The Advocate - June 8, 1961

Original title (1951-1987)--The Advocate: official publication of the Archdiocese of Newark (N.J.)

Adherence to continuous positive airway pressure therapy in obstructive sleep apnea syndrome: effect of visual education

WOS: 000311301700037PubMed ID: 22167633Continuous positive airway pressure (CPAP) therapy is the most effective treatment in obstructive sleep apnea syndrome (OSAS) although it is known that adherence to therapy is limited. The aims of this study were to evaluate the effect of visual education on CPAP adherence and to identify the factors affecting adherence. Out of 133 consecutive newly diagnosed moderate-to-severe OSAS patients, 66 were informed about OSAS and CPAP therapy and received visual education by videotape (video group), whereas only information was given to 67 of them (control group). The patients were followed up in the 1st, 3rd, and 6th months. After 6-month follow-up, adherence rate to CPAP therapy was 71.2% in the video group and 56.7% in the control group (p = 0.08). OSAS symptoms, such as witnessed apnea, morning headache, night sweating, dry mouth, and Epworth sleepiness score (ESS), were ameliorated more significantly in the video group (p < 0.05). In order to assess predictors of adherence, 85 patients using CPAP effectively were compared to 48 nonadherent patients; significant improvement in OSAS symptoms and ESS was observed in the adherent patients (p < 0.05). ESS was negatively correlated with the duration of CPAP use (r = -0.524, p < 0.0001). Adverse effects such as mask intolerance, choking, noise, and nasal congestion were related to poorer adherence (p < 0.01). It is shown that adherence rate to CPAP therapy might be improved by visual education although the difference was not significant. Besides, patients with better adherence to CPAP treatment report the greatest improvement in OSAS symptoms and daytime sleepiness, and adverse effects are significantly related to poorer adherence

Delayed Phase Nasal Metastasis of Renal Cell Carcinoma as a Rare Epistaxis Cause

WOS: 000376563400039Malign tumors of sinonasal area composes % 1 of malignant tumors in adults and % 3 of head and neck malignities. Metastasis to this area is rare but malignities that metastatic to head and neck and below down clavicula, renal cell carcinoma (RCC) is the third after lung and breast cancer. As the most frequent malignancy of kidney, RCC is generally seen in male over 40 year old and forms % 3 of malign tumors in adults and in RCC cases % 8 of disease arises by the metastasis to head and neck which is accepted as a bad prognostic factor. In this case report, a 81 year old male patient is presented with literature datas who is underwent nephrectomy 8 years ago for RCC and referred with recurrent epistaxis and delayed phase nasal RCC metastasis

Assessing the rhinoplasty outcome: inter-rater variability of aesthetic perception in the light of objective facial analysis

WOS: 000364507300016PubMed ID: 25563240The aim of this study was to assess the success of rhinoplasty by evaluating the inter-rater variability in the light of primary indication as functional or cosmetic. Subjective aesthetic perception was compared with objective facial analysis. 45 rhinoplasty patients were included in the study. 25 had cosmetic plus functional reasons with septal deviation (group 1) and 20 had pure cosmetic reasons without septal deviation (group 2). Preoperatively and 6 months postoperatively, four individuals (patient, surgeon, 2 independent surgeons) rated the aesthetic appearance of the nose with visual analogue scale. Facial photogrammetric analysis was applied. The patient's aesthetic perception score was significantly correlated with the two independent surgeons (p < 0.05) whereas not with the primary surgeons. Regarding the objective parameters, patient's aesthetic perception was significantly correlated with the dorsal alignment in both groups (p < 0.05). General satisfaction score was significantly correlated with the nasal breathing as well as with the aesthetic perception scores in both groups. This correlation was higher for aesthetic perception in group 1 and nasal breathing in group 2. Inter-rater variability of outcome perception was higher in cosmetic patients. Nasal dorsal alignment was the only objective parameter which was correlated with the patient's perception. Patient's perception of outcome has better represented the objective photogrammetric analysis rather than the primary surgeons. An interesting finding was the more significant correlation of general satisfaction with aesthetic perception in the functional group whereas nasal breathing in the cosmetic group

Gastroesophageal reflux with children requiring adenotonsillectomy

BACKGROUND: Our aim is to determine the incidence of reflux in children older than 3 years requiring adenotonsillectomy and relationship between GER and diagnostic tests. METHODS: Forty-four patients, who were listed for adenoidectomy/tonsillectomy at Pediatric Ear Nose Throat department due to severe hypertrophy, were evaluated for accompanying GER (Group 1). GER was diagnosed as having at least one positive GER test result (including esophagitis or pH monitoring). Twenty children without reflux symptoms were used as healthy control group (Group 2) and LPR was held. RESULTS: Reflux was detected in 32 children requiring adenotonsillectomy (72.7%). LPR score was negative in all patients in Group 2. There was no correlation between pH monitoring and histopathological evaluation of esophagus. There was a correlation between the LPR score and histological esophagitis in the proximal esophagus. CONCLUSIONS: GER was high in patients with adenotonsillary hypertrophy. LPR score and the history of patients are as effective as invasive techniques like pH monitorization and endoscopy in determining GER disease

Reconstruction of Orbital Walls with Bone Cement in a Maxillectomy Patient

WOS: 000373224500009PubMed ID: 29392004Orbital wall defects occur because of trauma and secondary to oncologic surgery. Reconstruction of orbital bones is of most importance to ensure normal eye functions and cosmesis. Acrylic resin materials can be used instead of a bone in orbital wall defects that are secondary to the resection of tumors invading the orbita. Polymethyl methacrylate is one of the acrylic resin materials. In this study, the orbital wall reconstruction technique with bone cement after maxillectomy and results are reported