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Children who underwent tonsillectomy due to OSAS have significantly bigger tonsils than those with hypertrophic tonsils without OSAS 由于OSAS而行扁桃体切除术的儿童扁桃体明显大于没有OSAS的肥大扁桃体
Q4 Medicine Pub Date : 2020-09-01 DOI: 10.25121/newmed.2020.24.3.92
Wiktoria Olińska, J. Urbančič, Piotr Kwast, L. Zawadzka-Głos
Introduction. Tonsillectomy is one of the most commonly performed procedures in otolaryngology departments. Main indications include tonsil hypertrophy with or without obstructive sleep apnea and recurrent throat infections. The size of tonsils in the group of children qualified for tonsillectomy with obstructive sleep apnea may differ from the size of tonsils in the group without obstructive sleep apnea. Aim. Comparison of morphological features of tonsils in children with and without OSAS undergoing tonsillectomy. Material and methods. Retrospective study conducted from 2011 until 2020, including patients under 18 years old who underwent a total or partial tonsillectomy at the Department of Otorhinolaryngology at the University Medical Center in Ljubljana. Results. Among 824 patients included in the analysis, 96 underwent tonsillectomy due to OSAS and 728 due to tonsil hypertrophy without OSAS. Both groups were comparable in terms of mean age and sex distribution. Tonsil size statistically differed in both groups (p = 0.01), with the prevalence of big tonsils (grade 3 of 4) in the non-OSAS group (in 47% of patients) and large tonsils (grade 4 of 4) in the OSAS group (in 53% of patients). Conclusions. In age and sex-matched groups of children who underwent total or partial tonsillectomy, patients who underwent the procedure due to OSAS had bigger tonsils than those with hypertrophy without OSAS.
介绍。扁桃体切除术是耳鼻喉科最常见的手术之一。主要适应症包括扁桃体肥大伴或不伴阻塞性睡眠呼吸暂停和反复咽部感染。患有阻塞性睡眠呼吸暂停的儿童扁桃体切除术组的扁桃体大小可能与未患有阻塞性睡眠呼吸暂停的儿童组的扁桃体大小不同。的目标。行扁桃体切除术的osaas患儿与非osaas患儿扁桃体形态特征比较。材料和方法。回顾性研究于2011年至2020年进行,包括在卢布尔雅那大学医学中心耳鼻喉科接受全部或部分扁桃体切除术的18岁以下患者。结果。在纳入分析的824例患者中,96例因OSAS而行扁桃体切除术,728例因扁桃体肥大而无OSAS。两组在平均年龄和性别分布方面具有可比性。两组患者扁桃体大小差异有统计学意义(p = 0.01),非OSAS组大扁桃体(3 / 4级)患病率为47%,OSAS组大扁桃体(4 / 4级)患病率为53%。结论。在年龄和性别匹配的接受全部或部分扁桃体切除术的儿童中,由于OSAS而接受手术的患者的扁桃体比没有OSAS的肥大患者的扁桃体更大。
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引用次数: 0
The oral health status and dental treatment needs of children affected by osteogenesis imperfecta – part I 成骨不全儿童的口腔健康状况及牙科治疗需求——第一部分
Q4 Medicine Pub Date : 2020-06-01 DOI: 10.25121/newmed.2020.24.2.60
A. Kozubska, D. Chlebna-Sokół, E. Jakubowska-Pietkiewicz, I. Michałus, Karolina Beska-Bartecka, J. Szczepanska
Introduction. Osteogenesis imperfecta is an inherited disorder of the connective tissue. Which in most cases, is caused by mutations in the genes encoding collagen type I. Apart from clinical features, there are characteristic dental aberrations. Aim. The purpose of this research was the assessment of the condition of teeth and therapeutic needs of children with the congenital brittle bone disease. Material and methods. The questionnaires with patient’s parents, consisting medical history and dental history were performed. The intra-oral examination included the condition of the dentition, the presence of dentinogenesis imperfecta, malocclusion, the assessment of the attrition index and dmft/DMFT index. Results. 62 patients with osteogenesis imperfecta were examined – 32 boys and 30 girls. There were normal eruption times of deciduous (48 patients – 77.42%) and permanent teeth (34 patients – 82.93%) reported in the majority of the patients with OI. In most cases bad eating and hygienic habits were observed. Dentinogenesis imperfecta in deciduous and permanent teeth was reported mostly in type III of OI. dmft/DMFT index among children with OI were low in comparison to the population studies of corresponding age groups. Conclusions. Despite bad eating and hygienic habits as well as pathological structure of dentition of patients with the congenital brittle bone disease, caries index among these children were low in comparison to the population studies of corresponding age groups.
介绍成骨不全是一种遗传性结缔组织疾病。在大多数情况下,这是由编码I型胶原的基因突变引起的。除了临床特征外,还有特征性的牙齿畸变。目标本研究的目的是评估先天性脆性骨病儿童的牙齿状况和治疗需求。材料和方法。对患者父母进行问卷调查,包括病史和牙科病史。口腔内检查包括牙列状况、是否存在牙本质发育不全、错牙合、磨损指数和dmft/dmft指数的评估。后果对62名成骨不全患者进行了检查——32名男孩和30名女孩。据报道,大多数OI患者的乳牙(48例,占77.42%)和恒牙(34例,占82.93%)萌出时间正常。在大多数情况下,观察到不良的饮食和卫生习惯。乳牙和恒牙的成牙不全主要发生在III型OI中。与相应年龄组的人群研究相比,OI儿童的dmft/dmft指数较低。结论。尽管先天性脆性骨病患者有不良的饮食和卫生习惯以及牙列的病理结构,但与相应年龄组的人群研究相比,这些儿童的龋齿指数较低。
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引用次数: 0
Analysis of tracheotomy indications in children treated in the Department of Pediatric Otolaryngology of Medical University of Warsaw between 2015-2020 华沙医科大学儿科耳鼻喉科2015-2020年患儿气管切开术指征分析
Q4 Medicine Pub Date : 2020-06-01 DOI: 10.25121/newmed.2020.24.2.39
M. Chromniak, Maria Koziołek, K. Pawlik, Monika Jabłońska-Jesionowska, L. Zawadzka-Głos
Introduction. Tracheostomy is the opening enabling breathing without the larynx, throat and mouth, which aims to restore and sustain airway patency. Indications of this intervention have changed over the years. The selection of patients for this procedure, as well as the moment, when it has to be performed are still not clearly defined. Those require a multidisciplinary approach and a standardized protocol. More analyses are necessary to create widely available guidelines. Aim. Analysis of tracheotomy indications in children performed between 2015-2020 in the Department of Pediatric Otolaryngology, Medical University of Warsaw. Material and methods. During the 5-year period (2015-beginning of 2020) 64 children with tracheostomy were treated in the Department of Pediatric Otolaryngology. Groups of tracheotomy indications were separated after a retrospective overview of the 64 cases from our clinic and after manual and electronic search through medical databases for indications for tracheotomy in previous years. Then patient’s data (age at the time of surgery, concomitant diseases and/or disabilities) was collated, which allowed to present the characteristics of children and compare the tracheotomy indications in previous years with the results of this research. Results. Tracheotomy was performed among 64 children. The median patients’ age was 0.5 year and the average age was 4.26 years. Our patients were affected by many various conditions. We divided them into 8 main groups: congenital malformation syndromes, trauma, vocal folds palsy, perinatal complications, infection, autoimmune diseases, oncological and post-intubation subglottic stenosis. Currently, congenital malformation syndromes turned out to be the most common indication for tracheotomy. Conclusions. 1. Tracheotomy indications in children have changed over the years. 2. There is increasing number of tracheotomies due to various congenital defects. 3. New groups of tracheotomy indications among children are autoimmune diseases and injuries; those groups have the highest average of age. 4. The result of effective pharmacological treatment of laryngeal hemangiomas is the lack of tracheotomy performed in this indication. 5. The number of tracheotomies performed due to post-intubation stenosis has decreased. 6. Vocal cords palsy as an indication for tracheotomy in children is most often a complication of cardiac surgery due to congenital heart defect; this group of patient’s is the youngest among all. 7. Viral infections are still the tracheotomy indication among children.
介绍气管造口术是一种能够在没有喉、喉咙和嘴巴的情况下进行呼吸的开口,旨在恢复和维持气道通畅。多年来,这种干预的迹象已经发生了变化。这项手术的患者选择以及必须进行的时机仍不明确。这些需要多学科方法和标准化协议。需要进行更多的分析,以制定广泛可用的指导方针。目标华沙医科大学儿童耳鼻喉科2015-2020年间进行的儿童气管切开指征分析。材料和方法。在5年期间(2015年至2020年初),64名气管造口患儿在儿童耳鼻咽喉科接受了治疗。在对我们诊所的64例病例进行回顾性综述后,并在前几年通过医疗数据库手动和电子搜索气管切开适应症后,将气管切开适应证分组。然后对患者的数据(手术时的年龄、伴随疾病和/或残疾)进行整理,从而呈现儿童的特征,并将前几年的气管切开指征与本研究的结果进行比较。后果对64名儿童进行了气管切开术。患者的中位年龄为0.5岁,平均年龄为4.26岁。我们的病人受到许多不同情况的影响。我们将他们分为8个主要组:先天性畸形综合征、创伤、声带麻痹、围产期并发症、感染、自身免疫性疾病、肿瘤学和插管后声门下狭窄。目前,先天性畸形综合征已成为气管切开术最常见的适应症。结论。1.多年来,儿童气管切开指征发生了变化。2.由于各种先天性缺陷,气管切开术的数量越来越多。3.儿童气管切开术的新适应症是自身免疫性疾病和损伤;这些群体的平均年龄最高。4.有效的药物治疗喉血管瘤的结果是在该适应症中缺乏气管切开术。5.由于插管后狭窄而进行的气管切开术次数有所减少。6.声带麻痹作为儿童气管切开术的指征,最常见的是先天性心脏缺陷引起的心脏手术并发症;这群病人是所有病人中最年轻的。7.病毒感染仍然是儿童气管切开的指征。
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引用次数: 0
Treatment methods of deep caries in immature permanent teeth 未成熟恒牙深龋的治疗方法
Q4 Medicine Pub Date : 2020-06-01 DOI: 10.25121/newmed.2020.24.2.76
Anna Szufnara, Sylwia Majewska-Beśka, J. Szczepanska
Caries was qualified by UN as non-communicable disease – NCD. It can be avoided by preventive measures. Especially, deep caries lesions in immature permanent teeth constitute a serious clinical problem for contemporary pediatric dentistry. It is caused by a different anatomical and histological structure compared to mature permanent teeth. The aim of the study was to present contemporary methods of deep caries treatment in histologically and morphologically immature teeth with currently used materials. The literature review was based on Pubmed and Elsevier databases (2005-2018) and two articles out-of-range. The search criteria were: “caries”, “remineralization”, “indirect capping” and “immature teeth”. Development in medicine and biomedical science leads to creating more modern procedural records when it comes to deep caries treatment. They are based on minimally invasive dentistry. Development of bioengineering enables creation of more biocompatible materials which do not have irritating influence on dental pulp. These materials allow deeper remineralization of dental tissues. Deep caries treatment still involves usage of restorations with calcium hydroxide, zinc oxide with eugenol and glass ionomers. Good cooperation with patient, prospects of early diagnosis, and regular examinations of treated teeth have great impact on success of treatment. Further research on methods of diagnosis and treatment needs to be carried out. They should allow regeneration of early qualitative changes to avoid quantitative damages in a tooth’s hard tissue.
Caries被联合国认定为非传染性疾病。采取预防措施是可以避免的。特别是,未成熟恒牙的深龋病变对当代儿童牙科来说是一个严重的临床问题。与成熟的恒牙相比,它是由不同的解剖和组织结构引起的。本研究的目的是介绍用目前使用的材料治疗组织学和形态学未成熟牙齿深龋的现代方法。文献综述基于Pubmed和Elsevier数据库(2005-2018)以及两篇超出范围的文章。搜索标准为:“龋齿”、“再矿化”、“间接覆盖”和“未成熟牙齿”。随着医学和生物医学的发展,在深龋治疗方面创造了更多的现代程序记录。它们基于微创牙科。生物工程的发展使得能够创造出对牙髓没有刺激性影响的更具生物相容性的材料。这些材料允许对牙齿组织进行更深层次的再矿化。深龋治疗仍然包括使用氢氧化钙、丁香酚氧化锌和玻璃离聚物进行修复。与患者的良好合作、早期诊断的前景以及对治疗牙齿的定期检查对治疗的成功有很大影响。需要对诊断和治疗方法进行进一步的研究。它们应该允许早期质量变化的再生,以避免牙齿硬组织的定量损伤。
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引用次数: 1
The attitude of polish dentists towards children treatment 波兰牙医对待儿童治疗的态度
Q4 Medicine Pub Date : 2020-06-01 DOI: 10.25121/newmed.2020.24.2.51
M. Prokopczyk, Zuzanna Piotrkowicz, Anna Turska-Szybka
Introduction. The dentist’s attitude towards treating children influences the success of dental treatment and can be shaped by the healthcare system, appropriate preparation for treating young patients, and the use of various methods of cooperation. Aim. The aim of the study was to present the dentists’ approach to the treatment of juvenile patients and to discuss treatment procedures and factors, which have an influence on communication and treatment planning. Material and methods. The study included 736 dentists. The questionnaire consisted of 46 questions and covered topics related to socio-demographic data, number of treated children, pharmacological premedication, adaptation visits, treatment of deciduous and immature permanent teeth, behavioral methods of shaping the child’s attitude, non--cooperative patients as well as dentophobia. Results. Amount of 577 questionnaires were qualified for the final analysis, women: 85.4%, men: 14.6%. The mean age was 33 ± 8.2 years. Only 17.9% of the respondents had a specialization, including 24.3% in pedodontics. Among the respondents, 85.1% treated young children up to the age of 6. Treatment of deciduous teeth without local anesthesia was performed by 18.5% of dentists. According to 84.9% of the respondents, it was possible to overcome the child’s dentophobia thanks to adaptation visits. Prophylactic procedures were performed by 98.0% of physicians, while pharmacological premedication was used by 16.7%. As much as 93.5% of dentists used glass ionomer cement to restore deciduous teeth. Non-cooperative children were referred to treatment under general anesthesia by 71.5% of the respondents. Disabled patients were treated by 60.5%. Every fourth dentist used child immobilization and every sixth expressed an interest in pedodontics courses. Conclusions. The vast majority of dentists treat children, including the youngest up to 6 years old, as well as disabled children. Almost every dentist performs preventive treatment. There is a strong correlation between the age of the dentist and the type of treatment used. Uncooperative children are referred for treatment under general anesthesia. It is possible to overcome dentophobia in young patients thanks to properly planned adaptation visits.
介绍牙医对治疗儿童的态度影响着牙科治疗的成功,并且可以通过医疗保健系统、治疗年轻患者的适当准备以及各种合作方法的使用来形成。目标本研究的目的是介绍牙医治疗青少年患者的方法,并讨论影响沟通和治疗计划的治疗程序和因素。材料和方法。这项研究包括736名牙医。该问卷由46个问题组成,涵盖了与社会人口统计数据、接受治疗的儿童数量、药物治疗前、适应访视、乳牙和未成熟恒牙的治疗、塑造儿童态度的行为方法、不合作患者以及恐齿症有关的主题。后果符合最终分析条件的问卷共577份,女性85.4%,男性14.6%,平均年龄33±8.2岁。只有17.9%的受访者有专业知识,其中24.3%的受访者从事口腔正畸。在受访者中,85.1%的人治疗了6岁以下的幼儿。18.5%的牙医在没有局部麻醉的情况下治疗乳牙。84.9%的受访者表示,通过适应访问,有可能克服孩子的牙齿恐惧症。98.0%的医生进行了预防性手术,16.7%的医生使用了药物治疗。多达93.5%的牙医使用玻璃离子聚合物水泥修复乳牙。71.5%的受访者将不合作的儿童转诊到全麻下接受治疗。60.5%的残疾患者接受了治疗。每四分之一的牙医使用儿童固定器,每六分之一的牙科医生表示对儿童牙科课程感兴趣。结论。绝大多数牙医治疗儿童,包括最小的6岁以下的儿童,以及残疾儿童。几乎每个牙医都进行预防性治疗。牙医的年龄和所使用的治疗类型之间有很强的相关性。未手术的儿童在全身麻醉下接受治疗。由于有适当计划的适应访视,有可能克服年轻患者的牙齿恐惧症。
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引用次数: 0
Idiopathic left-sided buccal abscess – a case report 特发性左颊脓肿1例
Q4 Medicine Pub Date : 2020-06-01 DOI: 10.25121/newmed.2020.24.2.45
M. Wolniewicz, L. Zawadzka-Głos
Abscesses of the head and neck region account for an important clinical problem. They are most frequently of dental origin (mainly due to carious changes or state after dental interventions), especially when located in the buccal region (about 1/3 cases). The correct diagnosis is the key to determine the proper treatment protocol: systemic antibiotics and/or surgical procedure (usually drainage) in order to prevent further progression of the inflammatory process (including transgression of the blood-brain barrier). Ultrasound is a sufficient first line diagnostic tool for the changes localized in the superficial spaces. Additionally, it is helpful in monitoring the effectiveness of the introduced treatment. Alternatively, MRI could be used, enabling more thorough 3D visualization of the affected areas and tissues differentiation, but due to its cost and availability its role is restricted, especially in monitoring (when examination needs to be repeated regularly). Below we would like to present a case report of our teenage patient, who developed idiopathic left-sided buccal abscess.
头颈部脓肿是一个重要的临床问题。它们最常见的是牙齿起源(主要是由于牙齿干预后的龋齿变化或状态),特别是位于颊区(约1/3)。正确的诊断是确定适当治疗方案的关键:全系统抗生素和/或外科手术(通常是引流),以防止炎症过程进一步发展(包括越过血脑屏障)。超声是一个足够的一线诊断工具的变化局限于浅表空间。此外,它有助于监测所引入治疗的有效性。另外,也可以使用MRI,使患处和组织分化的3D可视化更彻底,但由于其成本和可用性,其作用受到限制,特别是在监测(当检查需要定期重复时)。下面我们想提出一个病例报告,我们的青少年患者,谁发展为特发性左侧颊脓肿。
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引用次数: 0
A paediatric patient with nasal septal perforation – symptoms, diagnosis and treatment options 小儿鼻中隔穿孔-症状,诊断和治疗方案
Q4 Medicine Pub Date : 2020-03-01 DOI: 10.25121/NEWMED.2020.24.1.11
M. Pilch, A. Tuszyńska, Karolina Raczkowska-Łabuda, L. Zawadzka-Głos
Introduction. Nasal septum is an anatomical structure which not only separates both nasal cavities, but is also a supporting element for the external nose, and has an impact on its physiology. Structural abnormalities of the nasal septum, such as deviations and defects, affect the airflow in the nasal cavities. Nasal septal perforation is one of the factors that impair nasal patency due to secondary pathological changes. There are various treatment options, depending on the symptoms reported and the stage of septal lesions. Treatment strategy is selected individually for each patient. Aim. The aim of this paper was to discuss the symptoms, diagnostic methods and treatment options in children with nasal septal perforation. Patients of the Department of Paediatric Otolaryngology, Medical University of Warsaw, were included in the analysis. Material and methods. We present cases of 18 patients aged between 3 and 17 years, admitted to the Outpatient ENT Clinic at the Department of Paediatric Otolaryngology, Medical University of Warsaw. Results. A total of 18 patients aged between 3 and 17 years (mean age 12.83 years, SD = 4.34) reported to our clinic. In most cases, nasal septal perforation developed as a complication of septoplasty (4) or nasal trauma. Nasal bleeding and crusting were the most commonly reported symptoms. Perforation was accompanied by external nasal deformity in about 1/3 of patients. Conclusions. Only few reports on paediatric patients with nasal septal perforation may be found in literature. All data obtained was analysed based on reports describing adult and paediatric patients. The severity of symptoms varied depending on the aetiology.
介绍。鼻中隔是一种解剖学上的结构,它不仅分隔了两个鼻腔,而且是外鼻的支撑元件,对外鼻的生理有影响。鼻中隔的结构异常,如偏差和缺陷,影响鼻腔内的气流。鼻中隔穿孔是由于继发性病理改变而影响鼻腔通畅的因素之一。根据所报告的症状和鼻中隔病变的分期,有多种治疗方案。针对每个患者单独选择治疗策略。的目标。本文旨在探讨儿童鼻中隔穿孔的症状、诊断方法和治疗方案。华沙医科大学儿科耳鼻喉科的患者被纳入分析。材料和方法。我们报告了18例年龄在3至17岁之间的患者,他们住在华沙医科大学儿科耳鼻喉科门诊部。结果。我院共收治18例患者,年龄3 ~ 17岁,平均年龄12.83岁,SD = 4.34。在大多数病例中,鼻中隔穿孔是鼻中隔成形术(4)或鼻外伤的并发症。鼻出血和结痂是最常见的症状。约1/3的患者伴有鼻外畸形。结论。文献中只有少数关于小儿鼻中隔穿孔的报道。所有获得的数据都是根据描述成人和儿科患者的报告进行分析的。症状的严重程度因病因而异。
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引用次数: 0
The first dental visit of a 3-year-old child. Reasons and socioeconomic determinants 一个3岁孩子的第一次牙科检查。原因和社会经济决定因素
Q4 Medicine Pub Date : 2020-03-01 DOI: 10.25121/NEWMED.2020.24.1.26
P. Sobiech, Anna Turska-Szybka, Angelika Kobylińska, D. Olczak-Kowalczyk
Introduction. Early childhood caries affects 41.1% of Polish 3-year-olds. If left untreated, it can affect overall health, cause local infections, and reduce quality of life. Objective. To evaluate the first dental visits of children in the first three years of life in the Warsaw agglomeration. Material and methods. A questionnaire survey of parents/legal guardians of children aged 12 to 36 months, living in the Warsaw agglomeration was conducted. The questionnaire included questions about socioeconomic factors (level of education and age of both parents, number of children in the family, economic level of the family) and the child's first dental visit (age and reason for visiting). Statistical analysis was performed on data obtained from correctly completed questionnaires (Spearman's rank correlation coefficient to assess the relationships between selected variables and using the chi-square test to compare the percentages, p <0.05). Results. 496 out of 827 returned questionnaires were included in the analysis. The mean age of the children was 24.16 ± 6.92 months. 249 (50.2%) children visited the dentist. The most common reasons for the first visit were: dental check-up (47.4%), tooth trauma (19.7%) and the presence of carious lesions (13.3%). The first visits due to trauma were usually reported by children aged 12-18 months. Only 57 (11.5%) children visited the dentist in the first year of life. Among them, the most frequent reason for the visit was check-up (34; 6.9% of the entire study group). There was an increasing frequency of the first dental visit with the age of the child, as well as a negative correlation between the level of education of parents and the visit caused by toothache, abscess or the presence of carious lesions. Tooth decay as a reason of first dental visit was also associated with the lower age of the mother. Conclusions. The recommendation to schedule the first dental visit in the first year of a child's life is not satisfactorily implemented in Poland. It is necessary to disseminate recommendations among the medical personnel providing pediatric and dental care.
介绍41.1%的波兰3岁儿童患有儿童早期龋齿。如果不及时治疗,它会影响整体健康,导致局部感染,并降低生活质量。客观的评估华沙地区儿童出生前三年的首次牙科就诊情况。材料和方法。对居住在华沙地区的12至36个月儿童的父母/法定监护人进行了问卷调查。问卷包括有关社会经济因素(父母双方的教育水平和年龄、家庭中孩子的数量、家庭的经济水平)和孩子第一次牙科就诊(就诊的年龄和原因)的问题。对从正确填写的问卷中获得的数据进行统计分析(Spearman秩相关系数用于评估所选变量之间的关系,并使用卡方检验来比较百分比,p<0.05)。827份返回的问卷中有496份被纳入分析。儿童平均年龄为24.16±6.92个月。249名(50.2%)儿童去看牙医。第一次就诊的最常见原因是:牙齿检查(47.4%)、牙齿创伤(19.7%)和龋齿病变(13.3%)。由于创伤导致的第一次就诊通常由12-18个月的儿童报告。只有57名(11.5%)儿童在出生的第一年去看牙医。其中,就诊最频繁的原因是检查(34;占整个研究组的6.9%)。随着孩子年龄的增长,第一次就诊的频率越来越高,父母的教育水平与牙痛、脓肿或龋齿病变引起的就诊呈负相关。蛀牙作为第一次就诊的原因也与母亲年龄较低有关。结论。关于在儿童出生的第一年安排第一次牙科就诊的建议在波兰没有得到令人满意的执行。有必要在提供儿科和牙科护理的医务人员中传播建议。
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引用次数: 1
The foreign bodies in lower respiratory tract in pediatric patients treated in referral academic department of pediatric otolaryngology 转介儿科耳鼻喉科治疗小儿下呼吸道异物
Q4 Medicine Pub Date : 2020-03-01 DOI: 10.25121/NEWMED.2020.24.1.15
Irina Drogobytska, M. Pilch, L. Zawadzka-Głos
Introduction. Foreign bodies in lower respiratory tract for many years are big challenge for otolaryngologists. These objects could present variability of clinical symptoms. Increase of infection and mortality due to delay of accurate diagnosis. Interview is the most important part of examination of patient with suspected foreign body in airways. Any suspicion of aspiration is qualification to diagnostic bronchoscopy. Aim. This paper refers occurrence assessment, clinical course, diagnostic process and treatment of the pediatric patients with suspected foreign body in lower respiratory tract hospitalized in referral Academic Department of Pediatric Otolaryngology. Material and methods. Retrospective analysis of 74 patients with suspected foreign body in lower respiratory tract, who were hospitalized in Clinical Department of Pediatric Otolaryngology in Warsaw Medical University in 2016-2018. Analysis includes demographic data, occurrence frequency, localization and the type of foreign body, diagnostic process and treatment. Results. This study includes 42 boys (57%) and 32 girls (43%) in age of 8 months to 16-year-old. The episode of choking occurs in interview in 71 patients (96%). Foreign bodies in lower respiratory tract were confirmed and evacuated in bronchoscopy procedure in 44 cases (59.5%). In 30 cases (40.5%) there were any foreign body in airways. The most common group of patients admitted to Clinic with suspected foreign body in airways was children in age between 1 to 3-year-old, which accounted for 22 cases (50%). Coughing was the most commonly reported symptom (54.5%), wheezing (27.5%) and dyspnea (15.9%). Twenty-three patients were presenting wheezing and whirring in physical examination. Air trap found in thorax x-ray were in 22 patients (45%). The right main bronchus was the most common place of foreign body retention – 22 patients (50%). The organic foreign bodies were in 32 cases (72.7%) and non-organic in 12 (27.3%). The nuts were the most common foreign body aspirated to airways. Conclusions. Foreign body aspiration should be suspected in every patient, not only those with choking episode but also with patients who presents ambiguous change in physical examination and x-ray scan. In pediatric patient with suspected foreign body in lower respiratory tract, in every time the bronchoscopy is needed to be done, even in patients with no abnormalities in physical examination and x-ray scan.
介绍。多年来,下呼吸道异物一直是耳鼻喉科医师面临的一大挑战。这些对象可能表现出临床症状的可变性。由于延误准确诊断,感染和死亡率增加。访视是疑似气道异物患者检查中最重要的环节。任何误吸的怀疑都是诊断支气管镜检查的条件。的目标。本文对转诊儿科耳鼻喉科住院的小儿疑似下呼吸道异物的发生评估、临床过程、诊断过程及治疗进行了综述。材料和方法。回顾性分析华沙医科大学临床儿科耳鼻咽喉科2016-2018年住院的74例疑似下呼吸道异物患者。分析包括人口统计数据、发生频率、异物的定位和类型、诊断过程和治疗。结果。本研究包括8个月至16岁的42名男孩(57%)和32名女孩(43%)。71例(96%)患者在访谈中发生窒息。支气管镜检查确认下呼吸道异物44例(59.5%)。气道内有异物30例(40.5%)。以疑似气道异物就诊的患者以1 ~ 3岁儿童居多,占22例(50%)。咳嗽是最常见的症状(54.5%),喘鸣(27.5%)和呼吸困难(15.9%)。23例患者在体检中出现喘息和呼呼声。22例(45%)患者在胸片上发现气阻。右主支气管是最常见的异物滞留部位,22例(50%)。有机异物32例(72.7%),非有机异物12例(27.3%)。坚果是最常见的吸入气管异物。结论。每位患者都应怀疑异物吸入,不仅是那些有窒息发作的患者,而且在体格检查和x线扫描中表现出模糊变化的患者。对于怀疑下呼吸道异物的小儿患者,即使在体格检查和x线扫描没有异常的患者,每次都需要进行支气管镜检查。
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引用次数: 0
SARS-CoV-2: the key issues SARS-CoV-2:关键问题
Q4 Medicine Pub Date : 2020-03-01 DOI: 10.25121/NEWMED.2020.24.1.3
K. Raczkowska-Labuda, L. Zawadzka-Głos
At the end of 2019, in the industrial city of Wuhan, which is the capital of the Chinese province of Hubei, a new coronavirus disease (nCoV-19) began to erupt At the beginning, the scale of the threat posed by the virus was underestimated, and the information coming from China was residual and does not provide a complete picture of the situation Since then, nCoV-19 has spread to 183 different countries around the world, causing many cases and thousands of deaths On March 11, World Health Organization (WHO) Director-General Tedros Adhanom Ghebreyesus officially declared the COVID- 19 outbreak a pandemic This review work aims to provide some basic information about the virus (SARS-CoV-2) and the disease it causes (COVID-19) In addition, it covers diagnostic methods, recommended management and methods to reduce the extent of infection This is a kind of summary of the state of knowledge at the end of April 2020 To summarize main observations based on the review of world literature on the subject is driving us into conclusion that the transmission mechanisms of SARS-CoV-2 are not fully recognized The spread of the virus from human to human occurs mainly through respiratory drops;symptomatic infections spectrum ranges from mild to critical, with a significant prevalence of mild/asymptomatic cases Molecular test for the SARS-CoV-2 virus RNA is currently recommend Other test include rapid direct SARS-CoV-2 antigen or indirect antibody detection, lung CT and LUS Recommendation for ENT surgical procedures are collected in The International Paediatric Otolaryngology Group (IPOG) statement published on the 14th of April 2020 Personnel involved in aerosol generating procedures should be fitted with PPE
在2019年底,武汉的工业城市,是中国湖北省的首都,一个新的冠状病毒病(nCoV-19)初开始爆发,病毒带来的威胁的规模被低估,和信息来自中国残留,不提供完整的画面之后,nCoV-19已经蔓延到全世界183个国家,导致很多情况下,3月11日,成千上万的人死亡世界卫生组织(WHO)总干事Tedros Adhanom Ghebreyesus正式宣布COVID-19疫情为大流行疫情。这项审查工作旨在提供有关该病毒(SARS-CoV-2)及其引起的疾病(COVID-19)的一些基本信息,此外还包括诊断方法,这是对2020年4月底的知识状况的总结。总结基于对该主题的世界文献的回顾的主要观察结果,我们得出的结论是,SARS-CoV-2的传播机制尚未得到充分认识。病毒在人与人之间的传播主要通过呼吸道滴液发生;目前建议进行SARS-CoV-2病毒RNA分子检测。其他检测包括快速直接检测SARS-CoV-2抗原或间接抗体、肺部CT和LUS。国际儿科耳鼻喉科小组(IPOG)于2020年4月14日发表的声明收集了耳鼻喉外科手术的建议。参与气溶胶产生过程的人员应配备个人防护装备
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引用次数: 0
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New Medicine
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