scholarly journals Considerations for Continuing Semielective and Emergency Otolaryngological Procedures During the COVID-19 Pandemic

2020 ◽  
Vol 100 (1) ◽  
pp. 19-25
Author(s):  
Sarina K. Mueller ◽  
Maximilian Traxdorf ◽  
Konstantinos Mantsopoulos ◽  
Antoniu-Oreste Gostian ◽  
Matti Sievert ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Emergency Surgery ◽  
Transmission Rate ◽  
Medical Personnel ◽  
Human Beings ◽  
Threatening Condition ◽  
Long Time ◽  
Life Threatening

Introduction: During the COVID-19 pandemic, worldwide over 600,000 human beings died due to the cause of the disease. In order to deescalate the transmission rate and to avoid crush loading the countries medical health systems social distancing, face masks, and lockdowns have been considered essential by the majority of governments. Whereas some countries have highly reduced or completely stopped otorhinolaryngological procedures, other countries have continued selected surgeries. The objective of this study was to analyze procedures and outcomes of continuing semielective and emergency surgeries during the COVID-19 pandemic. Methods: Retrospective analysis of n = 750 patients who received semi-elective or emergency surgery between March 26 and June 16, 2020, in the Otolaryngology Department of the Friedrich-Alexander-University of Erlangen-Nürnberg. All patients were screened for COVID symptoms and swabbed for SARS-CoV-2 prior to surgery. Results: Of the n = 750 patients, n = 699 patients received semielective surgery and n = 51 emergency surgery. For 27 patients, the swab result could not be awaited due to a life-threatening condition. In these cases, surgery was performed in full protective equipment. No patient was tested positive during or after the surgery (follow-up 45 to 127 days). No member of the medical personnel showed symptoms or was tested positive after contact with patients. Due to the continuation of surgeries, patients’ lives were saved and improvement of long-term quality-of-life and outcomes is anticipated. Conclusions: Continuing selected otorhinolaryngological surgeries is crucial for patients’ health, survival, and long-time quality of life, yet, the protection of the medical personnel has to be granted.

scholarly journals Adrenal Insufficiency - Aetiology, Diagnosis and Treatment

2015 ◽  
Vol 3 (1) ◽  
pp. 36-47
Author(s):  
Nazma Akter ◽  
Nazmul Kabir Qureshi
Keyword(s):  
Quality Of Life ◽  
Adrenal Insufficiency ◽  
Presenting Symptoms ◽  
Life Saving ◽  
Life Threatening ◽  
Diagnostic Work ◽  
Work Up ◽  
Term Management

Adrenal insufficiency is caused by either primary adrenal failure or by hypothalamic-pituitary impairment of the corticotropic axis. Adrenal insufficiency, first codified in 1855 by Thomas Addison, remains relevant in 2014 because of its lethal nature. Though, it is a rare disease but is life threatening when overlooked. Main presenting symptoms such as fatigue, anorexia and weight loss are nonspecific, thus diagnosis is often delayed. The diagnostic work-up is well established but some pitfalls remain. The diagnosis is adequately established by the 250 ?g ACTH (adrenocorticotropic hormone) stimulation test in most cases. Glucocorticoids provide life saving treatment but long-term quality of life is impaired, perhaps because therapy is not given in a physiologic way. Dehydroepiandrosterone-replacement therapy has been introduced that could help to restore quality of life. It may be useful in pubertal girls, but not in adults. Monitoring of glucocorticoid-replacement is difficult due to lack of objective methods of assessment and is therefore largely based on clinical grounds. Thus, long-term management of patients with adrenal insufficiency remains a challenge, requiring an experienced specialist. DOI: http://dx.doi.org/10.3329/dmcj.v3i1.22238 Delta Med Col J. Jan 2015; 3(1): 36-47

The effects of animal-assisted interactions on quality of life in children with life-threatening conditions and their parents

2021 ◽  
Vol 27 (10) ◽  
pp. 524-530
Author(s):  
Haley Walker ◽  
Mary Chapman Miller ◽  
Brittany Cowfer ◽  
Terrah Akard ◽  
Mary Jo Gilmer
Keyword(s):  
Quality Of Life ◽  
Clinical Trial ◽  
Palliative Care ◽  
Primary Caregivers ◽  
Randomised Clinical Trial ◽  
Severe Stress ◽  
Quality Of Life Research ◽  
Threatening Condition ◽  
Life Threatening

Background: Children with advanced cancer and their primary caregivers may experience severe stress and anxiety in coping with their life-threatening condition. As a way to help reduce these stressors and increase overall quality of life, research suggests that animal-assisted interactions may be beneficial when integrated into palliative care. Aims: This pilot study aims to provide evidence for the feasibility and efficacy of a randomised clinical trial using animal-assisted interactions to help improve the quality of life for children with an advanced life-threatening condition and their primary caregivers. This protocol paper outlines the basis of the research, goals, experimental design and methodology.

scholarly journals USE OF THERAPEUTIC EXERCISES FOR POST-STROKE CORRECTION OF SWALLOWING

2021 ◽  
Vol 9 (2) ◽  
pp. 129-137
Author(s):  
Valentina Buivalo ◽  
Olga Yezhova ◽  
Anatoliy Krasnyukov
Keyword(s):  
Quality Of Life ◽  
Speech Therapy ◽  
Masticatory Muscles ◽  
Neurogenic Dysphagia ◽  
Therapeutic Exercises ◽  
Screening Study ◽  
Long Time ◽  
Life Threatening ◽  
Complications Of Stroke

Dysphagia (Greek. Dys + phagein ­­– eat, swallow) ­– is a violation of swallowing, in which there is a feeling of discomfort or difficulty in transporting the food bolus from the mouth to the stomach. Because the disorder of the act of swallowing in stroke is usually of neurogenic origin and is defined by a number of neurologic disturbances and dysfunctions, it is better to use the term "neurogenic dysphagia" for patients with acute disturbance of cerebral circulation. The urgency of this problem is especially emphasized in the development of a set of therapeutic exercises for such socially important disease as acute cerebrovascular accident. One of the formidable complications of stroke is a violation of the act of swallowing. This leads to a significant reduction in quality of life increasing the risk of secondary complications, which, in turn, significantly increases the likelihood of death. Violation of the act of swallowing is observed in 26–45% of patients due to acute ischemic stroke. Dysphagia leads to the development of life-threatening complications such as aspiration pneumonia, dehydration, and significantly reduces the quality of life of such patients. Thus, the correction of the act of swallowing by means of physical rehabilitation after brain injury is a very important task of the rehabilitologist. For a long time, speech therapy was the only method of rehabilitation of dysphagia; now we can widely use therapeutic exercises to restore the functions of facial muscles and masticatory muscles. Screening for swallowing disorders allows us to assess the function of the masticatory muscles in five stages, which makes it possible to develop a more individual and thorough set of therapeutic exercises after each stage of the screening study. Depending on the phase of swallowing in which disorders are observed, we have developed an individual set of therapeutic exercises that will be performed by the patient in each of the five stages of the screening study, if the patient could not overcome this stage.

scholarly journals Overview of Palliative Care

2014 ◽  
Vol 9 (2) ◽  
pp. 3-10
Author(s):  
B D Paudel ◽  
G Dangal ◽  
D Munday
Keyword(s):  
Quality Of Life ◽  
Palliative Care ◽  
Symptom Control ◽  
Oral Morphine ◽  
Common Symptom ◽  
Depression And Anxiety ◽  
Threatening Condition ◽  
Life Threatening ◽  
The 1960S

Patients diagnosed with a life threatening condition like cancer suffer physically, socially and mentally. Their quality of life can be improved by effective communication and good symptom control even when the disease is incurable. Pain is the most common symptom and can be controlled by optimal use of analgesics especially oral morphine if severe. Psychosocial issues like depression and anxiety can be minimized by counseling and use of medicines. Death is more painful than birth but can be minimized by understanding the reality and by honest sharing which will help to minimize unnecessary sufferings. Palliative care is the care of these patients and their family members to make their life comfortable. Modern palliative care has developed around the world since the 1960s and in Nepal, since the beginning of 21st century. Much remains to be done before palliative care can be an integrated part of health care in Nepal. In this context gynaecologist having knowledge and skills in palliative care, have an important role in improving the quality of life of patients with life threatening condition and their family members.DOI: http://dx.doi.org/10.3126/njog.v9i2.11724

The approach to the rehabilitation of the patients presenting with central dysphagia on an individual basis

2016 ◽  
Vol 15 (3) ◽  
pp. 137-141
Author(s):  
I. V Sidyakina ◽  
Mariya Viktorovna Voronova
Keyword(s):  
Quality Of Life ◽  
Brain Damage ◽  
Aspiration Pneumonia ◽  
Unique Pattern ◽  
Significant Challenge ◽  
Individualized Approach ◽  
Long Time ◽  
Life Threatening ◽  
Elongation Phase

Disorder of the swallowing act occurs in 25-50% of patients in the acutephase of stroke. The presence of dysphagia in a patient notonly can develop life-threatening complications, such as aspiration pneumonia, exhaustion and dehydration, but al so significantly reduces the quality of life of patients. Thus, the correction of thes wallowing act disorders after brain damage is a quite significant challenge for neurorehabilitation. For a long time logopedic correction remained the only method of rehabilitation inneurogenic dysphagia, and now different stimulation techniques such as surface and intra pharynx electro stimulation are widely used. Evaluation of swallowing by scintigraphy indicates that each patienth as a unique pattern of disorders of the swallowing act. Depending on which elongation phase of swallowing is essential, we have developed an individualized approach to there habilitation of patients with dysphagia, which improves the efficiency of there habilitation process.

scholarly journals Long-term follow-up for different varicose vein therapies: is surgery still the best?

2016 ◽  
Vol 31 (1_suppl) ◽  
pp. 125-129 ◽  
Author(s):  
Roshan Bootun ◽  
Alun H Davies
Keyword(s):  
Quality Of Life ◽  
Varicose Vein ◽  
Varicose Veins ◽  
Cost Effective ◽  
Turn Of The Century ◽  
Beneficial Impact ◽  
Long Term Follow Up ◽  
Long Time

Management of varicose vein disease has changed drastically over the past decades. Since its introduction in vein practice, surgery has gone through several stages of evolution until the method of ligation with stripping eventually became and remained the standard for a long time. It was found to be effective at treating the condition and, indications of its beneficial impact on patients’ quality of life soon also became evident. However, being associated with significant morbidity, surgery gradually fell out of favour, especially, once the newer endovenous techniques were launched around the turn of the century. These endothermal methods allowed procedures to be carried out under local anaesthetic as day case interventions, often with a similar or even better effect on occlusion rates and quality of life. In addition, there is mounting evidence that these newer techniques might be more cost-effective. This review evaluates surgical treatment of varicose veins compared to endovenous methods and also assesses its place in current phlebological practice.

Aerodynamic, acoustic and functional results of posterior transverse laser cordotomy for bilateral abductor vocal fold paralysis

2006 ◽  
Vol 120 (4) ◽  
pp. 282-288 ◽  
Author(s):  
Gürsel Dursun ◽  
M Kürşat Gökcan
Keyword(s):  
Vocal Fold ◽  
Functional Results ◽  
Subjective Symptom ◽  
Vocal Fold Paralysis ◽  
Symptom Scale ◽  
Threatening Condition ◽  
Life Threatening ◽  
Posterior Glottis

Bilateral abductor vocal fold paralysis (BAVFP) is a rare but life-threatening condition which may require an emergency tracheotomy procedure. The ideal surgical technique for this condition should improve quality of life by relieving the airway obstruction while preserving laryngeal functions such as phonation and deglutition. Posterior transverse laser cordotomy (PTLC) was first described by Dennis and Kashima as a technique for providing an airway at the posterior glottis without pre-operative tracheotomy; they reported it as a successful method with satisfactory functional results. The aim of this prospective study was to evaluate long term acoustic, aerodynamic and functional results of the primary bilateral PTLC technique in 22 BAVFP patients. Severity of dyspnoea was evaluated using a five-level subjective symptom scale graded according to the limitation in daily activity and level of respiratory difficulty. Aerodynamic and acoustic analyses were performed pre-operatively and prospective changes in aerodynamic and acoustic parameters were collected after one post-operative year.

scholarly journals A Case of Intractable Hiccup Treated by Acupuncture and Moxibustion

2021 ◽  
Vol 5 (6) ◽  
pp. 22-24
Author(s):  
Hui Sun ◽  
Yufeng Bi ◽  
Changchun Ji ◽  
Qinlang Liu
Keyword(s):  
Quality Of Life ◽  
Western Medicine ◽  
Treatment Method ◽  
Systemic Diseases ◽  
Curative Effect ◽  
Acupuncture And Moxibustion ◽  
Intractable Hiccup ◽  
Life Threatening

Hiccup is a syndrome characterized by continuous sound in the throat, short and frequent sound, and difficult to stop [1]. Although the disease is not life-threatening, it seriously affects the quality of life of patients. Long term intractable hiccup will also have an impact on the psychology of patients and bring great trouble to patients. Hiccup is equivalent to diaphragmatic spasm in western medicine and involves a variety of systemic diseases [2]. At present, the treatment of this disease includes drugs and nerve block, but the curative effect and prognosis are not ideal. Acupuncture and moxibustion, as a green and simple treatment method, has unique curative effect in the treatment of hiccup. Now the test of one case of intractable hiccup caused by ineffective treatment is as follows.

Trauma of the Larynx and Cervical Esophagus

2021 ◽  
Author(s):  
David Young ◽  
Andrew Tkaczuk
Keyword(s):  
Quality Of Life ◽  
Caustic Ingestion ◽  
Airway Compromise ◽  
Rare Occurrence ◽  
Upper Aerodigestive Tract ◽  
Initial Management ◽  
Personal Experiences ◽  
Life Threatening

Upper aerodigestive tract trauma is rare occurrence, but can have devastating consequences. Immediate complications including airway compromise can be life threatening and complicate resuscitative efforts. Long-term sequelae can significantly affect a patient’s quality of life by limiting one’s ability to breathe, phonate, and/or swallow. This review provides an overview of upper aerodigestive trauma, where many of these injuries occur concomitantly, but this text is divided into three main categories of: laryngeal framework, upper aerodigestive perforation, and adult caustic ingestion. The initial management of these injuries can be reflexive and mundane, but also are frequently nuanced and challenging, where personal experiences in management of these patients results in mastery.  This review contains 9 figures, 4 tables and 82 references.  Keywords: Laryngeal trauma, laryngeal facture, esophageal perforation, caustic ingestion

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