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Miguel Maldonado

Publications and source records attributed to Miguel Maldonado.

5 recordsLinked to original sources
PubMed2006

Severe nasal polyposis and its impact on quality of life. The effect of a short course of oral steroids followed by long-term intranasal steroid treatment.

OBJECTIVES: Nasal polyposis is not a life-threatening disorder but has a great impact on the quality of life. Steroids constitute the first line of treatment of nasal polyps. The aims of this study were to evaluate the quality of life in nasal polyp patients after: (1) a short course of oral steroids; and (2) a long-term treatment with intranasal steroids. METHODS: Patients with severe nasal polyps received either oral prednisone (n = 60) or no steroid treatment (control group, n = 18) for 2 weeks. Patients treated with steroids were also followed-up and evaluated after 12, 24, and 48 additional weeks with intranasal budesonide treatment. RESULTS: Patients with nasal polyps showed worse scores on all SF-36 domains, except for physical functioning, compared to the Spanish general population. After two weeks, patients treated with oral prednisone demonstrated a significant improvement (p < 0.05) in all impaired QoL domains compared to both control group and baseline. The mental component summary (51.0 +/- 1.2, p < 0.05) and physical component summary (51.0 +/- 0.9, p < 0.05) were improved compared to both control group and baseline. The improvement of all SF-36 domains was sustained by intranasal budesonida (p < 0.05) after 12, 24, and 48 weeks. Nasal obstruction, sense of smell, and polyp size also improved after both the oral short course and the intranasal long-term steroids treatment (p < 0.05). CONCLUSION: These results suggest that the treatment with a short-course of oral steroids improves the quality of life of patients with severe nasal polyps and that this effect is maintained by a long-term treatment with intranasal steroids.

Administration, Intranasal↗
PubMed2004

Laryngeal solitary fibrous tumor treated with CO2 laser excision: case report.

The solitary fibrous tumor is an uncommon unilateral benign lesion that usually arises from the pleura. Recently, these tumors have been described in many other locations, such as the mediastinum, head and neck, orbit and urogenital system. To date, only two cases of solitary fibrous tumor arising from the larynx have been reported in the scientific literature. We describe a new case of laryngeal solitary fibrous tumor localized at the right false vocal fold. A 29-year-old man presented with a 6-month history of progressive hoarseness and foreign body sensation in the throat. A mass lesion was recognized in the right false vocal fold, and CT scan demonstrated a large, well-defined tumor without signs of infiltration. The tumor was removed by transoral CO(2) laser surgery. The definitive diagnosis was obtained by immunohistochemical analysis that showed vimentin and CD34-positive cells. The patient remains free of tumor after 15 months of follow-up.

Adult↗
PubMed2004

The antrochoanal polyp.

Antrochoanal polyps (ACP) are benign lesions that arise from the mucosa of the maxillary sinus, grow into the maxillary sinus and reach the choana, and nasal obstruction being their main symptom. It is an interesting model to compare the pathophysiological mechanisms with those of bilateral nasal polyposis (NP). There is a lack of research in some areas of ACP, which have to become the main aims for future investigations of this disease. In comparison to NP, ACPs are usually unilateral and appear in younger patients. Macroscopically, they have a cystic intramaxillary portion and a solid intranasal portion. Microscopically, they are similar to a maxillary cyst of the mucosa. Nasal endoscopy, computed tomography and magnetic resonance are the main diagnostic techniques. Surgery is the indicated treatment for ACP, with endoscopic resection the most recommended. Simple avulsion of the polyp has a high rate of recurrence, whereas the Caldwell-Luc procedure is associated with damage of the maxillary and dental growth centres. More research is needed to establish the relationship between chronic sinusitis and ACP. Further work is also needed to investigate the role of inflammatory mediators (histamine, IgE, adhesion molecules, PAF), as well as metalloproteases and nasal remodelling, and tumour marker expression in A CP.

Humans↗
PubMedDate not supplied

[Mucous membrane pemphigoid: clinical manifestations and treatment with corticosteroids, dapsone and cyclophosphamide in 5 patients].

INTRODUCTION: Cicatricial pemphigoid includes several processes which are characterized by the presence of subepidermal bullae, and which affect the mucous membranes and, more rarely, the skin. At present, the term mucous membrane pemphigoid (MMP) is more accepted than other names used in the past, as they do not clearly define the broad spectrum presented by this disease. MMP can cause significant dysfunctions, primarily in the mucous membranes. Therefore, it is necessary to diagnose the disease as soon as possible, in order to quickly initiate systemic immunosuppressive treatment. MATERIAL AND METHODS: We present our experience with 5 patients with MMP. We analyze the clinical manifestations and the response to immunosuppressive treatment during the evolution of the disease. RESULTS: The patients were aged 41 to 69 years. The most frequent location of the lesions was the oral mucosa (80 %) and the ocular mucosa (80 %), followed by the pharyngeal mucosa (60 %), laryngeal mucosa (40 %), skin, anal mucosa (20 %) and genital mucosa (20 %). Three patients received systemic corticosteroids, dapsone and cyclophosphamide, and several sessions of plasmapheresis were also associated in one patient. One patient was controlled with topical corticosteroids and dapsone. CONCLUSIONS: Many patients with MMP can present with severe secondary complications. For this reason, the diagnosis must be confirmed quickly and the appropriate treatment started as soon as possible. The association of corticosteroids, dapsone and cyclophosphamide is a combination that gives very good results.

Adrenal Cortex Hormones↗