The differential diagnosis of the complaint of dysphagia is extensive; however, a search of the literature gives the impression that pharyngocele as a cause of dysphagia is relatively infrequent, since only 18 well-documented cases have been reported. On the other hand, the author's experience reveals that pharyngocele occurs more commonly than indicated in the literature as, over the past 2 years, 24 patients with pharyngocele have been personally observed. This thesis is divided primarily into three sections: 1. a review of the physiology and anatomy involved in the swollowing mechanism; 2. a review of the English literature regarding pharyngocele, and 3. an evaluation of the author's 24 cases, allowing for discussion and conclusions. It is noted that laryngocele is frequently mistaken for pharyngocele; however, it is pointed out that a correctly performed barium swallow roentgenogram differentiates one from the other. Symptoms of laryngocele, Zenker's diverticulum and pharyngocele can be quite similar. Frequently, pharyngocele can be demonstrated by the Valsalva maneuver. Surgical repair is indicated when the symptoms are severe. Standard pharyngeal mucous membrane closure similar to the procedure utilized in the repair of Zenker's diverticulum should result in resolution of the problem.
Natural family planning, as a function of God's will is also a function of the natural law. For years we have been waging war on our fertility in the practice of artificial birth control to the point that many countries, especially in the West are demographically below replacement levels. On the other hand, while vast numbers of women are ignorant of the significance of those changing mucus sensations, modern methods of NFP, if the intention is to avoid/postpone pregnancy are scientifically secure. Natural family planning also has several advantages which benefit the marriage. Concluding, the article proposes that all Catholic physicians begin to conduct NFP-only practices.
Pregnancy is not a disease. But more fundamentally, neither is human fertility. They are normal physiologic processes of the sexually mature person. By classifying pregnancy and fertility as disease states, certain entities are able to position contraception as "the cure." Currently, these same organizations want to include oral contraceptive counseling and medications in the new national health-care plan under a preventive care mandate. But it is the physician's role to counsel patients on preventive care measures. We understand that these evidenced-based screenings help to change risky behaviors and catch disease in its earliest stages, thereby reducing patients' overall morbidity and mortality. However, we believe that patients incur substantial health risks when choosing oral contraceptives (OCPs). This paper reviews the major risks of OCPs. The authors presume that the prevailing widespread acceptance and promotion of OCPs indicates general agreement within the medical community that OCPs are good for the patient (or at least not significantly harmful). Therefore, this paper concentrates on the studies which show increased harm and risk to the patient choosing to use OCPs. We have concentrated our efforts on three major areas: increased rates of cardiovascular disease, breast cancer, and human papillomavirus (HPV) or cervical cancer. If fertility and pregnancy are not disease states, and are, in fact, normal conditions associated with healthy individuals, OCPs fail the most important test of preventive medicine: they increase risk of disease instead of decreasing it. Patients should not be misled or confused into believing that what they are taking is "good for them" and is of the same beneficial effect as other preventive measures.
Dr. John J. Billings died on April 1, 2007, after a long illness. Prior to his death he had been awarded the President's Medal by Georgetown University in recognition of his research in developing the Billings Ovulation Method of natural family planning. However, he was personally unable to accept the award due to his failing health. This paper is a biographic sketch of his long and illustrious career.
The otolaryngologist is frequently consulted by patients with a confusing array of complaints of pain in the head and neck region. It is the purpose of this paper to re‐introduce the problem of the temporomandibular joint pain dysfunction syndrome and stress its frequent occurrence. Costen in 1934 and 1944 brought to the attention of otolaryngologists the problem of temporomandibular joint dysfunction. In his 1944 report he stated that the diagnosis of tic doloreaux had been frequently made in patients with temporomandibular joint pain dysfunction syndrome. The number of cases included in this report are those collected over the past six months. Between June and December of 1973, 25 patients with the diagnosis of temporomandibular joint pain dysfunction syndrome were asked to fill out a questionnaire covering the history and symptomatology of their problem. Just over 50 percent were under the age of 50, with the largest number between the ages of 30 and 49. No patients had symptoms less than three months and most of the patients had symptoms from three months to one year. Unilateral symptoms were present in all but four cases, and the right side was most frequently involved. Many physicians were consulted and averaged 2.3 for each patient. All but two patients described pain in multiple areas, the most frequent combinations being the joint, ear and lower jaw; however, most patients were unaware of joint pain primarily. One patient complained only of throat pain and one complained only of pain in the lower jaw. Eight patients described “popping” in the joint, and eight had a history of teeth clenching or bruxing. Thirteen complained of fullness or pressure along with tinnitus and vertigo on an intermittent basis. Four case histories are presented to exemplify certain problems. The history is one of many nerve roots involved with pain in and around the ear, pain down the side of the neck, a gnawing aching tight feeling under the jaw to a burning sensation down the skin of the neck. In most all patients treatment has often been given by many doctors. They frequently present to the examiner as an individual with a large psychosomatic overlay. Physical examination reveals subjective pain and tenderness in the joint, clicking or crepitation upon auscultation of the joint, spasm of the external pterygoid, tenderness of the masseter muscle, deviation of the mandible on opening, impaired motion of one or both condyles and a generalized sensitiveness of the skin in the involved region. Representative X‐rays are presented. Intra‐articular injection of 1 cc. of 2 percent lidocaine will relieve some or all of the symptoms the patient is experiencing. Complications of the injection have been minimal. A small number of patients obtained complete relief of their head and neck pain after three to five injections. A possible mechanism to explain the genesis of the syndrome is presented. Treatment is varied and not agreed upon. Three patients have been treated by the insertion of a temporomandibular joint prosthesis.
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