Discussion on Deep X-Ray and Radium Therapy in Relation to the Mouth and Upper Respiratory Tract

The rays destroy, partially destroy, or injure cells, especially the nucleus. The injured cells may recover, so that further radiation is usually advisable after eight weeks. In throat conditions, overdosage is the great danger, owing to insufficient body-fluid coverings, and to the presence of large air cavities, which prevent the proper diffusion of rays and the striking back of those which penetrate the growth. The use of glucose and the permeating of the growth with metals in minute subdivision in order to cause secondary radiations advised. The best method of all, if practicable, would be to fill the air cavities with fluids, after preliminary tracheotomy. The main advantages of deep therapy are the ease with which wide areas can be radiated and the flexibility of the method. By varying the voltage and the filters with the depth from the surface, one can get diffusion of the rays, because the softer the ray the greater its absorption. This method is extremely safe, even for out-patients. Surgery when possible is always advisable. Diathermy is best, followed within three days by radiation. In doubtful cases partial radiation immediately before operation is advisable, to be completed within ten days after operation. Formation of antibodies is considered to be a vital factor. These are formed as the result of the absorption of the destroyed cells. In all malignant conditions the same dosage is now administered. After-treatment of hospital cases is most important. Artificial sunlight is advised, also sending the patient to an institution or convalescent home.

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Sinus Barotrauma in Divers

Annals of Otology Rhinology & Laryngology ◽

10.1177/000348947608500110 ◽

1976 ◽

Vol 85 (1) ◽

pp. 61-64 ◽

Cited By ~ 38

Author(s):

Paul Fagan ◽

Bart McKenzie ◽

Carl Edmonds

Keyword(s):

Respiratory Tract ◽

Occupational Disease ◽

Upper Respiratory Tract ◽

Fluid Level ◽

X Ray ◽

Sinus Barotrauma ◽

History Of ◽

Upper Respiratory ◽

Mucosal Thickening ◽

Maxillary Sinuses

Sinus barotrauma is a common occupational disease of divers, with the incidence of descent barotrauma approximately double that of ascent. Pain chronologically associated with the change of pressure is the most dominant symptom and is seen in 92% of the cases presented for treatment. The majority complain of a frontal distribution of pain, with ethmoidal and maxillary being much less significant. Epistaxis is the second commonest symptom, and may be the sole symptom in some ascent cases. A history of recent or past sinus barotrauma or upper respiratory tract pathology is very common. Clinical examination supports the evidence of upper respiratory tract pathology in many cases. The radiological signs of abnormality were present in over three quarters of the cases examined. Of these the maxillary sinus was affected in most cases, the frontal in approximately one quarter and the ethmoidal in less than a fifth. The pathology was more commonly that of mucosal thickening, but in 12% of cases there was a fluid level. It is noted that although symptoms were predominantly frontal, x-ray changes were most often present in the maxillary sinuses.

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Upper respiratory tract manifestations in patients with ANCA-associated vasculitides and their association with the presence and type of ANCA

Rheumatology Science and Practice ◽

10.47360/1995-4484-2021-555-562 ◽

2021 ◽

Vol 59 (5) ◽

pp. 555-562

Author(s):

I. G. Smirnova ◽

N. M. Bulanov ◽

P. I. Novikov ◽

I. A. Osipova ◽

S. V. Moiseev

Keyword(s):

Respiratory Tract ◽

Granulomatosis With Polyangiitis ◽

Saddle Nose ◽

Eosinophilic Granulomatosis With Polyangiitis ◽

Upper Respiratory Tract ◽

X Ray ◽

Saddle Nose Deformity ◽

Radiological Patterns ◽

Upper Respiratory ◽

Eosinophilic Granulomatosis

Aim of the work – to compare the frequency of upper respiratory tract (URT) involvement in patients with ANCAassociated vasculitides (AAV), to reveal its main clinical and radiological patterns and to estimate their association with the serological profile (ANCA presence and type).Material and methods. This retrospective study evaluated 369 patients with granulomatosis with polyangiitis (GPA), microscopic polyangiitis (MPA) and eosinophilic granulomatosis with polyangiitis (EGPA). The enrolled patients were diagnosed with AAV according to the ACR criteria, CHCC classification (2012) and EMA algorithm. Patients with URT manifestations underwent standard ENT assessment and X-ray/CT. Serum ANCA levels were measured by ELISA.Results. URT involvement was diagnosed in 280 (75.9%) patients with AAV. It was significantly more common amongthe patients with GPA (86.4%) and EGPA (85.5%) compared with the MPA group (29.2%) (p<0.001).URT manifestations mainly appeared as sinusitis (77.2% – GPA; 33.3% – MPA; 70.8% – EGPA) and rhinitis with crusting (87.8%, 72.2% and 16.9% respectively).Proteinase 3 ANCA positive patients had a significantly higher incidence of bone destructive URT lesions, including sinuses wall destruction (p<0.001) and saddle nose deformity (p=0.016), compared with myeloperoxidase-ANCA-positive patients. Similar results were obtained in the GPA group separately.Localized disease with isolated URT involvement was observed in 41.3% cases of ANCA negative GPA (p<0.001).Conclusion. The frequency and patterns of upper respiratory tract manifestations depend both on the nosologic form of AAV and type of ANCA. Localized forms of URT involvement can be observed in patients with GPA and are closely associated with absence of ANCA, which determines the need for especially high suspicion level.

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Radium Therapy in Malignant Disease of the Upper Respiratory Tract

The Journal of Laryngology & Otology ◽

10.1017/s0022215100004576 ◽

1939 ◽

Vol 54 (5) ◽

pp. 312-315

Author(s):

Walter Howarath

Keyword(s):

Respiratory Tract ◽

Malignant Disease ◽

Upper Respiratory Tract ◽

Upper Respiratory ◽

Radium Therapy

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Deep X-Ray and Radium Theraphy in Relation to the Mouth and Upper Respiratory Tract

The Journal of Laryngology & Otology ◽

10.1017/s0022215100031625 ◽

1928 ◽

Vol 43 (3) ◽

pp. 191-203

Author(s):

W. L. Watt ◽

N. S. Finzi

Keyword(s):

Respiratory Tract ◽

Upper Respiratory Tract ◽

X Ray ◽

Upper Respiratory

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731. Investigating Clinical Factors Contributing to Continued Antibiotic Therapy in Patients with Viral Upper Respiratory Tract Infections

Open Forum Infectious Diseases ◽

10.1093/ofid/ofy210.738 ◽

2018 ◽

Vol 5 (suppl_1) ◽

pp. S263-S263

Author(s):

Alexander Lawandi ◽

Charles Frenette

Keyword(s):

Respiratory Tract ◽

Antibiotic Therapy ◽

Emergency Departments ◽

Respiratory Virus ◽

Respiratory Viruses ◽

Upper Respiratory Tract ◽

X Ray ◽

Chest X Ray ◽

Upper Respiratory ◽

Tract Infections

Abstract Background It has previously been demonstrated that upwards of 50% of patients presenting to Emergency Departments with symptoms of an upper respiratory tract infection receive empirical antibiotics, and that even with a demonstrated viral infection, 70% of these patients are continued on antibiotics. However, the clinical and biochemical factors contributing to this continued therapy is unclear. This study assessed parameters that may impact antibiotic prescriptions in patients with a confirmed viral respiratory infection. Methods. Positive respiratory virus PCRs (RVPs) from nasopharyngeal aspirates performed on adult patients presenting to the McGill University Health Centre Emergency Departments and outpatient clinics over a period of 10 days during the peak of influenza season were included. For each patient, antibiotic administration pre- and post-PCR result were determined, as were the presence of leukocytosis, neutrophilia, an abnormal chest X-ray, and sepsis. Each parameter’s effect on antibiotic use was then determined. Results. During the study period, there were 123 positive RVPs included. These consisted of 34% Flu A, 43% Flu B, and 23% were a mixture of other common respiratory viruses. Antibiotics were administered in 38% of patients before the test was resulted and continued in 79% of these patients afterwards. There was no correlation between the presence of leukocytosis, neutrophilia, signs of sepsis or abnormalities on chest X-ray and continued antibiotic therapy. Conclusion. Despite identification of a respiratory virus infection, patients are routinely treated with antibiotics even without significant evidence of a bacterial process. The impact of testing for respiratory viruses in limiting antibiotic therapy could be improved by education and direct antibiotic stewardship interventions in this population. Disclosures All authors: No reported disclosures.

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