Acta otorrinolaringológica española
-
Changes in society's mentality have made health professionals get involved in legal aspects. In order to perform a correct medical proceeding, two premises must be fulfilled (Spanish Health General Law, 25th April 1986). First that it is carried out according to lex artis and second patient's consent. ⋯ This would not be necessary when there is any kind of risk for public health or when the urgency allows no delay. Likewise, the assumption of the patient being under age or not able to take any decision will also be analysed. Features to be fulfilled by informed consent models are also analysed and a prototype is proposed.
-
Acta Otorrinolaringol Esp · Aug 1999
[The nonserological diagnostic approach to infectious mononucleosis in an emergency service].
Patients with infectious mononucleosis often are seen in Emergency Services because the infection may produce tonsillitis resistant to antibiotic therapy. However, the diagnosis of choice is specific serology, which usually takes days or weeks before results become available. Detection of lymphocytosis in peripheral blood, heterophilic antibodies, and the characteristic mononuclear cells by means of specialized blood counters, together with the clinical signs, have improved the quality of diagnosis in emergency services (93% sensitivity and 97.2% specificity). We found that simple identification by optical microscopy of the lymphomonocytes typical of infectious mononucleosis in a drop of peripheral blood, together with the clinical findings, have a better diagnostic sensitivity (96. 5%) and specificity (99.1%) than any other method available in emergency services.
-
Acta Otorrinolaringol Esp · May 1999
Case Reports[Forestier's disease. Ear, nose and throat manifestations].
Forestier's disease is a skeletal pathology that sometimes affects the head and neck as a consequence of hyperostotic involvement of the cervical spine. We report the case of a 73-year-old man who had progressive difficulty in swallowing solids. Gastrointestinal endoscopy revealed a bony mass in the hypopharynx. The case is described and the disease manifestations in head and neck are discussed.
-
Anticonvulsant drugs, especially carbamazepine, are the treatment of choice for glossopharyngeal neuralgia. If no clinical response is obtained, surgical treatment, including nerve section or decompression, may be required. ⋯ Response was poor in patients who had undergone surgical nerve decompression. Gabapentin was concluded to be an effective therapeutic option for neuralgia of the IXth cranial nerve before surgery.
-
Acta Otorrinolaringol Esp · Jan 1999
Case Reports[Lingual abscess with atypical clinical presentation].
Lingual abscesses have become extremely rare since the discovery of antibiotics, with only about 200 cases reported in the last 160 years. Diagnosis on the basis of clinical symptoms alone is quite difficult. ⋯ We report a case of lingual abscess with otherwise unremarkable clinical findings that was diagnosed by CT scan. The etiology, pathophysiology, bacteriology, diagnosis, and treatment of these uncommon infections is discussed.