentage of them could have been treated in health centers or outpatient clinics of our speciality. MATERIAL AND METHODS: Retrospective study of 30,000 patients attended in the Emergency department by our on call ENT specialist between 1993 and 2002. RESULTS: In general, epistaxis (12.98%), nasal traumas (10.26%) and external otitis (6.92%) were the clinical entities more common, representing the nasal and otological pathology more than 63% of the assisted emergencies. CONCLUSIONS: We demonstrate and emphasize an increment in the recent demand from patients of the emergency department. Several final considerations at that respect are pointed.

Emergencies↗

PubMed2005

[Auricular perichondritis in adults. An evaluation-study of 12 hospitalized patients].

Perichondritis of the auricle in adults can be secondary to traumatic agents, external otitis or surgery being Pseudomona aeruginosa the bacteria more often isolated. We have performed a retrospective study of 12 hospitalized patients with that diagnosis and these following variables have been evaluated: Age, sex, personal antecedents, clinical symptoms, affected auricle, complementary explorations, treatment, evolution and stay.

Adolescent↗

PubMed2005

[Laryngeal tuberculosis masquerading as carcinoma. Report of one case and literature review].

Since the introduction of antituberculous medications, the incidence of laryngeal tuberculosis (LTB) has decreased. However, it is a fact the increasing number of cases of pulmonary or extrapulmonary TB mainly caused by the Acquired Immunodeficiency Syndrome. We report the clinical case of a 72 years old male with dysphonia secondary to LTB which masqueraded a carcinoma. It's certain diagnosis was the histopathologic exam of the biopsy obtained by microsurgery. There was a residual TB in lung after a complete study of Internal Medicine Department.

Aged↗

PubMed2005

[Granular cell tumor of the tongue (Abrikossoff's tumor). Report of a case and review of the literature].

Granular cell tumor, myoblastoma or Abrikossoff's tumor is an uncommon benign lesion, usually of slow-growing, that shows a predilection for the oral cavity, especially the tongue. Its real etiopathogenia remains still controversial and in it's histogenesis have been implicated several cell types. We report the case of a 18 years old woman with that diagnosis, confirmed in AP, who was operated by removal of the tumoration that was located in the left half-tongue. After 28 months she has not suffered any recurrences.

Adolescent↗

PubMed2005

[Glossopharyngeal neuralgia. A propos of one clinical case].

Glossopharyngeal or the 9th cranial nerve neuralgia is an uncommon pathology characterized by severe paroxysmal attacks of pain in the base of the tongue, posterior pharynx and tonsillar fossa some times associated with pain irradiated to the ear. It's Carbamazepine is the first choice of medical treatment while the microvascular decompression is considered the main surgical procedure.

Aged↗

PubMed2005

[Nasal osteocartilaginous necrosis caused by cocaine. Our experience with two patients].

Sinonasal osteocartilaginous necrosis induced by the abuse of inhaled cocaine must be considered in the differential diagnosis of those pathologies that produce facial midline destructions. We report two cases corresponding to women admitted in our Hospital because of such entity. There were analysed their respective clinical histories, exploration data, complementary tests, medical-surgical treatment and evolution. Cocaine is one of the drugs that has increased in last 10 years producing an elevated number of complications, as we could proved on the bibliographic review performed.

Adult↗

PubMed2005

[Multiple and synchronous neck metastasis from 4 different malignant tumors. Report of a case].

Multiple neoplasms are increasing in clinical practice mainly due to the longer survival of the patients with cancer. Besides, procedures as radiotherapy that are used for the treatment of different diseases and tumors can associate with the future occurrence of carcinomas. The synchronous presentation of two or more histological kind ofneoplasms is uncommon. We report and analyse the clinical case of a 71 years male who presented, after a functional neck disection, metastatic lymph nodes of 4 malignant cell types: Lymphocytic lymphoma, anaplasic clear cells carcinoma, epidermoid carcinoma and thyroid papillary carcinoma.

Aged↗

PubMed2005

[Risk factors and clinical variables in patients hospitalized for epistaxis. Review of 200 patients].

It is reported a review of 200 adult patients admitted for epistaxis in our Hospital during a 10 years period (1992-2002). This study evaluates several factors included in the clinical histories: HTA, infection of the upper airway, EPOC, cardiovascular pathology, use of anticoagulant medication or other drugs, tobacco, alcohol, diabetes, etc. Besides we collected variables like age, sex, bleeding location, type of nasal packing made and evolution. Less than 20% of the cases were classified as idiopatic and the hospitalized patients had one or more known risk factors.

Adolescent↗

PubMed2005

[External severe laryngeal trauma with multiple fractures and airway compromise].

External laryngeal traumas are rare but clinically can cause important life-threatening injuries. We report the case of a 33 yeras old male who suffered a severe traffic accident: TCE, facial trauma with multiple fractures and laryngeal trauma with fracture of the thyroid cartilage and the hyoid bone. Because an important edema in the airway, it was not possible an orotracheal intubation and he required urgent coniotomy with later reconstruction surgery and tracheostomy. Actually our patient has been decanulated and the fibroscopic image of the larynx and its functionality is correct.

Adult↗

PubMed2005

[Sinonasal cystic adenoid carcinoma with epiphora and orbital involvement. Report of a case and review of the literature].

We report the clinical case of a 41 years old male with nasal obstruction of 1 year, epistaxis and epiphora. The ENT exam showed a bleeding red mass in left nasal fossa and CT joint to IRM revealed a tumoral process on that level and informed about its extension to adyacents structures (cavum, ethmoides, sphenoids and maxillary sinus). The biopsy was positive for cystic adenoid carcinoma. Our patient was operated by paralateronasal rhinotomy with removal of the tumor. One year later we found recurrence on the left orbital floor and maxilar sinus. The Oncology Department informed that it was not possible a treatment with radiotherapy or chemotherapy because the low sensitivity of that lesion those treatment.

Adult↗

PubMed2005

[Thyroglossal duct cysts and fistulae. Review of 30 consecutive operated patients].

Thyroglossal duct cysts represent a very common pathology among the benign neck masses. An own review of 30 consecutive operated patients between 1994-2003 by our ENT Department is reported. There have been analysed different parameters like age, sex, personal antecedents, clinical symptoms, complementary explorations, surgical treatment, evolution and anatomopathologic result (AP). We think the Sistrunk procedure is the best operatory technique or strategy to perform to avoid recurrences.

Adolescent↗

PubMed2005

[Association between primary hyperparathyroidism and Paget's disease. Report of a case].

Although the association between hyperparathyroidism and Paget's disease is known, in the clinical practice occurs very rarely. We report the case of a 68 years old female who was diagnosed as such disease more than 5 years ago and later she got an increment of PTH levels and hypercalcemiajoint to other biochemical disorders that made to suspect a primary hyperparathyroidism. Besides the osteoarticular manifestations, clinically the patient suffered recurrent kidney lithiasis. She was operated by removal of one adenoma (1,5 cm) located in lower right parathyroid gland and her evolution was satisfactory without complications.

Aged↗

PubMed2005

[Multiple brown tumours in a patient with tertiary hyperparathyroidism].

We describe the case of a 49-year-old female with chronic renal failure and secondary hyperparathyroidism that not dissapeared after kidney transplant and turned into an autonomous form (tertiary hyperparathyroidism). The xRays and CT showed the presence of multiple brown tumors in iliac bones and tibia. We performed a parathyroidectomy removing a lower left adenoma confirmed in the histological exam the renal. After the surgery the osteoarticular manifestations improved and lithiasis dissapeared. There were not any postoperative complications such as hypocalcemia or recurrential palsy although Nephrology Department had to control her renal function.

Female↗