Pub Date : 2017-11-16DOI: 10.25121/NEWMED.2017.21.4.145
Karolina Raczkowska-Łabuda, Anna Gorzelnik, Jolanta Jadczyszyn, L. Zawadzka-Głos
In the recent years, there has been a rapid increase in the incidence of head and neck cancers in Europe. Every year, 6,000 persons in Poland are diagnosed with a neoplastic proliferative disease in the head and neck region. The risk of cancer of this group increases with age in both genders, with a peak incidence around the age of 64. A diagnosis of a head and neck tumor typically occurs between the age of 45 and 64. In many European countries, including Poland, the so-called “epidemiological phenomenon” is observed. Epidemiological phenomenon consists in an increasing incidence of head and neck cancers in persons under 40 years of age who had never smoked or abused alcohol. The profile of patient with head and neck cancer has changed. It is estimated that over 90% of men and 80% of women will be infected with at least one type of HPV in their lifetime. Half of the infections are caused by the oncogenic types. HPV type 16 is responsible for 90% of high-risk infections and increases the likelihood of human papillomavirus-related oropharyngeal cancers by 15 to 230 times, depending on the type of the virus. In the view of the differences in course and prognosis in patients with HPV-related cancers, these tumors have been excluded from the existing TNM staging system (tumor, nodes, metastasis), and a separate classification, only for this group of tumors, was created. HPV vaccines have been one of the most important steps in cancer prevention in the last few decades. In Poland, 3 different vaccines are included in the National Vaccination Program as recommended, but they are not reimbursed by the State. Keywords
{"title":"HPV-related head and neck tumors – 10 years of experience with human papillomavirus vaccinations","authors":"Karolina Raczkowska-Łabuda, Anna Gorzelnik, Jolanta Jadczyszyn, L. Zawadzka-Głos","doi":"10.25121/NEWMED.2017.21.4.145","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.4.145","url":null,"abstract":"In the recent years, there has been a rapid increase in the incidence of head and neck cancers in Europe. Every year, 6,000 persons in Poland are diagnosed with a neoplastic proliferative disease in the head and neck region. The risk of cancer of this group increases with age in both genders, with a peak incidence around the age of 64. A diagnosis of a head and neck tumor typically occurs between the age of 45 and 64. In many European countries, including Poland, the so-called “epidemiological phenomenon” is observed. Epidemiological phenomenon consists in an increasing incidence of head and neck cancers in persons under 40 years of age who had never smoked or abused alcohol. The profile of patient with head and neck cancer has changed. It is estimated that over 90% of men and 80% of women will be infected with at least one type of HPV in their lifetime. Half of the infections are caused by the oncogenic types. HPV type 16 is responsible for 90% of high-risk infections and increases the likelihood of human papillomavirus-related oropharyngeal cancers by 15 to 230 times, depending on the type of the virus. In the view of the differences in course and prognosis in patients with HPV-related cancers, these tumors have been excluded from the existing TNM staging system (tumor, nodes, metastasis), and a separate classification, only for this group of tumors, was created. HPV vaccines have been one of the most important steps in cancer prevention in the last few decades. In Poland, 3 different vaccines are included in the National Vaccination Program as recommended, but they are not reimbursed by the State. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46796978","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-11-15DOI: 10.25121/newmed.2017.21.4.135
Jolanta Jadczyszyn, Karolina Raczkowska-Łabuda, Małgorzata Dębska-Rutkowska, L. Zawadzka-Głos
Introduction. Sudden bilateral deep hearing loss is very rare in children. Its estimated prevalence is 2% among children with hearing loss. The causes include acute acoustic trauma, vascular disorders of the inner ear, sudden viral or bacterial infection, and trauma of the inner ear. Noise is currently an important risk factor for hearing impairment. Groups that are particularly vulnerable to noise damage include children and young adults. The effects of noise include hearing impairment of different degree and the more and more commonly diagnosed extra auditory effects of noise in the form of anxiety, irritability, cognitive impairment, reduced intellectual ability, difficulty in falling asleep, circulatory disorders, hormonal disorders, and changes in social behavior. Case report. We present a case of a 9-year-old girl who experienced sudden bilateral deep hearing loss of the left ear, which was caused by a school bell during a school break. Six weeks after the sudden hearing loss in the left ear, hearing loss in the right ear of the unknown etiology appeared. The girl was in good general condition, no vertigo and balance impairment were observed. In the tonal audiometry, bilateral deep mixed hearing loss was observed. The treatment in the hospital included surgery in the form of bilateral explorative tympanotomy of the middle ear with anterior tympanocentesis and tube insertion, as well as conservative treatment: dexamethasone, vipocentin, piracetam, B vitamins, xylometazoline, and hyperbaric oxygen therapy. Hospitalization lasted 14 days. A complete recovery of hearing was achieved. Conclusion. Sudden bilateral deep hearing loss in children can be caused by an acute acoustic trauma. Studies show that noise is an important disturbing factor in the school environment and may be harmful. Noise levels of ca. 80-85 dB measured in corridors during school breaks and in sports halls may pose a risk of hearing impairment. The consequences of trauma caused by noise in children are very difficult to predict. It is important to recognize the problem early, as well as to introduce a proper diagnostic process and implement the treatment quickly, which is a key to the positive outcome. Keywords
{"title":"Sudden bilateral deep hearing loss in a child – case study","authors":"Jolanta Jadczyszyn, Karolina Raczkowska-Łabuda, Małgorzata Dębska-Rutkowska, L. Zawadzka-Głos","doi":"10.25121/newmed.2017.21.4.135","DOIUrl":"https://doi.org/10.25121/newmed.2017.21.4.135","url":null,"abstract":"Introduction. Sudden bilateral deep hearing loss is very rare in children. Its estimated prevalence is 2% among children with hearing loss. The causes include acute acoustic trauma, vascular disorders of the inner ear, sudden viral or bacterial infection, and trauma of the inner ear. Noise is currently an important risk factor for hearing impairment. Groups that are particularly vulnerable to noise damage include children and young adults. The effects of noise include hearing impairment of different degree and the more and more commonly diagnosed extra auditory effects of noise in the form of anxiety, irritability, cognitive impairment, reduced intellectual ability, difficulty in falling asleep, circulatory disorders, hormonal disorders, and changes in social behavior. Case report. We present a case of a 9-year-old girl who experienced sudden bilateral deep hearing loss of the left ear, which was caused by a school bell during a school break. Six weeks after the sudden hearing loss in the left ear, hearing loss in the right ear of the unknown etiology appeared. The girl was in good general condition, no vertigo and balance impairment were observed. In the tonal audiometry, bilateral deep mixed hearing loss was observed. The treatment in the hospital included surgery in the form of bilateral explorative tympanotomy of the middle ear with anterior tympanocentesis and tube insertion, as well as conservative treatment: dexamethasone, vipocentin, piracetam, B vitamins, xylometazoline, and hyperbaric oxygen therapy. Hospitalization lasted 14 days. A complete recovery of hearing was achieved. Conclusion. Sudden bilateral deep hearing loss in children can be caused by an acute acoustic trauma. Studies show that noise is an important disturbing factor in the school environment and may be harmful. Noise levels of ca. 80-85 dB measured in corridors during school breaks and in sports halls may pose a risk of hearing impairment. The consequences of trauma caused by noise in children are very difficult to predict. It is important to recognize the problem early, as well as to introduce a proper diagnostic process and implement the treatment quickly, which is a key to the positive outcome. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-11-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42026011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.25121/NEWMED.2017.21.3.77
L. Zawadzka-Głos, K. Ślączka
Introduction. Laryngeal stenosis as a complication of prolonged endotracheal intubation is a current problem in paediatric laryngology because of the growing population of prematurely born children. The aim of our study was to analyse the cases of post-intubation laryngeal stenosis in terms of the frequency and severity of the complications, as well as to evaluate the effects of endoscopic treatment. Material and methods. The study included 92 children treated for laryngeal stenosis. The analysis involved the comparison of the children in terms of the degree of subglottic stenosis and its effect on treatment. Laryngeal stenosis was treated with endoscopy, which was performed under general anaesthesia. Results. In the group of children with laryngeal stenosis, supraglottic stenosis was found in 9.78% of children, grade I subglottic stenosis occurred in 10.87% of children, grade II in 41.3% of children, grade III in 18.48% of children, and grade IV in 19.57% of children. Of 92 patients, only 41 were full-term (44.57%) and 51 (55.43%) were premature. In the treated group, full recovery and a reduction of laryngeal stenosis were noted in 44 (48%) and 38 children (41%), respectively, while the failure of treatment was reported in 10 patients, representing 11% of the population. In the group of premature infants, 20 children (39.22%) were cured, the condition improved in 22 cases (43.14%) and treatment failed in 9 patients (17.65%). Of 41 full-term children, full recovery was observed in 24 (58.54%), improvement in 16 (39.02%) and failure in one case (2.44%). There was also an increase in the risk of treatment failure in advanced stenosis of grade III and IV according to Cotton–Myer. Conclusions. Laryngeal stenosis is a common problem in premature infants. Endoscopic treatment is an effective surgical method. Failure of endoscopic treatment is related to the degree of stenosis. Grades III and IV are more difficult to treat. Keywords
{"title":"Effects of post-intubation laryngeal stenosis treatment depending on the grade of stenosis","authors":"L. Zawadzka-Głos, K. Ślączka","doi":"10.25121/NEWMED.2017.21.3.77","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.3.77","url":null,"abstract":"Introduction. Laryngeal stenosis as a complication of prolonged endotracheal intubation is a current problem in paediatric laryngology because of the growing population of prematurely born children. The aim of our study was to analyse the cases of post-intubation laryngeal stenosis in terms of the frequency and severity of the complications, as well as to evaluate the effects of endoscopic treatment. Material and methods. The study included 92 children treated for laryngeal stenosis. The analysis involved the comparison of the children in terms of the degree of subglottic stenosis and its effect on treatment. Laryngeal stenosis was treated with endoscopy, which was performed under general anaesthesia. Results. In the group of children with laryngeal stenosis, supraglottic stenosis was found in 9.78% of children, grade I subglottic stenosis occurred in 10.87% of children, grade II in 41.3% of children, grade III in 18.48% of children, and grade IV in 19.57% of children. Of 92 patients, only 41 were full-term (44.57%) and 51 (55.43%) were premature. In the treated group, full recovery and a reduction of laryngeal stenosis were noted in 44 (48%) and 38 children (41%), respectively, while the failure of treatment was reported in 10 patients, representing 11% of the population. In the group of premature infants, 20 children (39.22%) were cured, the condition improved in 22 cases (43.14%) and treatment failed in 9 patients (17.65%). Of 41 full-term children, full recovery was observed in 24 (58.54%), improvement in 16 (39.02%) and failure in one case (2.44%). There was also an increase in the risk of treatment failure in advanced stenosis of grade III and IV according to Cotton–Myer. Conclusions. Laryngeal stenosis is a common problem in premature infants. Endoscopic treatment is an effective surgical method. Failure of endoscopic treatment is related to the degree of stenosis. Grades III and IV are more difficult to treat. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43043565","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.25121/NEWMED.2017.21.3.84
Karolina Raczkowska-Łabuda, Anna Gorzelnik, L. Zawadzka-Głos
Human papillomavirus (HPV) vaccines have been available on the world market for more than 10 years. They became available in Polish pharmacies in 2007, although they were only included in the National Vaccination Program almost one year later. Currently in our country, the vaccination against human papillomavirus can be performed in a 3-dose schedule with a 2-valent, 4-valent or 9-valent vaccine. Clinical studies after 10 years of the presence of the vaccine in the market indicate that these vaccinations are an efficient measure for reducing the risk of HPV infection and of cervical cancer. The article compares HPV vaccination programs in Poland and around the world, presents the newest guidelines for the use of particular products, and discusses the characteristics of the products. The preventive role of vaccinations in HPV-dependent head and neck tumors, as well as the need for immunoprophylaxis in both girls and boys is underlined. The paper emphasizes the expected benefits of the implementation of population programs, both in social and financial aspects, on the example of countries which had already implemented such a solution. The aim of the article was to popularize the topic of vaccination against HPV in Poland and to support the initiative of the inclusion of HPV vaccination to the obligatory part of the National Vaccination Program. Keywords
{"title":"Why is a laryngologist interested in cervical cancer? Summary information about HPV vaccination","authors":"Karolina Raczkowska-Łabuda, Anna Gorzelnik, L. Zawadzka-Głos","doi":"10.25121/NEWMED.2017.21.3.84","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.3.84","url":null,"abstract":"Human papillomavirus (HPV) vaccines have been available on the world market for more than 10 years. They became available in Polish pharmacies in 2007, although they were only included in the National Vaccination Program almost one year later. Currently in our country, the vaccination against human papillomavirus can be performed in a 3-dose schedule with a 2-valent, 4-valent or 9-valent vaccine. Clinical studies after 10 years of the presence of the vaccine in the market indicate that these vaccinations are an efficient measure for reducing the risk of HPV infection and of cervical cancer. The article compares HPV vaccination programs in Poland and around the world, presents the newest guidelines for the use of particular products, and discusses the characteristics of the products. The preventive role of vaccinations in HPV-dependent head and neck tumors, as well as the need for immunoprophylaxis in both girls and boys is underlined. The paper emphasizes the expected benefits of the implementation of population programs, both in social and financial aspects, on the example of countries which had already implemented such a solution. The aim of the article was to popularize the topic of vaccination against HPV in Poland and to support the initiative of the inclusion of HPV vaccination to the obligatory part of the National Vaccination Program. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41487475","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-06-01DOI: 10.25121/NewMed.2017.21.3.71
A. Kasprzyk, Piotr Kwast, L. Zawadzka-Głos
Introduction. Antrochoanal polyp (ACP) is a benign lesion originating from the mucosa of the maxillary sinus, growing through the sinus’ ostium (natural or accessory) into the middle meatus and extending into the choana and nasopharynx. ACPs constitute 33% of all nasal polyps in children. Aim. The aim of this study was to evaluate the clinical characteristics of ACP in children treated in the Department of Pediatric Otolaryngology of the Medical University of Warsaw between January 2016 and April 2017. Material and methods. A retrospective analysis of 15 cases was conducted. The following clinical data were analyzed: sex, age, polyp side, associated pathologies, previous surgical procedures and their extent. Result. Ten boys and 5 girls with a mean age of 12.2 (range 9-16) years were included in the study. There were 9 right-sided lesions and 6 left-sided lesions. Seven patients have undergone previous operations, including one patient that had undergone the removal of ACP. Following comorbidities were observed: chronic rhinosinusitis, adenoid hypertrophy, deviated septum, inferior turbinate hypertrophy, otitis media with effusion, and allergy. Three patients underwent other surgical procedures during ACP removal. Conclusions. ACP can lead to unilateral nasal obstruction. Complete removal of the ACP is the key for the successful treatment. Keywords
{"title":"Clinical characteristics of antrochoanal polyps in patients treated in the Department of Pediatric Otolaryngology of the Medical University of Warsaw","authors":"A. Kasprzyk, Piotr Kwast, L. Zawadzka-Głos","doi":"10.25121/NewMed.2017.21.3.71","DOIUrl":"https://doi.org/10.25121/NewMed.2017.21.3.71","url":null,"abstract":"Introduction. Antrochoanal polyp (ACP) is a benign lesion originating from the mucosa of the maxillary sinus, growing through the sinus’ ostium (natural or accessory) into the middle meatus and extending into the choana and nasopharynx. ACPs constitute 33% of all nasal polyps in children. Aim. The aim of this study was to evaluate the clinical characteristics of ACP in children treated in the Department of Pediatric Otolaryngology of the Medical University of Warsaw between January 2016 and April 2017. Material and methods. A retrospective analysis of 15 cases was conducted. The following clinical data were analyzed: sex, age, polyp side, associated pathologies, previous surgical procedures and their extent. Result. Ten boys and 5 girls with a mean age of 12.2 (range 9-16) years were included in the study. There were 9 right-sided lesions and 6 left-sided lesions. Seven patients have undergone previous operations, including one patient that had undergone the removal of ACP. Following comorbidities were observed: chronic rhinosinusitis, adenoid hypertrophy, deviated septum, inferior turbinate hypertrophy, otitis media with effusion, and allergy. Three patients underwent other surgical procedures during ACP removal. Conclusions. ACP can lead to unilateral nasal obstruction. Complete removal of the ACP is the key for the successful treatment. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41430454","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-08DOI: 10.25121/NEWMED.2017.21.2.39
Anna Gorzelnik, L. Zawadzka-Głos, A. Segiet, Karolina Raczkowska-Łabuda
Introduction. Hemorrhage is one of the most important complication of adenoidectomy (AT) and adenotonsillotomy (ATT) in children. The lack of hemostasis is an indication for Bellocq’s tamponade. Preoperative coagulation tests, complete blood count and blood type tests are taken to minimize the risk of bleeding after surgery. Material and methods. Data of 135 children with preoperative normal bleeding tests who underwent AT/ATT was collected. In study group (N = 41), postoperative hemorrhage requiring posterior nasal pack occurred. In the control group (N = 94), bleeding after AT/ATT resolved spontaneously and did not require nasal packing. Results. Hemorrhage was associated with older age. There was no relationship between hemorrhage and blood group, gender, type of the procedure and laboratory results obtained before the surgery. Conclusions. In our study, preoperative laboratory findings failed to effectively identify the patients at risk of hemorrhage after AT/ATT. However, a thorough medical interview and family history, as well as a detailed physical examination and laboratory testing might reveal bleeding disorders that had been asymptomatic. Keywords
{"title":"Hemorrhage risk factors assessment in pediatric patients undergoing adenoidectomy/adenotonsillotomy","authors":"Anna Gorzelnik, L. Zawadzka-Głos, A. Segiet, Karolina Raczkowska-Łabuda","doi":"10.25121/NEWMED.2017.21.2.39","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.2.39","url":null,"abstract":"Introduction. Hemorrhage is one of the most important complication of adenoidectomy (AT) and adenotonsillotomy (ATT) in children. The lack of hemostasis is an indication for Bellocq’s tamponade. Preoperative coagulation tests, complete blood count and blood type tests are taken to minimize the risk of bleeding after surgery. Material and methods. Data of 135 children with preoperative normal bleeding tests who underwent AT/ATT was collected. In study group (N = 41), postoperative hemorrhage requiring posterior nasal pack occurred. In the control group (N = 94), bleeding after AT/ATT resolved spontaneously and did not require nasal packing. Results. Hemorrhage was associated with older age. There was no relationship between hemorrhage and blood group, gender, type of the procedure and laboratory results obtained before the surgery. Conclusions. In our study, preoperative laboratory findings failed to effectively identify the patients at risk of hemorrhage after AT/ATT. However, a thorough medical interview and family history, as well as a detailed physical examination and laboratory testing might reveal bleeding disorders that had been asymptomatic. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43272656","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-05-06DOI: 10.25121/NEWMED.2017.21.2.49
K. Siewiorek, Olga Siewiorek, Piotr Kwast, L. Zawadzka-Głos
Introduction. The function of the palatine and adenoid tonsils is to provide defence against respiratory and digestive pathogens. Continuous antigenic stimulation may lead to tonsillar hypertrophy, which can be an indication for their removal. Aim. The purpose of this study was to analyse the symptoms, comorbidities, type of procedure and adverse effects after surgery in children less than 2 years of age who underwent adenoidectomy or adenotonsillotomy. Material and methods. Children less than 2 years of age hospitalized in the years 20092016 in the Department of Pediatric Otolaryngology of the Medical University of Warsaw were included in the study. Among 5833 patients with tonsillar hypertrophy, 60 patients (29 girls, 31 boys) met the inclusion criteria. Reported symptoms, comorbidities, type of procedure, and adverse symptoms during the post-operative observation period were analysed in age subgroups. Results. Adenoidectomy was performed in 38 cases, and adenotonsillotomy – in 22 cases. 26 children had concomitant otitis media with effusion treated with myringotomy with or without tympanostomy tube insertion. In regard to the symptoms and type of the procedure, the level of statistical significance was not reached. Drops in blood oxygen saturation and fever were observed postoperatively in three children with comorbid conditions. Conclusions. Adenoidectomy and adenotonsillotomy with myringotomy with or without tympanostomy tube insertion are relatively safe and efficient procedures in children under 2 years of age. No evident correlation between the age of the child and the frequency of performing adenoidectomy in relation to adenotonsillotomy has been noted. Parents should be informed about the risk of regrowth and the possible need for a future reoperation. Keywords
{"title":"Adenoidectomy and adenotonsillotomy in children less than 2 years of age – a retrospective analysis","authors":"K. Siewiorek, Olga Siewiorek, Piotr Kwast, L. Zawadzka-Głos","doi":"10.25121/NEWMED.2017.21.2.49","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.2.49","url":null,"abstract":"Introduction. The function of the palatine and adenoid tonsils is to provide defence against respiratory and digestive pathogens. Continuous antigenic stimulation may lead to tonsillar hypertrophy, which can be an indication for their removal. Aim. The purpose of this study was to analyse the symptoms, comorbidities, type of procedure and adverse effects after surgery in children less than 2 years of age who underwent adenoidectomy or adenotonsillotomy. Material and methods. Children less than 2 years of age hospitalized in the years 20092016 in the Department of Pediatric Otolaryngology of the Medical University of Warsaw were included in the study. Among 5833 patients with tonsillar hypertrophy, 60 patients (29 girls, 31 boys) met the inclusion criteria. Reported symptoms, comorbidities, type of procedure, and adverse symptoms during the post-operative observation period were analysed in age subgroups. Results. Adenoidectomy was performed in 38 cases, and adenotonsillotomy – in 22 cases. 26 children had concomitant otitis media with effusion treated with myringotomy with or without tympanostomy tube insertion. In regard to the symptoms and type of the procedure, the level of statistical significance was not reached. Drops in blood oxygen saturation and fever were observed postoperatively in three children with comorbid conditions. Conclusions. Adenoidectomy and adenotonsillotomy with myringotomy with or without tympanostomy tube insertion are relatively safe and efficient procedures in children under 2 years of age. No evident correlation between the age of the child and the frequency of performing adenoidectomy in relation to adenotonsillotomy has been noted. Parents should be informed about the risk of regrowth and the possible need for a future reoperation. Keywords","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-05-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44391689","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
1Department of Human Anatomy, Wroclaw Medical University, Poland Head of Department: Professor Bohdan Gworys, MD, PhD 2Faculty of Technology and Natural Science, Karkonoska State College, Jelenia Góra, Poland Dean of Faculty: Wioletta Palczewska, MD, PhD 3Vertex, Rehabilitation Unit, Wroclaw, Poland 4Department of Biostructure, University School of Physical Education, Wroclaw, Poland Head of Department: Professor Teresa Sławińska-Ochla, MD, PhD
{"title":"Changes in plantar pressure distribution after long-distance running","authors":"Rohan Anna, Nyc Małgorzata, Rogóż Anna, Fugiel Jarosław","doi":"10.25121/NEWMED.2017.21.2.58","DOIUrl":"https://doi.org/10.25121/NEWMED.2017.21.2.58","url":null,"abstract":"1Department of Human Anatomy, Wroclaw Medical University, Poland Head of Department: Professor Bohdan Gworys, MD, PhD 2Faculty of Technology and Natural Science, Karkonoska State College, Jelenia Góra, Poland Dean of Faculty: Wioletta Palczewska, MD, PhD 3Vertex, Rehabilitation Unit, Wroclaw, Poland 4Department of Biostructure, University School of Physical Education, Wroclaw, Poland Head of Department: Professor Teresa Sławińska-Ochla, MD, PhD","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":"21 1","pages":"58-68"},"PeriodicalIF":0.0,"publicationDate":"2017-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44654238","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-31DOI: 10.5604/01.3001.0009.7845
Jacek Wadełek
the main goal of nutritional support in critically ill patients is to minimize the negative protein balance by avoiding starvation, with the purpose of maintaining muscular, immune, and cognitive function, as well as to enhance recovery. nutrition can be given either by the enteral or the parenteral route. Patients should be provided with nutritional substrates, because starvation or underfeeding in intensive care unit (icu) patients is associated with increased morbidity and mortality. the guidelines of european society for clinical nutrition and Metabolism (esPen) and canadian society for clinical nutrition (cscn) recommend the initiation of enteral nutrition within 24-48 hours after the admission to icu. total parenteral nutrition (tPn), if indicated, should also be initiated within the first 24-48 hours after icu admission. the minimal amount of carbohydrate required is about 2 g of glucose/body weight per day. hyperglycemia above 180mg/dl (>10 mmol/l) may have fatal consequences for critically ill patients and should also be avoided. insulin therapy should be initiated for persistent hyperglycemia, with decision threshold no greater than 180 mg/dl, with a target glycemia range of 140 to 180 mg/dl for the majority of critically ill patients. intravenous insulin infusions adjusted according to validated protocols with demonstrated safety and efficacy are preferred.
{"title":"praCtiCal aspECts of nutritional thErapy and Blood gluCosE lEvEl in CritiCally ill patiEnts","authors":"Jacek Wadełek","doi":"10.5604/01.3001.0009.7845","DOIUrl":"https://doi.org/10.5604/01.3001.0009.7845","url":null,"abstract":"the main goal of nutritional support in critically ill patients is to minimize the negative protein balance by avoiding starvation, with the purpose of maintaining muscular, immune, and cognitive function, as well as to enhance recovery. nutrition can be given either by the enteral or the parenteral route. Patients should be provided with nutritional substrates, because starvation or underfeeding in intensive care unit (icu) patients is associated with increased morbidity and mortality. the guidelines of european society for clinical nutrition and Metabolism (esPen) and canadian society for clinical nutrition (cscn) recommend the initiation of enteral nutrition within 24-48 hours after the admission to icu. total parenteral nutrition (tPn), if indicated, should also be initiated within the first 24-48 hours after icu admission. the minimal amount of carbohydrate required is about 2 g of glucose/body weight per day. hyperglycemia above 180mg/dl (>10 mmol/l) may have fatal consequences for critically ill patients and should also be avoided. insulin therapy should be initiated for persistent hyperglycemia, with decision threshold no greater than 180 mg/dl, with a target glycemia range of 140 to 180 mg/dl for the majority of critically ill patients. intravenous insulin infusions adjusted according to validated protocols with demonstrated safety and efficacy are preferred.","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":"21 1","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2017-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47582780","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2017-03-31DOI: 10.5604/01.3001.0009.7844
K. Csaba, L. Medve, T. Gondos
{"title":"Renal blood supply and fluid therapy","authors":"K. Csaba, L. Medve, T. Gondos","doi":"10.5604/01.3001.0009.7844","DOIUrl":"https://doi.org/10.5604/01.3001.0009.7844","url":null,"abstract":"","PeriodicalId":55698,"journal":{"name":"New Medicine","volume":"21 1","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2017-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47513650","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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