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Biomedical subjects

R Fernández Liesa

Publications and source records attributed to R Fernández Liesa.

At least 19 recordsLinked to original sources

[Biopsy cannula as diagnostic alternative to puncture-aspiration biopsy with fine needle in head and neck tumors].

Biopsy cannula is a diagnostic tool allowing anatomopathological examination of tissue samples, achieved through a percutaneous perforation. Unlike puncture-aspiration with fine needle method that only permits a cytologic study, this technique eases the removal of pieces big enough to provide the knowledge of the whole architecture of the lesion. At length in other specialities in our has been forgotten perhaps for the great efficiency of PAFN on neck masses or as complement of traditional surgery. We present one case in which the biopsy-cannula showed its diagnostic usefulness. We also discuss on the technique and made a bibliographic perusal about the published literature.

Biopsy, Needle↗

[Diffuse deep cervical infection. Report of three cases].

Deep cervical infections still appear despite antibiotic use. Necrotizing fasciitis of the head and neck is a rare but serious infection caused by mixed, predominantly anaerobic bacterial flora. The natural course of the disease is spreading necrosis of the soft tissues of the neck and septicemia. Three recent cases of cervical necrotizing soft-tissue infection are presented. The importance of early and aggressive surgical treatment complemented by parenteral antibiotics with an aerobic-anaerobic spectrum is emphasized.

Aged↗

[Why evidence-based medicine? 20 years of meta-analysis].

BACKGROUND: Meta-analysis, described within evidence-based medicine, has become a frequent issue in recent medical literature. An exhaustive search of reported meta-analysis from any medical specialty is described. MATERIAL AND METHODS: Search of papers included in Medline or Embase between 1973-1998. A study of intra and inter-reviewers liability about selection and classification have been performed. A descriptive analysis of the reported papers (frequency tables and graphics) is described, including differences of mean of reported meta-analysis papers by medical specialty and year. RESULTS: 1,518 papers were selected and classified. Most frequently found (45.91%) were: methodology (15.7%), psychiatry (11.79%), cardiology (10.01%) and oncology (8.36%). Inter personal agreement was 0.93 in selecting papers and 0.72 in classifying them. Between 1977-1987 overall mean of reported studies of meta-analysis (1.67 + 4.10) was significatively inferior to the 1988-1998 (49.54 + 56.55) (p < 0.001). Global number of meta-analysis was positively correlated (p < 0.05) with the number of studies about fundamentals and methodology during the study period. CONCLUSIONS: The method used to identify meta-analysis reports can be considered to be adequate; however, the agreement in classifying them in medical specialties was inferior. A progressive increase in the number of reported meta-analysis since 1977 can be demonstrated. Specialties with a greater number of meta-analysis published in the literature were: psychiatry, oncology and cardiology. Diffusion of knowledge about fundamentals and methodology of meta-analysis seems to have drawn and increase in performing and reporting this kind of analysis.

Evidence-Based Medicine↗

[Acoustic analysis of the normal voice in nonsmoking adults].

Acoustic analysis was made of 154 voices of healthy non-smokers adults. A sustained vowel /a/ was recorded on a mini-disc. Acoustic analysis was carried out with Dr. Speech Science software. Fundamental frequency (F0), standard deviation of the fundamental frequency (SD F0), jitter PPQ (%), shimmer APQ (%), harmonic-to-noise ratio (HNR), and normalized noise energy (NNE) were estimated. Mean F0 was 201 Hz in women and 129 Hz in men. F0 increased with age in men. In women, changes in F0 with age were not statistically significant. Age, sex and F0 did not significantly influence jitter, shimmer or HNR. An acceptable normal threshold is 0.5% jitter. Three percent shimmer excludes 13% of healthy persons. Our HNR values were higher than those reported elsewhere (95th percentile: 18 dB). An NNE threshold of -10 dB is unacceptable because it excludes 38% of healthy persons. NNE differed with sex (mean difference: 3-5 dB). Methodology, sample characteristics and the vowel /a/ may account for some of the differences in results.

Adult↗

[Our experience in chondrosarcoma. Three case reports].

Sarcoma of the larynx are extremely rare neoplasms that account for approximately 1% of all tumors of this organ. Less than 0.1% correspond to chondrosarcomas. Three cases of laryngeal chondromas are described. The patient's age ranged between 65 and 75 years, and all they were men. Two of the tumors arose in the cricoid cartilage, and the other one, in the left wing of the thyroid cartilage. Two of the cases corresponded to high-grade, indifferentiated chondrosarcoma. Two of the patients were alive and free of recurrence of metastases 5 years after surgery.

Aged↗

[Adenoid cystic carcinoma of the larynx. Case report and literature review].

Adenoid cystic carcinoma is a rare neoplasm that comprise approximately 0.25% of all laryngeal malignancies. The rarity of these lesions has prohibited clarification of definitive therapy. Traditionally, radical surgery is performed because of the usually high stage at presentation. A case of larynx ACC is reported. The literature on this topic has been reviewed, in order to describe the natural course and the different treatments of this tumor.

Biopsy↗

[Retropharyngeal abscess due to atypical mycobacteria. Case report].

It is a rare clinico-pathological infection located in the retropharyngeal space. Our contribution refer to a young man suffering this complaint caused by atypical mycobacteria, being the aim of the paper to underline the exceptional placement. The difficulties encountered in establishing the bacteriological diagnosis as well the excellent response to a combined treatment with tuberculostatics and surgery.

Abscess↗

[Primary meningioma of the nose and the paranasal sinus].

Primary extracranial and extraspinal meningiomas are not very common, less than 1% out of meningiomas and with a pathogeny not well defined. Less than 60 cases have been described so far. The histopathological diagnosis can be really difficult. All the cases published were diagnosed after an anatomopathological study. We reviewed all publications about these tumors, which belong to the group of those rare neoplasms the otorhinolaryngologist must have in mind whenever he faces a paranasal sinus neoformation.

Child↗

[Ethmoidofrontal mucoceles. Their clinical picture, diagnosis and differential diagnosis].

Anterior sitting is the most frequent localisation of frontal or ethmoidal mucocele. Generally its evolution is slow, but some times they evolve as acute inflammatory processes. The AA. report 2 paradigmatic cases of each course. The CAT shows the thinning out of the bone and the spreading of the disease. Comments on the symptomatology, exploratory means and differential diagnosis with other sinusal or orbital conditions.

Aged↗

[Sphenoidal mucocele. A case report].

Mucocele of the sphenoidal sinus is a rare benign neoplasm. These tumors are probably under-diagnosed as they may be asymptomatic or cause non-specific symptoms. The findings of computed tomography and magnetic resonance imaging increase the precision of the pretherapeutic evaluation. Treatment is surgical. A case of sphenoidal sinus mucocele in a 41-year-old man is reported. Sudden dyplopia was the first symptom. The characteristics of sphenoidal mucocele are reviewed, with special attention to its clinical features and radiodiagnosis.

Adult↗

[The effect of tobacco consumption on acoustic voice analysis].

An observational study of acoustic voice parameters was made in non-dysphonic adult smokers and non-smokers. The sustained vocal /a/ of 79 smokers and 169 non-smokers was recorded with Mini-Disk equipment. Acoustic analysis was performed with the Dr. Speech Science 3.0 program. Some acoustic parameters differed between smokers and non-smokers: the fundamental frequency (FQ) was lower in smokers. Average jitter (PPQ) and shimmer (APQ) were higher in smokers (Ji:0.27%, Shi: 2.56%) than in non-smokers (Ji: 0.23%, Shi: 2.02%). HNR and NNE values did not differ significantly.

Adolescent↗

[Mastoid osteoma].

Extra-canalicular osteomas of the temporal bones are rare benign tumours. We report a retroauricular osteoma in a 18 years old patient. Usually symptomless, they may present for cosmetic reasons. We briefly comment this type of tumours.

Adolescent↗

[Solitary extramedullary plasmocytoma of the nasal cavity].

A case of Extramedullary Plasmacytoma of nasopharynx is reported in a 41 years old man. The presenting symptom was bilateral nasal obstruction. Multiple Myeloma was excluded. The treatment was surgical excision and postsurgical radiotherapy. At present the patient is well.

Adult↗

[Cervical chordoma].

Chordoma is an uncommon neoplasia with very aggressive behavior and very high local recurrence rate. It remains a difficult problem for the surgeon. A case of cervical chordoma in a 30 years old woman is reported. The patient had a retropharyngeal mass and changes in the quality of speech. A transoral approach was used to obtain complete removal. The biological, clinical and diagnostic characteristic of cervical chordomas are reviewed.

Adult↗

[Inflammatory pseudotumor of the paranasal sinuses].

The inflammatory pseudotumor of the head and of the neck is a lesion of unknown etiology which affects the orbita more frequently but cases have also been described in the paranasal sinuses, larynx, mouth, cervical column and by direct extension from the orbita in the Central Nervous System. In the majority of cases, it behaves as a limited benignant inflammation within the osseous walls of the area where it is to be found; other times it destroys the osseous limits and invades the surrounding areas, behaving as a neoplasia. It must be distinguished from sinusitis, granulomatous inflammations, vasculitis, diseases of the collagen, sarcoidosis, neoplasias and benignant tumours. We present a case of inflammatory pseudotumour, occupying the right maxillary sinus, nasal fossa and rhinopharynx. Surgical extirpation has been the treatment used.

Adult↗

[Juvenile nasopharyngeal angiofibroma. Apropos of a case].

We present the case of a 14 years old male with juvenile nasopharyngeal angiofibroma, treated in our Department with radiotherapy due to the patient having declined surgery. In the control carried out 2 years after finishing radiotherapy the tumour had disappeared. Up to now, we have not found important secondary effects of the treatment. We go over what has been published during the last few years about this disease.

Adolescent↗

[Cancer of the nasopharynx: our experience with 34 cases].

Thirty four cases of patients with nasopharyngeal cancer, all white people, are reviewed. The more frequent clinical signs are, in order of frequency: nasal obstruction, which is presented in 65% of patients, transmission deafness, in 59%; adenomegalies in 44%; epistaxis in 26% and migraine in 21% of cases. The mean time evolution between the first clinical symptom and the treatment was four and a half months. The pathologic study was: epidermoid carcinoma in 31 cases (91.9% and non-Hodgkin lymphoma in 3 cases 8.9%). The 31 cases of epidermoid carcinoma were treated with radiotherapy and the 5 years survival was 38%. In 62% of cases, the tumor recurred locally, in lymph nodes or were distant metastasis.

Adult↗