Late Health Effects of Radiation for Eustachian Tube Dysfunction: Previous Results and Ongoing Study in the Netherlands

1996 ◽  
Vol 115 (5) ◽  
pp. 417-421
Author(s):  
Peter G. Verduijn
Keyword(s):  
The Netherlands ◽  
Health Effects ◽  
Urogenital System ◽  
Neck Tumors ◽  
Significant Difference ◽  
Tube Dysfunction ◽  
Study Population ◽  
Effects Of Radiation ◽  
Nose And Throat

To study the late health effects of nasopharyngeal radium irradiation, a nonconcurrent prospective study was conducted in The Netherlands. Exposed subjects ( n = 2510) were treated unilaterally with nasopharyngeal radium irradiation at five ear, nose, and throat clinics between 1945 and 1965 and followed up through February 1, 1985. Unexposed subjects ( n = 2199) were matched to treated patients according to clinic, year of birth, and first consultation within 5 years. No overall significant increase in cancer mortality was found. A statistically significant difference was noted only for cumulative all-site cancer incidence, with the exposed having twice as many verified cancers as the nonexposed. This excess risk was caused mainly by head and neck tumors and other tumors flung, digestive tract, and urogenital system). The relative risk for these specific sites, however, was not significantly different from 1.00. These findings corroborate the hypothesis that there is some risk of tumor induction involved with nasopharyngeal radium irradiation at the dose level applied to this population. Because of ongoing interest in this subject, I plan to extend the follow-up of the cohort through December 31, 1995, and I am studying the possibility of expanding the study population.

scholarly journals Effect of head and neck radiotherapy on the Eustachian tube functions

2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Ahmed Abdullah Hamd ◽  
Essam Abd El-Wanes Behiry ◽  
Adel Tharwat Atallah ◽  
Sherif Maher Elaini ◽  
Ahmed Hamdy Alshafai
Keyword(s):  
Head And Neck ◽  
Eustachian Tube ◽  
Contralateral Side ◽  
Head And Neck Tumors ◽  
Eustachian Tube Dysfunction ◽  
Middle Ear Effusion ◽  
Neck Tumors ◽  
Tube Dysfunction ◽  
Ear Effusion

Abstract Background Nowadays, radiotherapy is widely used in management of many types of tumors including head and neck tumors; in this study, we concerned with its reverse effects on the Eustachian tube functions and if this effect is temporary or permanent. Results The whole (30) patients have tympanogram at both ears before starting radiotherapy; all patients (100%) were normal. In the immediate post radiotherapy tympanogram at the contralateral side, 6.7% of patients had effusion, and 20% had Eustachian tube dysfunction, while at the ipsilateral side, 20% of patients had effusion, and 33.3% had ET dysfunction. In the follow-up tympanogram 12 weeks post radiotherapy, we found that 6.7% of patients had effusion, and (10%) had Eustachian tube dysfunction at the contralateral side, while 6.7% of patients had effusion, and only 20% had Eustachian tube dysfunction at the ipsilateral side. Conclusion From this study, we concluded that patients with head and neck tumors treated by radiotherapy (apart from the nasopharynx) have a high incidence of affection of Eustachian tube function namely middle ear effusion and Eustachian tube dysfunction. The possibility for development of middle ear effusion and Eustachian tube dysfunction increases with increased tumor stage. Eustachian tube functions immediately post radiotherapy and after 12 weeks of the end of radiotherapy was affected by different effects according to the tumor site. The Eustachian tube functions significantly improved within 12 weeks after the last dose of radiotherapy, and we recommend audiological follow-up for patients with head and neck tumors treated with radiotherapy.

Surveillance of Hospital-Acquired Infection in England, Germany, and The Netherlands Will International Comparison of Rates Be Possible?

2001 ◽  
Vol 22 (6) ◽  
pp. 393-397 ◽  
Author(s):  
Rosa Coello ◽  
Petra Gastmeier ◽  
Annette S. de Boer
Keyword(s):  
The Netherlands ◽  
International Comparison ◽  
Surveillance Systems ◽  
Surveillance Strategy ◽  
Data Set ◽  
Hospital Acquired Infection ◽  
Or Groups ◽  
Study Population ◽  
Hospital Acquired

AbstractThree national surveillance systems for nosocomial infection have been developed independently and implemented successfully in England, Germany, and The Netherlands. All three are based on the American National Nosocomial Infections Surveillance System and have adopted a surveillance strategy that is targeted at specific infections or groups of patients for limited time periods. Case-finding methods, the minimum data set, and analysis of data are similar and could be standardized easily. Resolution of the differences in the definitions of infection, the study population, and follow-up should make possible the international comparison of infection rates. Such comparisons may identify differences in healthcare practices between countries and suggest areas for improvement.

Local Control in Pelvic Ewing Sarcoma: Analysis From INT-0091—A Report From the Children's Oncology Group

2006 ◽  
Vol 24 (24) ◽  
pp. 3838-3843 ◽  
Author(s):  
Torunn I. Yock ◽  
Mark Krailo ◽  
Christopher J. Fryer ◽  
Sarah S. Donaldson ◽  
James S. Miser ◽  
...  
Keyword(s):  
Local Control ◽  
Ewing Sarcoma ◽  
Local Failure ◽  
Distant Failure ◽  
Pelvic Tumors ◽  
Significant Difference ◽  
Study Population ◽  
The Impact ◽  
To Receive

Purpose The impact of the modality used for local control of Ewing sarcoma is uncertain. We investigated the relationship between the type of local control modality, surgery, radiation (RT) or both (S + RT), and subsequent risk for local failure (LF) in patients with nonmetastatic pelvic Ewing sarcoma treated on INT-0091. Patients and Methods Patients ≤ 30 years with Ewing sarcoma, primitive neuroectodermal tumor or primitive sarcoma of bone were randomly assigned to receive chemotherapy with doxorubicin, vincristine, cyclophosphamide, and dactinomycin, (VACA) or with these four drugs alternating with ifosfamide and etoposide (VACA-IE). The local control modality, surgery, RT or both was chosen by the treating physicians. The effect of local control modality was assessed after adjusting for the size of tumor (< 8 cm, ≥ 8 cm) and chemotherapy type. Results Seventy-five patients with pelvic tumors and a median follow-up of 4.4 years (0.6 to 11.4 years) comprised the study population. Twelve underwent surgery, 44 received RT, and 19 received both. The 5-year event-free survival (EFS) and cumulative incidence of LF was 49% and 21% (16%, LF only; 5%, LF and distant failure). There was no significant difference in EFS or LF by tumor size (< 8 cm, ≥ 8 cm), local control (LC) modality, or chemotherapy. However, VACA-IE seems to confer an LC benefit (11% v 30%; P = .06). Conclusion There was no significant effect of local control modality (surgery, RT or S + RT) selected by the treating physicians on rates of local failure or EFS. However, VACA-IE improves LC (11%) compared with previously published results for pelvic Ewing sarcoma.

Myringoplasty: a comparison of bismuth iodoform paraffin paste gauze pack and tri-adcortyl ointment ear dressing

2006 ◽  
Vol 121 (4) ◽  
pp. 329-332 ◽  
Author(s):  
V Nakhla ◽  
Y M Takwoingi ◽  
A Sinha
Keyword(s):  
Retrospective Study ◽  
Success Rate ◽  
Tympanic Membrane ◽  
Surgical Approach ◽  
Suitable Alternative ◽  
Significant Difference ◽  
Study Population ◽  
The Mean ◽  
Gauze Pack

Objectives: To assess the myringoplasty graft take rate, comparing two methods of post-operative ear packing: bismuth iodoform paraffin paste (BIPP) gauze versus tri-adcortyl ointment (TAO).Methods: A retrospective study of patients who had undergone myringoplasty at our department within a three-year period was undertaken. Data, including age, site and size of perforation, grade of surgeon, surgical approach, use of post-operative ear dressings, complications, and audiometric outcome, were collected from the patient notes and analysed. The overall success rate of the operation (with success being defined as an intact tympanic membrane at six months) was noted.Results: One hundred and seventy myringoplasties were performed over the study period, but data were complete on 154 patients and these constituted the study population. Age ranged from nine to 71 years (mean age 34 years) and the mean follow-up period was seven months. Consultants performed 62 per cent of the operations, with an 85 per cent success rate, whereas trainees performed the remaining 38 per cent, with a success rate of 73 per cent (p=0.059). The overall success rate was 80 per cent; 79 per cent for BIPP and 83 per cent for TAO (p=0.55), and 87 per cent for small perforations and 75 per cent for subtotal perforations (p=0.22). There was audiometric improvement in 74 per cent of cases.Conclusion: We found no significant difference in outcome between patients packed with TAO and BIPP. Packing with TAO is therefore a suitable alternative to BIPP gauze ear dressing following myringoplasty.

scholarly journals Evaluation of factors influencing tick bites and tick-borne infections: a longitudinal study

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Bo Bødker Jensen ◽  
Mie Topholm Bruun ◽  
Per Moestrup Jensen ◽  
Andreas Kristian Pedersen ◽  
Pierre-Edouard Fournier ◽  
...  
Keyword(s):  
Blood Donors ◽  
Seroconversion Rate ◽  
Clinical Manifestations ◽  
Weather Conditions ◽  
Igg Antibodies ◽  
Tick Bites ◽  
Significant Difference ◽  
Study Population ◽  
June July

Abstract Background Various tick-borne infections like borreliosis and rickettsiosis pose a health risk to humans in many parts of the world. We investigated seroprevalence of and seroconversion to Borrelia burgdorferi and Rickettsia spp. and relation to tick-bites, weather and clinical manifestations in Denmark. Methods Blood donors were enrolled at the Hospital of Southern Jutland in June–July with follow-up November–February of 2018 and 2019. Blood samples were collected, and a questionnaire regarding tick bites, potential exposures and symptoms was completed at each visit. Samples were tested for presence of IgM and IgG antibodies directed against B. burgdorferi and Rickettsia spp. using R. helvetica and R. felis as antigens. Data were examined for correlation between tick bites, serological results, potential exposures and symptoms. Results Two-hundred and fourteen (93 follow-ups) and 130 (38 follow-ups) blood donors were included in 2018 and 2019, respectively. The total borrelia seroconversion rate was 6.3% (CI 2.1–10.5), while the prevalence of IgM and IgG antibodies was 7.8% (CI 4.9–10.6) and 6.7% (CI 4–9.3), respectively. Seroconversion to Rickettsia spp. was detected in one participant. Tick bites and seroconversion were not significantly associated with the reported unspecific symptoms, but unspecific symptoms were common in the study population. There was no significant difference in number of tick bites or seroconversion/prevalence between seasons with highly alternating weather. Conclusions Results suggest that weather conditions in an individual year have a limited impact. Anti-Borrelia-antibodies do not seem to persist in serum for several years. Rickettsiosis is of limited concern in Denmark. Graphic abstract

scholarly journals Folate Levels in Patients Hospitalized with Coronavirus Disease 2019

Nutrients ◽  
2021 ◽  
Vol 13 (3) ◽  
pp. 812
Author(s):  
Eshcar Meisel ◽  
Orly Efros ◽  
Jonathan Bleier ◽  
Tal Beit Halevi ◽  
Gad Segal ◽  
...  
Keyword(s):  
Medical Center ◽  
Cell Metabolism ◽  
Kidney Injury ◽  
Length Of Hospital Stay ◽  
Study Data ◽  
Serum Folate ◽  
Significant Difference ◽  
Study Population

We aimed to investigate the prevalence of decreased folate levels in patients hospitalized with Coronavirus Disease 2019 (COVID-19) and evaluate their outcome and the prognostic signifi-cance associated with its different levels. In this retrospective cohort study, data were obtained from the electronic medical records at the Sheba Medical Center. Folic acid levels were available in 333 out of 1020 consecutive patients diagnosed with COVID-19 infection hospitalized from January 2020 to November 2020. Thirty-eight (11.4%) of the 333 patients comprising the present study population had low folate levels. No significant difference was found in the incidence of acute kidney injury, hypoxemia, invasive ventilation, length of hospital stay, and mortality be-tween patients with decreased and normal-range folate levels. When sub-dividing the study population according to quartiles of folate levels, similar findings were observed. In conclusion, decreased serum folate levels are common among hospitalized patients with COVID-19, but there was no association between serum folate levels and clinical outcomes. Due to the important role of folate in cell metabolism and the potential pathologic impact when deficient, a follow-up of folate levels or possible supplementation should be encouraged in hospitalized COVID-19 patients. Fur-ther studies are required to assess the prevalence and consequences of folate deficiency in COVID-19 patients.

scholarly journals The opinions of specialists and students regarding the use of visual and written expression forms in rhinoplasty education

2021 ◽  
Vol 38 (3) ◽  
pp. 350-360
Author(s):  
Sefa Ersan KAYA ◽  
Özgür KEMAL ◽  
Sevgi SOYLU KOYUNCU
Keyword(s):  
Written Expression ◽  
Nasal Surgery ◽  
Semantic Level ◽  
Quality Of Surgery ◽  
Significant Difference ◽  
Study Population ◽  
Surgery Department ◽  
Surgery Education ◽  
Nose And Throat

This research was conducted to investigate the contribution of visual and written expression to nasal surgery education and the preferences of usage. The research was conducted with the observation of cases in the Ear, Nose and Throat (ENT) Surgery Department of Ondokuz Mayıs University Medical Faculty. During the study, the processes of the ‘closed dorsum rhinoplasty’ cases were observed. The case illustrations made as a result of the observations were presented to the study population comprising 36 medical students from 3 different universities (Ondokuz Mayıs University, Hitit University, İstanbul Medeniyet University). Data were obtained concerning the sampling of the research, the specialization areas of the participants, title groups, number of participants, and the information from the Likert type responses and the non-parametric statistical findings. The results showed that although the use of illustrations was seen to be more important according to the opinion of specialists and non-specialists in the area, sole use was concluded to be insufficient. A total of 43 of 60 ENT specialists and 9 of 11 Plastic Surgery specialists preferred the use of illustrations, photographs and written expression together. Non-specialists were seen to be undecided about their responses while no significant difference was found between specialists. The preferences of the participants were determined to be illustration, photography and written expression, respectively. The results of this study indicate that the use of visual and written expression forms together when they are available is related to the quality of surgery education at a semantic level.

scholarly journals Telephone-based assessment of multiple sclerosis patients at Ain Shams University Hospital in the coronavirus disease 2019 pandemic

2021 ◽  
Vol 57 (1) ◽  
Author(s):  
Mohamed A. Abdel Hafeez ◽  
Dina A. Zamzam ◽  
Mahmoud S. Swelam ◽  
Alaa Abo Steit ◽  
Janet Masoud ◽  
...  
Keyword(s):  
Multiple Sclerosis ◽  
Motor Impairment ◽  
University Hospital ◽  
Healthcare Facilities ◽  
Significant Difference ◽  
Study Population ◽  
Psychological Impairment ◽  
Multiple Sclerosis Patients ◽  
Post Hoc

Abstract Background Assessment of multiple sclerosis (MS) patients during the era of the coronavirus disease 2019 (COVID-19) pandemic was confronted with the overwhelmed healthcare facilities in Egypt and fear of the patients to get infected while attending the follow-up visits. This study aimed to assess the value of telephone-based assessments in the follow-up of MS patients. It includes one hundred and five patients who participated in the study and completed 3 telephone-based assessments which are the Hauser Ambulation index, Multiple Sclerosis Neuropsychology Questionnaire (MSNQ), and Symptoms of Multiple Sclerosis Scale (SMSS). Results The Hauser Ambulation index was significantly correlated with the latest Expanded Disability Status Scale (EDSS) score done within 1 month from the telephone call (r=0.738, P<0.001). The analysis of MSNQ scores showed that one-third of the study population had evidence of cognitive and/or neuropsychological impairment. Post hoc analysis regarding the cognitive and psychological impairment component of SMSS revealed that the patients who answered “Never” had significantly lower MSNQ scores compared to those who answered “Sometimes” (P=0.016), “Often” (P=0.022), and “Always” (P=0.001). The comparison of the EDSS scores of the patients regarding the sensory-motor impairment component of SMSS showed a non-significant difference. Conclusion The Hauser Ambulation index may be a reliable telephone-based tool for the assessment of physical disability. The MSNQ and the cognitive and psychological impairment component of SMSS can be used for the assessment of cognitive and psychological impairment among patients with MS.

scholarly journals Reactive Hyperglycaemia Connected with Low Glycated Haemoglobin – Risk Factor for Cardiovascular Adverse Events

2021 ◽  
Vol 2 (2) ◽  
pp. 85-96
Author(s):  
Marek Andres ◽  
Tomasz Rajs ◽  
Ewa Konduracka ◽  
Jacek Legutko ◽  
Janusz Andres ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Creatine Kinase ◽  
Glucose Metabolism ◽  
Cardiovascular Events ◽  
Glycated Haemoglobin ◽  
Major Adverse Cardiovascular Events ◽  
Creatine Kinase Mb ◽  
Significant Difference ◽  
Study Population

Introduction: Concomitance of glucose metabolism disturbances and ischemic heart disease is well known and connected to several times higher incidence of cardiovascular events resulted from atherosclerosis. Aim of this study was to assess impact of reactive hyperglycaemia accompanying chronic and not always optimally treated hyperglycaemia assessed with glycated haemoglobin level on cardiovascular prognosis among patient hospitalised in the course of acute myocardial infarction. Methods: 92 patients diagnosed with ST – segment elevation myocardial infarction (STEMI) qualified to primary percutaneous coronary intervention (pPCI) was included in the study. Study population was divided into subgroups, depending glucose level on admission (reactive hyperglycaemia) and HbA1c concentration: subgroup A (HbA1c <6.5%, Glc<7.8 mmol/l: n = 37; 40,2%), subgroup B (HbA1c <6.5%, Glc ≥.,8 mmol/l: n = 27; 29,3%), subgroup C (HbA1c ≥6.5%, Glc ≥7.8 mmol/l: n = 20; 21,7%) and subgroup D (HbA1c ≥6.5% Glc<7.8 mmol/l: n = 8; 8.7%). Level of myocardium damage was assessed on the basis of concentration of myocardial necrosis enzymes: creatine kinase (CK) and creatine kinase MB fraction (CK-MB) in the 0 and 90th minute and thereafter 8, 16, 24 and 48 hours after hospital admission and also echocardiographic examination. Prognosis in long and short term observation was assessed by major adverse cardiovascular events (MACE) such as death, myocardial infarction, stroke, heart failure requiring hospitalisation and repeated revascularisation and level of glucose metabolism disturbances in intrahospital phase, 4 months and 4 years follow up observation. Results: Results in study population revealed significant change of average value of creatine kinase (p<0,001) and its MB fraction (p<0,001) during first 48 hours of hospitalisation in particular subgroups of patients. Mean values of CK and CK-MB assessed in subsequent hours of hospitalisation (1,5, 8, 16 and 48 hours) were significantly higher in subgroup B (CKp=0,034 and CK-MB p=0,01, respectively). It means that area under curve was significantly higher for subgroup B. In 4 months and 4 year follow up observation, statistically significant difference in frequency of MACE in particular subgroups of patients has been shown (p=0,016; p=0,01). Conclusions: Patients with STEMI undergoing pPCI, who were diagnosed with disturbed carbohydrate metabolism, have inferior clinical outcomes in long term follow up observation. Noticeable difference was observed particularly in subgroup B (HbA1c <6.5%, Glc ≥7.8 mmol/l).

Sign in / Sign up

Export Citation Format

Share Document