RESUMEN
INTRODUCTION: Mycotic infection of paranasal sinus could be the etiological factor of chronic sinusitis. The increase in number of fungal sinusitis cases have been reported recently among nonimmunocompromised patient after endodontic treatment of maxillary teeth. Nonspecific clinical signs and incorrect radiologic pictures interpretation as well as loss of therapeutic standards seems to be the cause of false negative diagnosis and difficulties in treatment of fungal sinusitis. AIM OF THE STUDY: Clinical and radiological picture of maxillary sinus aspergillosis was described in this paper. MATERIAL AND METHODS: In the period of 2006-2009 in the Department of Maxillo-Facial Surgery 19 patient with fungal maxillary sinusitis was treated. The endodontic treatment of maxillary teeth of the related side was performed previously in 80% examined cases. In 2 cases there were immunocompromised patients with immunosuppressive treatment. In 16 cases patients were referred to our Department due to metallic foreign body of the maxillary sinus. Routine diagnostic radiological imaging was performed in each case: paranasal sinus view--Water's view and panoramic radiograph (orthopantomograph). In 4 cases imaging was extended with computer tomography (CT) visualization. The surgical treatment was performed in each case. The final diagnosis was puted on histopathological examination and fungal culture. RESULTS: In 16 cases of analysed group histopathological examination and fungal culture revealed aspergilosis. In 2 cases fungal culture was negative, but histopathology slices confirm presence of hyphae of Aspergillus. In 1 case the root canal sealer was found in the maxillary sinus. In none case invasive form of aspergillosis was confirmed. In all cases Water's view of paranasal sinuses and ortopantomograph showed partially or totally clouded sinus with well-defined, single or multifocal radiopaque object similar to metallic foreign body. Characteristic finding in CT imaging was well-defined radiodence concretions that have been attributed to calcium deposits in inflammatory changed mucosa, that might suggest "foreign body" picture. In 1 to 3 years follow-up control there was a recurrence of symptoms in one case. CONCLUSIONS: Foreign body of maxillary sinus have to be differentiated with aspergilosis. Metallic "foreign body" view in maxillary sinus seems to be characteristic sign of aspergillosis. The most often form of maxillary sinus aspergilosis is aspergilloma.
Asunto(s)
Aspergilosis/diagnóstico por imagen , Seno Maxilar/diagnóstico por imagen , Seno Maxilar/microbiología , Sinusitis Maxilar/diagnóstico por imagen , Sinusitis Maxilar/cirugía , Aspergilosis/cirugía , Aspergillus flavus/aislamiento & purificación , Aspergillus fumigatus/aislamiento & purificación , Estudios de Seguimiento , Humanos , Sinusitis Maxilar/microbiología , Senos Paranasales/diagnóstico por imagen , Senos Paranasales/microbiología , Polonia , Radiografía , Estudios Retrospectivos , Resultado del TratamientoRESUMEN
The study was performed in 224 patients with exacerbated chronic duodenal ulcer and with Helicobater pylori (H. pylori) infection. The infection was confirmed by histological techniques and rapid urease test. The patients were treated randomly with one of the triple therapies: 1) omeprazole with amoxicillin and clarithromycin, 2) omeprazole with clarithromycin and metronidazole or 3) colloidal bismuth with amoxicillin and metronidazole and after eradication the antiulcer drug was continued for 4 weeks. The control endoscopy was performed 6 weeks after the beginning of the therapy and during two-year follow-up. The ulcer healing, macroscopic and microscopic appearance of the gastric mucosa and H. pylori infection was examined. Endoscopy was repeated 1 and 2 years after successful eradication. The ulcer was healed in 93%, 95% and 92% of patients from groups I, II and III, respectively, and eradication of H. pylori was seen in 83-90% of cases. The treatment significantly diminished the chronic active gastritis. During 1- and 2-year follow-up the ulcer recurrences were observed in 5.3% and 13% of patients and reinfection in 7.7% and 16.7% of cases. The ulcer recurrences appeared in patients with H. pylori infection. The H. pylori reinfection rate was higher than observed in western countries.
Asunto(s)
Quimioterapia Combinada/uso terapéutico , Úlcera Duodenal/tratamiento farmacológico , Infecciones por Helicobacter/tratamiento farmacológico , Helicobacter pylori , Adulto , Amoxicilina/administración & dosificación , Bismuto/administración & dosificación , Enfermedad Crónica , Claritromicina/administración & dosificación , Duodenoscopía , Femenino , Estudios de Seguimiento , Infecciones por Helicobacter/diagnóstico , Humanos , Masculino , Metronidazol/administración & dosificación , Persona de Mediana Edad , Omeprazol/administración & dosificación , Recurrencia , Cicatrización de HeridasRESUMEN
Barretts esophagus (BE) is a disorder in which the normal squamous mucosa of the esophagus is replaced by columnar epithelium. Data from the literature of the last years show that BE with so-called specialized intestine type mucosa is a frequently diagnosed disease during endoscopical examination, particularly in men over 60 years of age with heartburn. This type of epithelium is a recognized risk factor of the esophageal adenocarcinoma. There is presented the current classification, pathogenesis, diagnosis and treatment of BE as well as the problem of the BE connection with the esophageal adenocarcinoma.