Asunto(s)
Coartación Aórtica/complicaciones , Anomalías del Ojo/complicaciones , Pérdida Auditiva Conductiva/etiología , Síndromes Neurocutáneos/complicaciones , Angiomatosis/patología , Coartación Aórtica/diagnóstico , Coartación Aórtica/patología , Preescolar , Anomalías del Ojo/diagnóstico , Anomalías del Ojo/patología , Femenino , Pérdida Auditiva Conductiva/diagnóstico , Hemangioma/patología , Humanos , Síndromes Neurocutáneos/diagnóstico , Síndromes Neurocutáneos/patología , Otoscopía , SíndromeAsunto(s)
Humanos , Femenino , Preescolar , Niño , Coartación Aórtica/complicaciones , Anomalías del Ojo/complicaciones , Síndromes Neurocutáneos/complicaciones , Pérdida Auditiva Conductiva/etiología , Coartación Aórtica/diagnóstico , Coartación Aórtica/patología , Síndrome , Anomalías del Ojo/diagnóstico , Anomalías del Ojo/patología , Síndromes Neurocutáneos/diagnóstico , Síndromes Neurocutáneos/patología , Otoscopía , Pérdida Auditiva Conductiva/diagnóstico , Hemangioma/patología , Angiomatosis/patologíaRESUMEN
Recent studies have identified sensorineural hearing loss as a possible manifestation of ankylosing spondylitis. We conducted a study of 30 patients with ankylosing spondylitis to characterize their audiologic profile and to correlate their disease activity and functional indices with their hearing thresholds. The study group was made up of 18 men and 12 women, aged 25 to 58 years (mean: 46.5), who were diagnosed with ankylosing spondylitis. We compared their findings with a socially and demographically matched group of 30 healthy controls. All 60 participants underwent an audiologic assessment, consisting of pure-tone audiometry, speech audiometry, and tympanometry. We used validated indices to assess disease activity and functional status, and we compiled information on the time of diagnosis and the types of medications used to treat the ankylosing spondylitis. We found that the average of the mean air-conduction thresholds at 0.5, 1, 2, and 4 kHz in the ankylosing spondylitis group was significantly worse than that of the controls (p = 0.004). A statistically significant difference was observed at frequencies greater than 3 kHz (p < 0.05). A subgroup of case patients who used only a tumor necrosis factor-alpha inhibitor exhibited better hearing thresholds than patients who used other drugs (p = 0.01). Differences in functional and disease activity scores between case patients with and without hearing loss were not statistically significant. We found that patients with ankylosing spondylitis did indeed have a greater prevalence of sensorineural hearing loss but that it was not correlated with either disease activity or functional status.
Asunto(s)
Umbral Auditivo/fisiología , Pérdida Auditiva Sensorineural/etiología , Espondilitis Anquilosante/fisiopatología , Adulto , Audiometría/métodos , Estudios de Casos y Controles , Femenino , Pérdida Auditiva Sensorineural/epidemiología , Humanos , Masculino , Persona de Mediana Edad , Prevalencia , Espondilitis Anquilosante/complicaciones , Espondilitis Anquilosante/tratamiento farmacológico , Factor de Necrosis Tumoral alfa/antagonistas & inhibidoresRESUMEN
Introduction The etiology of Ménière disease (MD), a difficult-to-treat condition with great morbidity, remains controversial in the literature. The possible clinical and diagnostic impact of anatomical variations of the temporal bone among patients with MD has been recently studied. Objective To identify anatomical variations of the temporal bone associated with the diagnosis of MD. Methods Thirty-seven patients were included, although each ear was considered separately ( n = 74). A case group ( n A = 33) was composed of the affected ears of patients with definite MD and a control group ( n B = 41) was used consisting of the ears of individuals who did not meet the criteria for MD and of the contralateral ears from patients with unilateral disease. Tomographic images from the individuals included in the study were submitted to a blinded and systematic evaluation regarding a broad variety of anatomical variations of the temporal bone. Obtained data were compared statistically between the groups and after stratifying the study sample. Significance level was set at 0.05. Results Among the affected ears, it was observed an increased number of tomographic scans in which the vestibular aqueduct could not be identified ( p = 0.01, Fisher exact test). No statistically significant differences were observed when comparing the affected and contralateral ears from patients with unilateral MD, between affected ears from patients with unilateral and bilateral disease or between contralateral ears of patients with unilateral affection and patients without the disease. Conclusion Some anatomical variations might be more frequent in the affected ears of patients with MD, such as the lower rates of individualization of the vestibular aqueduct.
RESUMEN
Abstract Introduction The etiology of Ménière disease (MD), a difficult-to-treat condition with great morbidity, remains controversial in the literature. The possible clinical and diagnostic impact of anatomical variations of the temporal bone among patients with MD has been recently studied. Objective To identify anatomical variations of the temporal bone associated with the diagnosis of MD. Methods Thirty-seven patients were included, although each ear was considered separately (n = 74). A case group (nA = 33) was composed of the affected ears of patients with definiteMDand a control group (nB = 41) was used consisting of the ears of individuals who did not meet the criteria for MD and of the contralateral ears from patients with unilateral disease. Tomographic images from the individuals included in the study were submitted to a blinded and systematic evaluation regarding a broad variety of anatomical variations of the temporal bone. Obtained data were compared statistically between the groups and after stratifying the study sample. Significance level was set at 0.05. Results Among the affected ears, it was observed an increased number of tomographic scans in which the vestibular aqueduct could not be identified (p = 0.01, Fisher exact test). No statistically significant differences were observed when comparing the affected and contralateral ears frompatients with unilateral MD, between affected ears from patients with unilateral and bilateral disease or between contralateral ears of patients with unilateral affection and patients without the disease. Conclusion Some anatomical variations might be more frequent in the affected ears of patients with MD, such as the lower rates of individualization of the vestibular aqueduct.
Asunto(s)
Humanos , Masculino , Femenino , Hueso Temporal/patología , Hueso Temporal/diagnóstico por imagen , Enfermedad de Meniere/patología , Enfermedad de Meniere/diagnóstico por imagen , Acueducto Vestibular/patología , Acueducto Vestibular/diagnóstico por imagen , Tomografía Computarizada por Rayos X , Estudios de Casos y Controles , Acueducto Coclear/patología , Acueducto Coclear/diagnóstico por imagenRESUMEN
AbstractParacoccidioidomycosis is a systemic mycosis caused by Paracoccidioides brasiliensis. It occurs more frequently in its chronic form, which particularly affects male adults from rural areas. These patients present with pulmonary involvement and systemic symptoms. Skin and mucosal lesions are rather typical and might suggest the diagnosis. The involvement of the upper airway mucosa is common and the patients usually complain of dysphagia and dysphonia. Nonetheless, in endemic areas, physicians should maintain a high level of suspicion even when faced with some atypical symptoms. We present the case of an adult diagnosed with nasopharyngeal paracoccidioidomycosis after presenting with an unusual otolaryngologic syndrome including unilateral soft palate paralysis with velopharyngeal insufficiency and hearing loss secondary to middle ear effusion.
Asunto(s)
Pérdida Auditiva/diagnóstico , Otitis Media con Derrame/diagnóstico , Paracoccidioides/aislamiento & purificación , Paracoccidioidomicosis/diagnóstico , Adulto , Antiinfecciosos , Oído Medio/microbiología , Oído Medio/patología , Pérdida Auditiva/tratamiento farmacológico , Pérdida Auditiva/microbiología , Pérdida Auditiva/patología , Humanos , Masculino , Ventilación del Oído Medio , Nasofaringe/microbiología , Nasofaringe/patología , Otitis Media con Derrame/tratamiento farmacológico , Otitis Media con Derrame/microbiología , Otitis Media con Derrame/patología , Paladar Blando/microbiología , Paladar Blando/patología , Paracoccidioides/efectos de los fármacos , Paracoccidioides/patogenicidad , Paracoccidioidomicosis/tratamiento farmacológico , Paracoccidioidomicosis/microbiología , Paracoccidioidomicosis/patología , Resultado del Tratamiento , Combinación Trimetoprim y SulfametoxazolRESUMEN
Ascite quilosa (AQ) é condição rara, sendo caracterizada pelo acúmulo de linfa na cavidade abdominal. Os linfomas constituem-se, em adultos, em sua causa mais frequente; enquanto cirrose e/ou trombose da veia porta são especialmente raras. Este relato apresenta paciente com 36 anos de idade, masculino, com cirrose associada à hepatite C crônica e alcoolismo, emagrecimento de 15 kg e ascite leitosa, com predominância de triglicérides (1.500 mg/dL). Os métodos de imagem identificaram a concomitância de trombose de veia porta e cavernoma. A melhora clínica significativa foi obtida com a administração de nutrição parenteral total associada ao octreotide. A abstinência ao álcool não foi conseguida e houve reaparecimento da AQ e deterioração da condição clínica. O prognóstico da AQ em vigência de cirrose hepática é ruim. O tratamento deve ser individualizado de acordo com a condição clínica subjacente.
Chylous ascites (QA) is a rare condition, being characterized by the accumulation of lymph in the abdominal cavity. In adults, lymphomas constitute its most frequent cause; while cirrhosis and/or thrombosis of the portal vein are especially rare. This report presents a male patient, 36 years old, with chronic hepatitis C-related cirrhosis and alcoholism, 15 kg weight loss, and milky ascites with a predominance of triglycerides (1,500 mg/dL). The imaging methods identified the concomitance of thrombosis of the portal vein and cavernoma. The significant clinical improvement was obtained with the administration of total parenteral nutrition associated with octreotide. Alcohol abstinence was not achieved resulting in QA reappearance and deterioration of the clinical condition. The prognosis of QA in term of liver cirrhosis is bad. The treatment should be individualized according to the underlying clinical condition.
RESUMEN
A figura mítica dos vampiros é, sem dúvida, uma das mais intrigantes, sedutoras e horripilantes da cultura popular atual. Esses personagens já habitam há centenas de anos a crença de muitos indivíduos - sendo lembrados pela sua inesgotável sede de sangue e pelo medo que desencadeiam nas pessoas. Durante os anos, tornaram-se figuras presentes em várias representações gráficas, literárias e cinematográficas. Esse fenômeno histórico ganhou diversas teorias nas quais se tentou dissecar a verdadeira origem das lendas sobre esses seres da noite. Este artigo, por meio de uma revisão de literatura, apresenta as tentativas de explicação da origem do vampirismo por meio de abordagem científica...
The mythical figure of the vampire is undoubtedly one of the most intriguing, seductive, and horrifying in current popular culture. For hundreds of years, these characters have inhabited the belief systems of many individuals and are remembered for their insatiable blood lust and the fear they trigger in people. Over the years they have been present inseveral pictorial, literary, and cinematic representations. This historical phenomenon has generated several theories that try to dissect the true origin of the legends regarding these creatures of the night. This article is a literature review presenting the attempts to explain the origin of vampirism through a scientific approach...