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Sulcus vocalis is an epithelial invagination along the free edge of the membranous vocal fold. It interferes with the glottic closure and vibration pattern. Sulcus vocalis provokes voice fatigue, hoarseness and breathiness, and it usually appears in association with hyperkinetic phonatory pattern. Hyperkinesis develops secondarily, due to the compensatory effort to overcome the deficiency in glottic closure. The treatment of sulcus vocalis is very difficult. Phonosurgery is used, and is followed by postoperative voice therapy. ⋯ The surgical procedure which is safe and accepted by the majority of surgeons has not yet been at our disposal. The treatment of sulcus vocalis should start with voice therapy, which lasts as long as the patient shows a progress. Only then the surgical procedure can be discussed. We obtained the best results with the combination of excision and voice therapy. However, the surgeon and the patient must be aware that the treatment is demanding and long-lasting.
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The benefit of adjuvant therapy in colorectal cancer (CRC) has been provided in clinical studies that have demonstrated reduction of up to 30% in a 5-year overall mortality in patients (pts.) with TNM stage III (Dukes' stage C) carcinoma. Patients with metastatic CRC are usually in a relatively good condition despite their advanced disease. Therefore, some clinicians wished to withheld the toxicity of chemotherapy until the disease became symptomatic. ⋯ We have treated and followed-up these stable disease patients as patients without clinical benefit. We have no answer if they could reach better time to progression and/or survival if they had been treated for more than 4 courses. Careful studies in the evaluation of the quality of life in connection with treatment effects for all stable disease subpopulations of patients are warranted. (ABSTRACT TRUNCATED)
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Lumbar spinal stenosis (LSS) may be defined as any type of the narrowing of the spinal nerve root canal (the lateral recess), intervertebral foramina, or its combination. It may be local, segmental or generalized; it can be caused by bone or soft tissue, and the narrowing can involve the bony canal or the dural sac or both. The normal sagital diameter of the lumbar canal is 15 to 25 mm and measurements below this are regarded as suggestively abnormal; a diameter less than 12 mm confirms the presence of stenosis. On the other hand, the lateral recess height less than 3 mm is suggestive, and less than 2 mm is a diagnostic sign of stenosis. There are two large groups of LSS: congenital-developmental stenosis and acquired stenosis with many subgroups (Scheme 1). The number of surgical operations due to LSS is increased during the ensuing years especially in elderly persons. This is why we would like to emphasize the important role of this phenomenon as there are only a few published papers in domestic literature. ⋯ A certain number of patients had congenital-developmental stenosis with thickening of the laminae and development of short, squat pedicles with a decreased anterior-posterior diameter of the spinal canal. There are numerous variations of this pattern which remain asymptomatic until later developmental changes precipitate the typical radiculopathy and cauda equina changes in LSS. (ABSTRACT TRUNCATED)
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In adults and in children urinary system infections are mostly caused by gram-negative and rarely by gram-positive bacteria. Of gram-negative bacteria the most frequent cause of infections are Escherichia coli, Klebsiella species, Proteus mirabilis, Pseudomonas aeruginosa, Acinetobacter, Serratia etc., and of gram-positive bacteria Enterococcus, Staphylococcus, Streptococcus agalactiae. In rare cases the cause of infection may also be Pneumococcus and Haemophilus influenzae.
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It is well known and described in literature that cardiac symptoms such as dyspnoea, palpitations and sometimes stenocardiac pain may develop in the course of anaemia. The incidence of electrocardiographic abnormalities varies significantly in different studies ranging from 10-80%. The study is aimed to determine the incidence of certain electrocardiographic changes in anaemic and non anaemic patients (control group) before and after the stress test. PATIENTS AND METHODS OF EXAMINATION: A total of 60 patients divided in two groups were studied. Group 1 included 30 patients with anaemia, free of cardiorespiratory diseases and normal x ray findings. Control group comprised 30 healthy individuals with normal x ray findings and normal ECG findings at rest, free of anaemia and iron deficiency. The average haemoglobin value in the studied and control group was 85.6 g/L and 127 g/L, respectively. The subjects underwent submaximal ergometric test. The following electrocardiographic parameters were monitored: P wave, PR interval, R amplitude, R difference, ST segment depression, T wave, QT interval and QTc interval. ⋯ Based on the results of the study it may be concluded that the prevalence of ECG abnormalities in patients with anaemia was 63%. As for the individual ECG changes the prevalence of ST segment depression was 33%, T wave inversion 10%, prolonged QT interval 27%, increased R difference 30%. The incidence of ECG abnormalities (ST segment depression and T wave inversion) was markedly higher after the stress test. The recorded electrocardiographic changes may result not only from heart diseases but also from anaemia as a sign of myocardial ischaemia.