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

Comparative study on the insurance market between AIG Life products and ASIROM Vienna Insurance Group

An increasingly confirmed theory in recent decades claims that a product is purchased for what it represents for the customer, and not for what it is itself (subjective utility theory), the product is purchased for the service they provide, for the safety, for the comfort, for fashion, for what it gives to its user. Life insurance is a way of financial protection, safeguard and preserve the family property. It is part of a family financial plan, along with other real estate investments, shares, bank deposits, insurance is a guarantee fund related to the availability of needed cash in case of unexpected situations, without being affected the other saving forms, usually with pre-established terms.market, insurance market, customer, financial plan, investment

National budget – an ethical dilemma of financial crisis

Expectations related to the draft budget and action plan of the government are high, but the possibilities are limited, fiscal policy needs time to regain credibility after two years of drift. Although the economic crisis knocking on the door Romanian government has a few available means to stop it. Regarding the quality of the budget, this is far from what might be called a model of good practice.budget, ethical dilemmas, crisis, financial crisis, deficit, saving

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

Intraoperative transfusion practices in Europe

BACKGROUND: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. METHODS: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. RESULTS: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl(-1) and increased to 9.8 (1.8) g dl(-1) after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). CONCLUSION: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl(-1)), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold. CLINICAL TRIAL REGISTRATION: NCT 01604083

Intraoperative transfusion practices in Europe

© 2016 The Author. Published by Oxford University Press on behalf of the British Journal of Anaesthesia.Background: Transfusion of allogeneic blood influences outcome after surgery. Despite widespread availability of transfusion guidelines, transfusion practices might vary among physicians, departments, hospitals and countries. Our aim was to determine the amount of packed red blood cells (pRBC) and blood products transfused intraoperatively, and to describe factors determining transfusion throughout Europe. Methods: We did a prospective observational cohort study enrolling 5803 patients in 126 European centres that received at least one pRBC unit intraoperatively, during a continuous three month period in 2013. Results: The overall intraoperative transfusion rate was 1.8%; 59% of transfusions were at least partially initiated as a result of a physiological transfusion trigger- mostly because of hypotension (55.4%) and/or tachycardia (30.7%). Haemoglobin (Hb)- based transfusion trigger alone initiated only 8.5% of transfusions. The Hb concentration [mean (sd)] just before transfusion was 8.1 (1.7) g dl-1 and increased to 9.8 (1.8) g dl-1 after transfusion. The mean number of intraoperatively transfused pRBC units was 2.5 (2.7) units (median 2). Conclusions: Although European Society of Anaesthesiology transfusion guidelines are moderately implemented in Europe with respect to Hb threshold for transfusion (7-9 g dl-1), there is still an urgent need for further educational efforts that focus on the number of pRBC units to be transfused at this threshold