Crohn's disease and ulcerative colitis belong to a group of inflammatory bowel diseases (IBD). IBD are characterized by a chronic character of inflammatory process and overlapping immunological abnormalities, which, along with therapeutic strategies are currently available, underlie an increased risk of venous thromboembolic events (VTE). The most common sites of VTE in IBD patients are deep venous thrombosis (DVT) and pulmonary embolism (PE). These complications are particularly important in clinical practice due to a very high mortality rate. Therefore, an early diagnosis of new IBD cases and the control of inflammatory process are thought to play a crucial role in risk reduction for thromboembolic events. Despite considerable evidence supporting the association between IBD and VTE, there is still a lack of recognition of this risk, with dangerous consequences for patients. In this paper authors report three cases of VTE in IBD patients and discuss the most relevant clinical studies found in MEDLINE, Cochrane Library and EMBASE regarding its prevention and management.
Aim: To evaluate outcomes of stapes surgery in children with congenital stapes fixation and juvenile otosclerosis. Methods: A retrospective chart review was performed from 1987 to 2013 to identify patients under 18 years old who underwent a stapes surgery. Patients' age, gender, pre- and postoperative audiograms, intraoperative findings including aetiology of stapes fixation, prosthesis type, and complications were analysed. Results: 18 children (6 - 17 years old), all with bilateral conductive hearing loss were identified and 34 stapes surgeries were performed (two patients underwent surgery only on one side). The cause of fixation included juvenile otosclerosis in 88% and congenital stapes fixation in 12%. The mean pre-operative air-bone gap (ABG) was 36,24 dB (SD: 10,86) compared to a postoperative mean ABG of 7,74 (SD: 3,3) (p < 0.000). The profound sensorineural hearing loss was not observed in long-term follow-up. Conclusions: Paediatric stapes surgery has comparable results to stapedectomy in adults regardless of the cause of stapes fixation; however, the better hearing outcome was observed for cases of juvenile otosclerosis rather than congenital stapes fixation.
<p class="abstract"><strong>Background:</strong> The primary goal of this study was to evaluate the long-term influence of tonsillectomy on the quality of life and voice performance of opera singers. Survey study which was reviewing the long-term effects of tonsillectomy. </p><p class="abstract"><strong>Methods:</strong> Retrospective review of patients’ records and surveys in which patients have answered the questions about the influence of tonsillectomy on their voice. A total group of 30 singers was included in the study. They answered the questions about the indications for surgery, symptoms, and changes in their voice after surgery. The study group consisted of 19 women and 11 men. Mean age was 18.53 years old at the moment of surgery. The group included eleven sopranos, six mezzos, two contraltos, four tenors, five baritones, and one bass singer. </p><p class="abstract"><strong>Results:</strong> A most common indication for tonsillectomy in opera singers was recurrent tonsillitis and was present in over 83% of cases. After surgery, the voice performance was better in 60% of cases, breathing improved in 50% of cases, voice emission was higher in 53% of cases. Over 80% of singers would recommend that surgery to another opera singer.</p><p class="abstract"><strong>Conclusions:</strong> Singers evaluated long-term influence of tonsillectomy as positive. Over 80% admitted improved effect on emission and the function of voice.</p>
Objectives. The main goals of this study were to assess the most significant morphological changes and acoustic measures for the ageing process of a professional opera singer’s voice. Design. This investigation included 58 healthy professional opera singers, who were compared with 42 young opera singers from a control group. Methods. All participants underwent a voice assessment protocol: an ENT specialist examination and a speech therapist evaluation. Acoustic parameters and subjective observations were obtained, and then analysed. Results. The fundamental frequency (F0) level was distinctly decreased in the case of older female singers, but F0 in older male singers had stable levels in comparison to that in younger singers. Older singers were found not to have substantially different values of jitter than younger ones. Maximal phonation time (MPT) was longer in the older women group when compared to younger singers, but not relatively different in the men group. Shimmer value presented no age related change. Morphological changes seem to correlate with the age of subjects. Conclusions. The main characteristic of voice change over age was a decreased F0 level among older female professional singers and rather stable F0 levels in male singers. This study gives preliminary results on ageing voice in the population of professional opera singers.
Introduction: Tuberculum sellae meningiomas (TSM) represent 5-10% of all intracranial meningiomas. Tumours are located on tuberculum sellae or chiasmatic sulcus of the sphenoid bone. These suprasellar lesions often displace the optic nerves causing visual impairment that is commonly the presenting symptom. Tuberculum sellae meningiomas are traditionally operated by transcranial approach. There is an alternative method to remove tumours of anterior skull base by using endoscopic transnasal surgery. Methods: In this article we describe a case of the patient with tuberculum sellae meningioma. Results: 63-year old women was diagnosed due to a headache, facial sensation defects on the right and peripheral vision loss. Ophthalmology examination showed bitemporal vision loss up to 10-15%. Using magnetic resonance imaging scan the tumour of diameter 8.1x8.0mm was located in tuberculum sellae. The endoscopic transsphenoidal operation was made confirming diagnosis of meningioma. In postoperative period the symptoms was almost completely minimalized. Conclusion: The treatment of choice for tuberculum sellae meningiomas is a surgery. Neurosurgeons have two options to remove the tumour: by transcranial approaches or via endoscopic transsphenoidal surgery with rhinologist. The decision of the optimal surgical technique should be individually made. Knowing possible complications during endoscopic approach, the benefits prevail. Cerebrospinal fluid leak is still challenging but using nasoseptal flap (Hadad’s flap) makes reconstruction easier. Recovery is quicker and postoperative results are promising.
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