Orbital complications of acute rhinosinusitis

Introduction. Rhinosinusitis is the infection and inflammation of at least one of the 4 paranasal sinuses (frontal, maxillary, ethmoid and sphenoid). Their correct diagnosis is generally determined by examining the patient clinically and by rhinosinusal endoscopic examination. There are also cases that show complications or continued evolution despite the correct treatment, and then we will use some imaging investigations to find out more about affection(radiography of anterior sinuses of the face, sinus computerized tomography, sinus magnetic resonance imaging). In particular, acute rhinosinusitis should be carefully managed to avoid complications such as the local ones: orbital cellulitis, orbital abscess, osteomyelitis, cavernous sinus thrombosis; and intracranial complications: meningitis, epidural abscess, subdural abscess, cerebral abscess.Materials and methods. There will be presented all orbital complications according to the cases treated in the ENT Clinic of the Coltea Clinical Hospital.Conclusions. Diagnosis of rhinosinusitis is largely clinical and endoscopic.When complications of the condition arise, these should be investigated imagistically to determine their exact extent and to institute the correct treatment as soon as possible. The complications of rhinosinusitis are medical and surgical life-threatening emergencies, which is why in order to diagnose and correct and quickly institute therapy requires a multidisciplinary approach

Pharynx Reconstruction and Quality of Life

Patients who are diagnosed with squamous cell carcinoma of the pharynx have a first delayed presentation, with advanced stages of the disease. Therefore, they frequently require a multimodal approach—by surgery, radio, and chemotherapy. Due to anatomic spatial limits and particularities, therapy can imply large organ resection with difficulties in reconstruction. Nowadays, there is a paradigm shift in the management of this pathology, with significant first referral to oncology departments and initiation as the first line of treatment of radio/radio-chemotherapy. As a consequence, salvage surgery may be mandatory in some selected cases. The proposed chapter will address the oncological particularities of the pharynx, with a focus on the oro- and hypopharynx, ways of reconstruction after oncological ablative surgery of these segments, and impact on quality of life (QoL) index. Speech, respiratory, and deglutition rehabilitation of these patients is essential and will be a distinct topic. This paper will have the structure of a literature review with clinical examples of reconstruction from ENT and Head and Neck Surgery Department of Coltea Clinical Hospital, Bucharest. Reconstruction methods used in our clinic are regional flaps and biocompatible prostheses in advanced stages. QoL index in our clinic is assessed with questionnaires developed by the European Organization for Research and Treatment of Cancer – EORTC QLQ C30

Improving the Implementation of Clinical Decision Support Systems

Abstract — Clinical decision support (CDS) systems promise to improve the quality of clinical care by helping physicians to make better, more informed decisions efficiently. However, the design and testing of CDS systems for practical medical use is cumbersome. It has been recognized that this may easily lead to a problematic mismatch between the developers’ idea of the system and requirements from clinical practice. In this paper, we will present an approach to reduce the complexity of constructing a CDS system. The approach is based on an ontological annotation of data resources, which improves standardization and the semantic processing of data. This, in turn, allows to use data mining tools to automatically create hypotheses for CDS models, which reduces the manual workload in the creation of a new model. The approach is implemented in the context of EU research project p-medicine. A proof of concept implementation on data from an existing Leukemia study is presented. I

Isotopic labeling of recombinant proteins expressed in the protozoan host Leishmania tarentolae

Abstract Isotope labeling of recombinant proteins is a prerequisite for application of nuclear magnetic resonance spectroscopy (NMR) for the characterization of the three-dimensional structures and dynamics of proteins. Overexpression of isotopically labeled proteins in bacterial or yeast host organisms has several drawbacks. In this work, we tested whether the recently described eukaryotic protein expression system based on the protozoa Leishmania tarentolae could be used for production of amino acid speciWc 15 N-labeled recombinant proteins. Using synthetic growth medium we were able to express in L. tarentolae and purify to homogeneity (15)N-valine labeled Enchanced Green Fluorescent Protein (EGFP) with the Wnal yield of 5.7 mg/liter of suspension culture. NMR study of isolated EGFP illustrated the success of the labeling procedure allowing identiWcation of all 18 valine residues of the protein in the HSQC spectrum. Our results demonstrate the suitability of the L. tarentolae expression system for production of isotopically labeled proteins. © 2006 Elsevier Inc. All rights reserved. Keywords: 15 N-labeling; Recombinant protein; Eukaryotic expression system Nuclear magnetic resonance spectroscopy (NMR) 1 is one of two existing methods that allow determination of protein structure at atomic resolution. A majority of NMR techniques in biology require isotopic labeling ( 2 H, 13 C, and/or 15 N) of recombinant proteins. Currently, most isotopically labeled recombinant proteins are expressed heterologously in Escherichia coli. Despite its obvious advantages such as rapid growth, developed methods of protein expression and cheapness of cultivation E. coli has a range of shortcomings that limits its utility in protein studies. The most prominent problem relates to ineYciency of E. coli to assist folding of eukaryotic polypeptides producing only ca. 15% of eukaryotic proteins in their active form We recently described a new protein expression system based on the non-pathogenic trypanosomatid Leishmani

The Impact of Laryngeal pathology on sleep disorders patients

Sleep disorders are a common disorder the most frequent being obstructive sleep apnea characterized by repetitive episodes of upper airway collapse and respiratory pause. It is associated with a significant cardiovascular morbidity and mortality and severely alters the quality of life .In many cases it can remain undiagnosed because of its symptoms that can be underestimated by both the patient and the doctor. Tobacco, alcohol abuse and obesity are amongst the most common risk factors but the most important ones are related to different anatomical structures that can stop the airflow.Treating this disorder sometime requires multilevel surgery depending on the structures involved the most common of them being palatal, oropharyngeal and tongue base. The development and increased usage of sleep endoscopy has somewhat changed the treatment options due to the fact that laryngeal collapse is almost always seen only on sleep endoscopy. The role of laryngeal pathology has to be taken into account especially in cases where CPAP and surgery have failed