Clinical medicine insights. Ear, nose and throat最新文献

Objective: The objective of this study was to evaluate and correlate hematologic indices, vitamin B₁₂ levels, and depression in patients with suspected laryngopharyngeal reflux (LPR) treated with proton pump inhibitor (PPI).

Methods: This was a prospective study with a population (n = 23) consisted of patients with suspected LPR and treated with 2 daily doses of Omeprazole 40 mg (80 mg or full dose). The study volunteers performed a complete blood count and vitamin B₁₂ dosage before and after 3 and 6 months of treatment, as well as depression screening using the Center of Epidemiologic Studies-Depression (CES-D) questionnaire before and after 6 months of treatment. Scores greater than 16 were considered as suggestive of depression.

Results: The mean score on the CES-D scale of study participants at baseline significantly decreased after 6 months of treatment. A significant decrease was observed in the red blood cells count (RBC) after 6 months in relation to 3 months. Significant increases in mean corpuscular volume (MCV) and mean corpuscular hemoglobin (MCH) were observed from 3 months to 6 months in this study. Vitamin B₁₂ levels increased significantly between baseline and after 6 months of treatment.

Conclusion: Decreased scores on the CES-D scale were associated with increased MCV values, with no association with vitamin B₁₂ levels. However, vitamin B₁₂ levels also increased significantly after 6 months of treatment with PPI.

Background: Pneumosinus dilatans (PSD) is a rare pathological paranasal sinus expansion. This condition is usually symptomatic or cosmetically apparent, requiring surgical intervention. Multiple hypotheses have been postulated as to the cause of this condition; however, the precise cause and pathogenesis remain obscure.

Case report and methods: An 11-year-old boy presented with right eye bulging and was subsequently found to have PSD of the maxillary sinus. A search was conducted of the PubMed electronic database, using the keywords "pneumosinus dilatans," "pneum(oco)ele," "pneum(oc)ele," "pneum(atoco)ele," and "air cyst." Articles published in English were reviewed.

Results: The literature review identified 29 cases of PSD involving the maxillary sinus. The mean age of presentation was 25 years old. Only the right maxillary sinus was affected in 16 cases, followed by the bilateral sinuses in 7 cases and the left sinus in 6 cases. In 5 cases, all paranasal sinuses, along with the maxillary sinus, were expanded. The most common presenting symptom was facial swelling, which was found in 55% of the cases, followed by proptosis and pain. Computed tomography is the gold standard radiological method for diagnosing PSD.

Conclusions: Pneumosinus dilatans is a rare condition that is usually symptomatic and requires surgical intervention. The etiology of the disease is attributed to multiple hypotheses, but more studies are needed to explore this condition further.

The supposed relics of "Mary-Magdalene" are preserved in Provence (France) in an ancient tradition. They consist of a dry skull and a lock of hair. For the first time, they were officially subjected to an extensive medico-surgical examination by photogrammetry, high-magnification binocular lenses, scanning electron microscope, and energy-dispersive X-ray elemental analysis, to propose a full computer-aided facial reconstruction. The preliminary results are presented here.

Background: Upper and lower respiratory tract infections are common conditions for which medical advice is sought, and their management relies on the use of prescription and over-the-counter (OTC) medicines. Ambroxol, bromhexine, carbocysteine, erdosteine, N-acetyl cysteine (NAC), and sobrerol are mucoactive agents for which clinical trials have been conducted, have been awarded well-established status by regulatory authorities, and are available as OTC or prescription products.

Objective: To briefly review the evidence-based efficacy and safety of these substances in the therapy of upper respiratory airways infections.

Methods: We conducted searches in MEDLINE and other databases for clinical trials and reviews done on the efficacy and safety of ambroxol, bromhexine, carbocysteine, erdosteine, NAC, and sobrerol.

Results: Clinical trials have shown that these mucolytics have an important place in the relief of cough symptoms by easing the elimination of mucus. All drugs have shown comparable efficacy in the symptomatic treatment of productive cough, with some shared characteristics and some specific features.

Conclusions and relevance: All mucolytics reviewed have a good safety profile, although some precautions should be taken when using ambroxol and bromhexine, and the use of NAC and carbocysteine should be monitored in special patient groups. Overall, however, the available evidence from randomised, controlled, and observational trials, as well as pragmatic, real-life experience, suggests that these products are useful in the therapy of upper respiratory airways infections, including bronchitis, sinusitis, and rhinosinusitis.