Kvalitet života laringektomisanih bolesnika u Srbiji

Introduction/Objective Total laryngectomy is a very mutilating operation and it leads to drastic changes in life quality. The purpose of this study was to examine factors of importance to the laryngectomized patients' quality of life and to evaluate characteristics of esophageal voice and speech. Methods The study was conducted at the Clinic of Otorhinolaryngology and Maxillofacial Surgery, at the Clinical Center of Serbia (Belgrade, Serbia), during the period between March 2012-2015. The study included 223 patients diagnosed with laryngeal cancer, who underwent total laryngectomy. The total of 168 laryngectomized patients were provided with phoniatric rehabilitation. Results The quality of life was significantly better for those laryngectomized patients who did undergo phoniatric rehabilitation. By means of intensive phoniatric rehabilitation the esophageal voice and speech was established in 86.3% of laryngectomized patients registered by objective acoustic analysis. Rehabilitated laryngectomy patients had a significantly lower presence of voice handicap sense (VHI: 19.57 ± 7.35) and expressed significantly lower symptoms of depression and anxiety (PHQ-9: 3.8 ± 4.2; GAD-7: 3.4 ± 4.2). Cronbach's alpha coefficient was above 0.7 EORTC QLQ-C30 on three levels of Likert scales: the scale of physical and emotional functioning and fatigue; as well as EORTC QLQ-H&N43 questionnaire: the symptoms of head and neck pain, speech, swallowing and eating problems and body image. Conclusion Significantly improving the quality of life of laryngectomized patients was achieved by a multidisciplinary rehabilitation. Phoniatric rehabilitation carried out in a planned and systematic way is the most efficient rehabilitation of laryngectomized patients.Uvod/Cilj Totalna laringektomija, kao veoma mutilantna operacija, dovodi do drastičnih promena u kvalitetu života. Cilj ove studije je da istraži faktore od značaja za kvalitet života laringektomisanih bolesnika i da proceni karakteristike ezofagusnog glasa i govora. Metode Istraživanje je sprovedeno u Klinici za otorinolaringologiju i maksilofacijalnu hirurgiju Kliničkog centra Srbije u Beogradu, u periodu od marta 2012. do marta 2015. godine. Ispitivanjem je bilo obuhvaćeno 223 bolesnika kojima je zbog verifikovanog karcinoma larinksa učinjena totalna laringektomija i sprovedena fonijatrijska rehabilitacija kod 168 laringektomisanih bolesnika. Rezultati Kvalitet života laringektomisanih bolesnika kod kojih je sprovedena fonijatrijska rehabilitacija je značajno bolji od onih koji nisu imali fonijatrijsku rehabilitaciju. Intenzivnom fonijatrijskom rehabilitacijom je uspostavljen ezofagusni glas i govor kod 86,3% laringektomisanih bolesnika, koji je registrovan objektivnom akustičkom analizom. Rehabilitovani laringektomisani bolesnici imaju značajno niže prisustvo hendikepa zbog glasa (VHI: 19,57 ± 7,35) i značajno niže izražene simptome depresije i anksioznosti (PHQ-9: 3,8 ± 4,2; GAD-7: 3,4 ± 4,2). Kronbahov α koeficijent je bio iznad 0,7 na tri skale upitnika EORTC QLQ-C30: fizičko funkcionisanje, emocionalno funkcionisanje i umor, kao i kod pet skala QLQ-H&N43 upitnika: bol u glavi/vratu, problemi sa gutanjem, problemi sa govorom, problemi pri jelu i slika o sebi. Zaključak Značajno poboljšanje kvaliteta života laringektomisanih bolesnika postiže se multidisciplinarnom rehabilitacijom. Fonijatrijska rehabilitacija, koja se sprovodi planski i sistematično, predstavlja najekonomičniji način rehabilitacije laringektomisanih bolesnika

Klinoskop: Zeitschrift der Klinikum Chemnitz gGmbH

Das Klinoskop ist die Firmenzeitschrift des Klinikums Chemnitz für Mitarbeiter, Patienten, Angehörige und für unsere Partner. Es erscheint in vier bis fünf Ausgaben pro Jahr in einem Umfang von 40 bis 92 Seiten im Vollfarbdruck.Unsere Firmenzeitschrift wurde seit 2006 von einer qualitativen Mitarbeiterinformation kontinuierlich zu einem relevanten Informationsmedium für unsere Partner wie niedergelassene Ärzte weiterentwickelt. Parallel soll das Klinoskop eine Publikation sein, mit der Patienten und Angehörige einen informativen Zugang zu Ihrem Klinkum Chemnitz erhalten. Damit möchten wir auch unseren Anspruch einer offenen Kommunikation unterlegen.The Klinoskop is the corporate magazine of the Klinikum Chemnitz for our staff, patients and their family members as well as for our cooperating partners. It is published in full colour, with four or five issues per year, and each issue contains between 40 and 92 pages. Since 2006, our corporate magazine has been continuously refined from a high-quality publication for our staff to the relevant information medium for our partners, in particular physicians in private practice. At the same time, the Klinoskop is intended to be a publication that provides patients and their relatives with more detailed information about their Hospital in Chemnitz. This also helps us to emphasize our intentions of fostering open communication

Klinoskop: Zeitschrift der Klinikum Chemnitz gGmbH

Das Klinoskop ist die Firmenzeitschrift des Klinikums Chemnitz für Mitarbeiter, Patienten, Angehörige und für unsere Partner. Es erscheint in vier bis fünf Ausgaben pro Jahr in einem Umfang von 40 bis 92 Seiten im Vollfarbdruck.Unsere Firmenzeitschrift wurde seit 2006 von einer qualitativen Mitarbeiterinformation kontinuierlich zu einem relevanten Informationsmedium für unsere Partner wie niedergelassene Ärzte weiterentwickelt. Parallel soll das Klinoskop eine Publikation sein, mit der Patienten und Angehörige einen informativen Zugang zu Ihrem Klinkum Chemnitz erhalten. Damit möchten wir auch unseren Anspruch einer offenen Kommunikation unterlegen.The Klinoskop is the corporate magazine of the Klinikum Chemnitz for our staff, patients and their family members as well as for our cooperating partners. It is published in full colour, with four or five issues per year, and each issue contains between 40 and 92 pages. Since 2006, our corporate magazine has been continuously refined from a high-quality publication for our staff to the relevant information medium for our partners, in particular physicians in private practice. At the same time, the Klinoskop is intended to be a publication that provides patients and their relatives with more detailed information about their Hospital in Chemnitz. This also helps us to emphasize our intentions of fostering open communication

gender and quality of life in laryngectomized patients

Background: the aim of this study was to investigate possible correlations between the perception of postoperative quality of life and gender. Methods: the questionnaires “the Brief illness Perception Questionnaire” (B-iPQ) and “Voice handicap index” (Vhi) were administered to 94 patients divided into two groups according to gender group a: 73 men, group B: 21 women. RESULTS: The results showed that gender should be considered a factor influencing perceived quality of life in laryngectomized patients. Specifically, women showed greater concern towards the disease, its evolution, and the consequences on their lives, compared to men. CONCLUSIONS: the care of the laryngectomized woman should consider the impact that loss of voice has on the perception of her femininity, and the physical, functional, and above all emotional issues that such surgeries may lead to for women

Hydrograph separation using isotopic, chemical and hydrological approaches (Strengbach catchment, France)

The streamflow components were determined in a small catchment located in Eastern France for a 40 mm rain event using isotopic and chemical tracing with particular focus on the spatial and temporal variations of catchment sources. Precipitation, soil solution, springwater and streamwaters were sampled and analysed for stable water isotopes (18O and 2H), major chemical parameters (SO4, NO3, Cl2, Na1, K1, Ca21, Mg21, NH4, H1, H4SiO4, alkalinity and conductivity), dissolved organic carbon (DOC) and trace elements (Al, Rb, Sr, Ba, Pb and U). 18O, Si, DOC, Ba and U were finally selected to assess the different contributing sources using mass balance equations and end-member mixing diagrams. Isotopic hydrograph separation shows that the pre-event water only contributes to 2% at the beginning of the stormflow to 13% at the main peak flow. DOC associated to Si and U to Ba allow to identify the different contributing areas (upper layers of the saturated areas, deep layers of the hillslope and rainwater). The streamflow (70%) originates from the deep layers of the hillslope, the remaining being supplied by the small saturated areas. The combination of chemical (both trace and major elements) and isotopic tracers allows to identify the origin of water pathways. During the first stage of the storm event, a significant part of the runoff (30±39%) comes from the small extended saturated areas located down part of the basin (overland runoff then groundwater ridging). During the second stage, the contribution of waters from the deep layers of the hillslope in the upper subcatchment becomes more significant. The final state is characterised by a balanced contribution between aquifers located in moraine and downslopes. Indeed, this study demonstrates the interest of combining a variety of hydrometric data, geochemical and isotopic tracers to identify the components of the streamwater in such conditions

Calidad de vida de los pacientes tras una laringectomía total

Trabajo fin de grado en EnfermeríaIntroducción: El cáncer de laringe es el más común dentro de los carcinomas de cabeza y cuello. La laringe interviene en la función respiratoria, fonatoria y deglutoria. Cualquier alteración que afecte a esta estructura y sobre todo su extirpación completa como ocurre en la laringectomía total tendrá gran afectación en la calidad de vida de estos pacientes. Objetivo: revisar la literatura sobre la afectación de la calidad de vida de los pacientes tras una laringectomía total; así como el papel enfermero en la continuidad de cuidados. Método: se realiza una revisión narrativa mediante la búsqueda en las bases de datos: Pubmed, Cuiden, Cinahl, Scielo, Cochrane, Lilacs y el buscador especializado Google Scholar. Resultados: se seleccionaron 28 artículos agrupados en tres categorías de análisis, abordando el impacto físico y psicosocial, vivencias y perspectivas de la situación de enfermedad y papel enfermero en la continuidad de cuidados. Conclusiones: la presente revisión bibliográfica muestra el gran impacto que sufren estos pacientes tras una laringectomía total, debido principalmente a la pérdida de la función fonatoria junto con otras alteraciones que quedan en segundo plano. La enfermería está presente en el postoperatorio más inmediato, pero no tanto en la continuidad de cuidados enfermeros tras el alta hospitalaria, para así garantizar un seguimiento íntegro e individualizado del mismo.Background: The cancer of larynx is the most common inside the carcinomas of head and neck. The larynx intervenes in the respiratory function, phonation function and swallow. Any alteration that concerns this structure and especially the complete extirpation of the larynx, will have great affectation in the quality of life of these patients. Objective: To review the literature about the affectation of quality of life of patients after a total laryngectomy; as well as the nurse role in the continuity of taken care. Methods: Narrative review by means of the bibliographic search in databases: Pubmed, Cuiden, Cinahl, Scielo, Cochrane, Lilacs and the specialized seeker Google Scholar. Results: There were selected 28 articles grouped in three categories of analysis, approaching the physical and psychosocial impact, experiences and perspectives of the situation of disease and nurse role in the continuity of taken care. Conclusion: The present bibliographical review shows the great impact that these patients suffer after a total laryngectomy, fundamentally due to the loss of phonatory function together with other alterations that stay secondly. Nurses are presents in the immediate postoperatory, but not so much in the continuity of taken care after hospital discharge, in order to assure a complete and individualized follow-up of the same

Otolaryngologic manifestations of klippel-feil syndrome in children

IMPORTANCE: Children with Klippel-Feil syndrome (KFS), characterized principally by abnormal fusion of 2 or more cervical vertebrae, may have many additional congenital anomalies. The overall prevalence of otolaryngologic manifestations among patients with KFS has not been previously characterized. OBJECTIVE: To define the otolaryngologic diagnoses made and procedures performed in95 patients with KFS, which, to our knowledge, is the largest series of this challenging patient population published to date. DESIGN, SETTING, AND PARTICIPANTS: For this retrospective review, all patients with KFS who underwent otolaryngology consultation at our institution over a 26-year period (January 1989 to December 2015) were included. Patients were identified using International Classification of Diseases, Ninth Revision (ICD-9) codes and were confirmed through individual medical record review. Relevant otolaryngologic diagnoses and procedures were extracted using ICD-9 and Current Procedural Terminology codes, respectively. Selected demographics included age, sex, number of clinic visits, and number of procedures. MAINOUTCOMES ANDMEASURES: The primary outcomes were the otolaryngologic diagnoses and procedures associated with the KFS patient population; the secondary outcome was Cormack-Lehane classification documented during airway procedures. RESULTS: Overall, 95 patients with KFS were included in this study (55 males [58%] and 40 females [42%]); mean (range) age at time of presentation to the otorhinolaryngology clinic was 5.8 (birth-23.0) years. Each patient with KFS averaged 8 visits to the otorhinolaryngology office and 5 otolaryngologic diagnoses. The most common diagnosis was conductive hearing loss (n = 49 [52%]), followed by sensorineural hearing loss (n = 38 [40%]), and dysphagia (n = 37 [39%]). Sixty-two (65%) patients underwent otolaryngologic procedures, with 44 (46%) undergoing multiple procedures. The most common procedure was tympanostomy tube placement (n = 36 [38%]), followed by office flexible endoscopy (n = 23 [24%]). Twelve of the20 patients who underwent direct laryngoscopy had documented Cormack-Lehane classification; 5 of 12 patients (42%) had a compromised view (grade 2, 3, or 4) of the larynx. Three patients required tracheotomies at this institution for airway stabilization purposes; each had severe upper airway obstruction leading to respiratory failure. CONCLUSIONS AND RELEVANCE: Patients with KFS require consultation for a variety of otolaryngologic conditions. Among these, hearing loss is the most common, but airway issues related to cervical spine fusion are the most challenging. Formulating an appropriate care plan in advance is paramount, even for routine otolaryngology procedures