Biomedical subjects

M P Prim

Publications and source records attributed to M P Prim.

At least 19 recordsLinked to original sources

PubMed2006

Utility of prophylactic antibiotics in pediatric adenoidectomy.

OBJECTIVE: To determine the utility of prophylactic antibiotics in non-risk pediatric patients undergoing adenoidectomy. METHODS: We performed a prospective, controlled, randomized, and double-blind study on patients under 14 years of age, scheduled for adenoidectomy who accomplished the following criteria: absence of immunosuppressive and/or cardiovascular risk factors, no antimicrobial therapy for at least 15 days prior to operation, and no fever 1 week before surgery. Venous blood samples for culture were obtained at 30s and 20 min after the curettage of adenoidal tissue. Likewise, immediate and delayed complications were registered in all cases. The usefulness of prophylaxis was analyzed according to three major standpoints: bacteremia, immediate complications, and delayed complications. RESULTS: One-hundred one patients fulfilled the inclusion criteria and were included in the study. Fifty-one children received prophylaxis and the remainder did not. In the non-prophylactic group incidence of bacteremia at 30s was significantly higher than in the prophylactic group (32.7% versus 4.0%) (p<0.001). Neither bacteremia at 20 min, nor immediate or delayed complications showed statistical differences between both treatment groups. CONCLUSIONS: Preoperative antimicrobial prophylaxis in pediatric adenoidectomy did not offer advantages preventing complications in non-risk patients. Only bacteremia that occurs 30s after the curettage of adenoid tissue is reduced with the employment of prophylactic antibiotics.

Adenoidectomy↗

PubMed2006

Comparison of different mobile telephones in Combi40+ users.

CONCLUSION: Telephone usage is a difficult challenge for cochlear implanted patients. A significant number of cochlear implanted patients are able to carry on a land-line or mobile telephone conversation. The telephone model may be a critical factor for telephone performance. OBJECTIVES: The goals of this study were to evaluate speech discrimination through land-line and mobile telephones in Combi40+ users, and to compare different mobile telephone models to find out which could be more advisable for them. PATIENTS AND METHODS: Eighteen Combi40+ implantees were tested with CID sentences and bisyllabic words presented through land-line and mobile telephones, in both quiet and noisy environments. RESULTS: Mean scores for telephonic speech discrimination were over 85% for CID sentences and 28-59% for bisyllabic words. The Siemens M55 was superior to the other mobile telephones tested.

Adolescent↗

PubMed2005

Neurological complications following functional neck dissection.

A retrospective study was done to assess the incidence and factors associated with neurological complications in patients who have undergone a functional neck dissection (FND). Four hundred forty-two epidermoid cancer patients operated on from January 1984 to December 2002 were included in the study. Clinical parameters, neurological sequelae, and other complications were evaluated in all cases. The incidence of neural damage was calculated on the nerves at risk (n =714). Paralysis of the 11th nerve occurred in 12 cases (1.68%). A lesion of the marginal branch of the 7th cranial nerve was observed in nine cases (1.26%). Bernard-Horner's syndrome and hypoglossal nerve paralysis were noted in four and three cases (0.56 and 0.42%), respectively. Thus, the incidence of neurological sequelae after FND is low. Neurological complications were not associated with either clinical parameters or non-neurological complications (P >0.05). None of the factors studied can predict the appearance of neural problems in the postoperative period.

Accessory Nerve Injuries↗

PubMed2005

Bacteremia following pediatric adenoidectomy.

OBJECTIVE: Adenoidectomy is frequently performed in children. The goals of this work were to determine the incidence of bacteremia during the adenoidectomy, to identify the microorganisms implicated, and to analyze the possible association of bacteremia with postoperative complications. METHODS: One hundred pediatric patients operated of adenoidectomy without preoperative antibiotic prophylaxis were prospectively included in this study. They had no immunosuppressive and/or cardiovascular risk factors, no antimicrobial therapy for at least 15 days prior to operation, and no fever 1 week before surgery. Venous blood samples were obtained 30 s and 20 min after the curettage of adenoidal tissue. RESULTS: The 33 and 14% of the samples were positive at 30 s and 20 min. The organism more commonly isolated was the streptococcus viridans. Bacteremia was only related to postoperative acute otitis media (p=0.012). CONCLUSIONS: Bacteremia exists after pediatric adenoidectomy, although it seldom correlates with clinical signs or symptoms. Postoperative acute otitis media is the only complication related to postsurgical bacteremia.

Acute Disease↗

PubMed2005

[Quality of life in cochlear implanted patients].

Several articles show the audiologic benefits of cochlear implants, although it is still necessary to prove their impact on quality of life. In this study, 36 Med-El processor users were included. The Glasgow Benefit Inventory (GBI) was used to measure changes in quality of life, and another questionnaire was used to evaluate the communication abilities. Eighty-six percent of the patients answered our questionnaire. The quality of life improved significantly according to the specific questionnaire. The average total benefit obtained with the GBI was +41, and the average scores related to general, social and physics benefits were +57, +16, and +3, respectively. No significant difference was found between quality of life and other parameters like insertion depth of the array, etiology or duration of the deafness.

Adolescent↗

PubMed2004

Status of internal jugular veins in patients with carcinomas of the head and neck area.

OBJECTIVE: To assess the status of internal jugular veins (IJV) in patients with head and neck carcinomas. STUDY DESIGN AND SETTING: This study included 108 IJV of 54 cancer patients who were prospectively evaluated between September 1994 and February 1997. Patency, presence of thrombosis, characteristics of vein wall, compressibility, area of the veins both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were registered in all cases. Also, 30 IJV of 15 normal volunteers were used as a control group. The study was performed in a tertiary care referral center. RESULTS: Right expiratory flow speed was higher in volunteers (P = 0.0280), and left basal area was bigger in oncologic patients (P = 0.0394). No significant changes were found between cancer patients and controls in the remaining parameters (P > 0.05). CONCLUSIONS AND SIGNIFICANCE: According to these results, head and neck carcinomas do not seem to affect the ultrasonographic characteristics of IJV. Thus, preoperative evaluation of IJV is not mandatory in these patients.

Adult↗

PubMed2004

[Does clustering exist in non-traumatic epistaxis?].

OBJECTIVE: Non traumatic epistaxis seems to be clustering in different periods. This paper tries to find out if there is any relationship between incidence of epistaxis and the year season, month, week, day, hour and/or lunar phase. METHODS: We have retrospectively studied 754 episodes seen between May 2001 and April 2002 in our Hospital. The following parameters were registered in each patient: age, sex, number of episodes, season, month, week, day, hour and lunar phase. RESULTS: Epistaxis represented 12.1% of the total otolaryngological emergencies. That means an incidence of 0.1% of non traumatic epistaxis which needed hospital specialized attention. We found statistical differences (p = 0.003) in the number of epistaxis per day and the different months (greater in june and november). No differences were found in the remaining periods studied. CONCLUSIONS: This paper shows monthly clustering of epistaxis episodes.

Adolescent↗

PubMed2003

Analysis of the causes of immediate unanticipated bleeding after pediatric adenotonsillectomy.

OBJECTIVES: To assess the incidence of unexpected postoperative bleeding in children undergoing adenoidectomy and/or tonsillectomy (T&A), and to investigate its possible undetected haematological causes. METHODS: We prospectively collected all patients under 14 years of age with a normal preoperative haematologic work-up (activated partial thromboplastic time, prothrombin time, fibrinogen, and platelet count), who underwent surgery of adenoids and/or tonsils at our institution between January 1997 and November 2000. RESULTS: There were 1516 cases that accomplished the inclusion criteria in the period of survey. Thirteen patients bled after surgery. This represents an incidence of 0.8% of immediate postoperative haemorrhage among the 1516 procedures analyzed. No statistical differences were found between bleeding and non-bleeding patients according to age, sex, and type of procedure (P>0.05). In 6 of the 13 bleeding patients (46.1%) an alteration of the coagulation system was subsequently found: 5 von Willebrand's disease, and 1 releasing thrombopathy. CONCLUSIONS: The incidence of bleeding after adeno and/or tonsillectomy at our institution is comparable with series previously reported in the current medical literature. In nearly one half of the cases, undetected coagulation diseases (mainly von Willebrand's disease) are diagnosed after surgery in the haematological study.

Adenoidectomy↗

PubMed2002

Spontaneous resolution of recurrent tonsillitis in pediatric patients on the surgical waiting list.

OBJECTIVE: To assess the impact of the waiting list on the spontaneous resolution of recurrent acute tonsillitis in children. METHODS: We have evaluated 623 cases placed on the waiting list for elective tonsillectomy (with or without adenoidectomy) between February 1994 and May 1999 at our institution. In each child, age, time on the waiting list, type of procedure and outcome were registered. There were two possible outcomes after the preoperative evaluation: tonsillectomy was still indicated or tonsillectomy was not necessary. RESULTS: Mean length of time on the waiting list was 10.8 months (range: 3.0-35.6 months; median: 8.2 months). In 507 of the 623 children (81.4%), the operation was still indicated. However, 116 patients (18.6%) did not need surgery because of spontaneous resolution of the clinical picture. No relation was found between outcome and age, time on the waiting list or type of procedure (P>0.05). CONCLUSION: There was no clinical evidence for claiming that resolution of recurrent acute tonsillitis in children is spontaneous with time.

Child↗

PubMed2002

Effect of atmospheric factors on the incidence of Bell's palsy.

To assess the possible influence of atmospheric factors on the incidence of Bell's palsy, a retrospective case review of patients seen between 1 January 1992 and 30 June 1996, was designed. The population included all Bell's palsy patients in whom the exact date of onset of paralysis (day, month, year) was known. The following parameters were registered daily by the Spanish National Service of Meteorology throughout the period of survey: temperature, atmospheric pressure and air pollutants (total number of particles and levels of SO2, CO, O3, NO2, NO, CH4 and total organic carbon). The only factor significantly related to Bell's palsy was temperature (P = 0.0164). Lower temperatures were associated with a higher incidence of Bell's palsy. A relationship between atmospheric pressure and/or air pollutants and Bell's palsy was not found.

Adolescent↗

PubMed2002

[The value of waiting in spontaneous remission of recurrent tonsillitis without associated adenoid pathology].

In order to assess the rate of spontaneous remission in children with recurrent acute tonsillitis (RAT), we revised the pediatric patients who were seen between 1994 and 1999. For this purpose, 123 cases that were on the waiting list for tonsillectomy under the indication of RAT without associated adenoid disease were selected. Only 23 (18.7%) of the children who were included in the study were removed from the waiting list after a mean time of 9 months because of spontaneous remission of the disease. Thus, there is no justification for claiming that long waiting lists for tonsillectomy are frequently associated with spontaneous remission of RAT.

Acute Disease↗

PubMed2001

Post-transplant lymphoproliferative disease in tonsils of children with liver transplantation.

OBJECTIVE: To assess the incidence and characteristics of post-transplant lymphoproliferative disease (PTLD) in tonsils of the liver transplanted children. METHODS: All patients under 14 years of age recipients of a liver transplant at the institution and operated on for tonsillectomy under suspicion of malignancy were included in this study. RESULTS: Seven patients underwent surgery on their tonsils under suspicion of PTLD. One case of B-cell lymphoma, and three cases of polymorphic diffuse B-cell hyperplasia were found. This represents an incidence of 1.4% of PTLD in the tonsils of the 283 pediatric liver transplants performed at the hospital. CONCLUSION: The incidence of PTLD in tonsils after liver transplantation is very low at the institution. However, it is very important to follow-up allograft recipients for early diagnosis of this entity.

Child↗

PubMed2001

Comparison of amoxicillin and azithromycin in the prevention of recurrent acute otitis media.

OBJECTIVE: To compare the outcome of patients with recurrent acute otitis media (AOM) treated either with amoxicillin or with azithromycin. METHODS: This prospective, controlled, and randomized study, compares the outcome of 71 patients with recurrent AOM treated with azithromycin (31 patients) or amoxicillin (40 patients) for the prevention of AOM. azithromycin was given at a dose of 10 mg/kg once a week, whereas amoxicillin was administered daily as a single intake of one third of the therapeutic dosage (20 mg/kg per day). All treatments were prescribed for 3 months. Both groups were homogeneous with regard to the currently accepted predisposing factors of recurrent AOM. Mean age of children was 35.3 months, and average follow-up was 11.5 months. The treatment was considered effective when the number of episodes of AOM dropped to less than 50% after the prophylaxis. RESULTS: Patients in the azithromycin group had a clinical response to prophylaxis (80.6%) comparable to those treated with amoxicillin (89.5%) (P=0.300). The incidence of adverse effects was similar in both groups. CONCLUSION: According to these results, a prophylaxis with azithromycin is as useful as amoxicillin to prevent recurrent AOM.

Acute Disease↗

PubMed2001

Graft-vs-host disease as a cause of enlargement of the epiglottis in an immunocompromised child.

We report a rare case of dyspnea due to enlargement of the epiglottis in a severely immunocompromised patient. The child underwent a previous tracheostomy at another hospital because of respiratory distress under the diagnosis of acute epiglottitis. The patient was subsequently decannulated without incident. One year later, the child developed a new episode of dyspnea with inspiratory stridor. A new tracheostomy was neccessary, and a biopsy specimen of the enlarged epiglottis was taken to confirm the diagnosis of graft-vs-host disease. The therapeutic measures in these situations are discussed below, and a review of the current literature concerning the etiology and management of epiglottic enlargement is performed.

Child, Preschool↗

PubMed2001

[Result of middle fossa vestibular neurectomy in Meniere's disease].

The results and complications of 224 middle fossa vestibular neurectomies (MFVN) performed between 1968 and 1994 are reported. Relief of vertigo, hearing and tinnitus (both pre- and postoperative), facial paralysis, wound infection, suture dehiscence, cerebrospinal fluid (CSF) leak, meningitis, subdural hematoma, average hospitalization time, and death were evaluated. The procedure was effective against vertigo in Ménière's disease in 100% of the cases with unilateral involvement. The excellent results with regard to relief of vertigo and the acceptable incidence of complications make MFVN one of the most adequate surgical treatments for Ménière's disease.

Adolescent↗

PubMed2001

[Electrooculographic findings in patients with neurofibromatosis].

Neurofibromatosis are frequent genetic syndromes, with the electrooculographic examination (EOG) as an useful tool in their evaluation. We present the EOG findings of 16 patients with this entity which were seen at our Department between 1969 and 1991. Mean of age was 31 years. Nine patients were female (56%). The most frequent pathologic findings were: spontaneous nystagmus (37.5%) and abnormalities in the pursuit tracking test (31.2%). These results are discussed and the main literature concerning this matter is reviewed.

Adolescent↗

PubMed2001

Reproducibility of ultrasonographic measures in internal jugular veins of normal subjects.

OBJECTIVE: To assess the reproducibility of ultrasonographic quantitative parameters of internal jugular veins (IJV) in normal subjects. MATERIAL AND METHODS: Thirty IJV of 15 normal volunteers were prospectively evaluated by means of duplex Doppler ultrasonography (US). Patency, presence of thrombosis, characteristics of the vein wall, compressibility, area of vein both in rest and during Valsalva maneuver, expiratory flow speed, Valsalva flow speed, jugular flow in each side, and total jugular flow were registered in all cases. Two measures were performed in each subject. RESULTS: High reproducibility was encountered in jugular flow (R=0.95) and in area during Valsalva (R=0.90) in the left IJV. Low reproducibility was found in Valsalva flow speed of the left side (R=0.35). The remaining measurements had a good reproducibility (R=0.50-0.75). CONCLUSIONS: The ultrasonographic parameters of IJV in normal subjects show an adequate grade of reproducibility. Thus, duplex Doppler US can be used as a reliable method for evaluation or comparison of IJV in different situations of future studies.

Adult↗

PubMed2001

Factors related to nerve injury and hypocalcemia in thyroid gland surgery.

To identify potential risk factors related to complications after thyroidectomy, a study was designed that included 675 patients. Recurrent laryngeal nerve (RLN) paralysis, hypocalcemia, serohematoma, wound infection, and postoperative hemorrhage were evaluated. The rate of paralysis of the RLN was calculated on nerves at risk for hypocalcemia (n = 890) in patients undergoing bilateral procedures or unilateral procedures if they had previously undergone a contralateral operation (n = 321). Multivariate analysis was used to identify the relationships between the variables included in the study. All statistical tests received the same level of significance of 0.05. Permanent hypocalcemia occurred in 2.2% of the patients, whereas unilateral paralysis of the RLN developed in 0.9%. Mortality was 0.1% in this series. The RLN paralysis had a significant relationship with preoperative diagnosis of malignancy (P < 0.03). Likewise, hypocalcemia was related to sex and surgical procedure (P < 0.03). Serohematoma was linked with age (P < 0.001), and hemorrhage was associated with previous radiation of the neck (P < 0.03).

Adolescent↗