La prevalencia de infección por virus del papiloma humano en pacientes con diagnóstico de carcinoma espinocelular de cavidad oral, orofaringe y laringe.

Antecedentes: El carcinoma de cabeza y cuello comprende un grupo de neoplasias que comparten un origen anatómico similar. La mayoría se originan de la mucosa del tracto Aero digestivo y más del 90% corresponden al carcinoma espinocelular, En los últimos 15 años se observó un incremento en la incidencia de carcinoma espinocelular inducido por el VPH en jóvenes, principalmente los serotipos 16 y 18 los cuales son los más estudiados en cáncer de cavidad oral y orofaringe, y los serotipos 6 y 11 en cáncer de laringe. Existen reportes en la literatura sobre el VPH como principal causa de carcinoma espinocelular principalmente de orofaringe. Objetivo: Determinar la prevalencia de infección por virus del papiloma humano (VPH) de alto riesgo en pacientes con diagnóstico de carcinoma espinocelular de cavidad oral, orofaringe y laringe. Material y métodos: Estudio observacional, transversal, descriptivo, no ciego. Se determinó la prevalencia de infección por virus del papiloma humano por medio de la extracción de ADN de tejido tumoral en pacientes con carcinoma espinocelular de cavidad oral, orofaringe y laringe. Se realizó tipificación de serotipos de alto riesgo. Resultados: Se aisló VPH en dos pacientes lo cual representó una prevalencia global del 4% en nuestra población y del 10% para los tumores de laringe. Conclusiones: Existe una baja prevalencia de carcinoma espinocelular de cabeza y cuello asociado a infección por VPH en nuestra población. Estudios prospectivos en población más joven con cáncer de cabeza y cuello podrían aportar mayor información sobre la influencia del VPH en dicha patología

Quiste dermoide en el piso de la boca: comunicación de un caso

Los quistes dermoides son lesiones benignas que aparecen en la línea media del piso de la boca. Se originan por el atrapamiento del epitelio germinal durante el cierre de los arcos branquiales. Constituyen 23% de los quistes dermoides de la cabeza y el cuello. Son lesiones de crecimiento lento, no dolorosas y se manifestan a cualquier edad, principalmente entre los 15 y 35 años. Desde el punto de vista histopatológico, están constituidos por una cubierta epitelial, contienen elementos de origen ectodérmico y mesodérmico (piel y anexos). El tratamiento consiste en resección quirúrgica. Se comunica el caso de un paciente de 51 años de edad con quiste dermoide en el piso de la boca, intervenido quirúrgicamento con abordaje intraoral. Abstract: Dermoid cysts are benign lesions present in the midline of the floor of the mouth cause by germinal epithelium entrapment during branchial arcs closing development. They compose 23% of the dermoid cysts of head and neck. These lesions, which develop slowly and are painless, occur in young adults between 15 to 35 years old, but they can be present at any age,. Common histological findings are mesoderm and ectoderm tissue (skin and annex). Surgical resection is the treatment. A 51-year-old male with a dermoid cyst on the floor of the mouth surgically treated by a trans-oral approach is presented

Laryngeal amyloidosis: An uncommon cause of dysphonia

Introduction: Amyloidosis is used to describe a range of disorders deined by extracellular deposition of abnormal protein ibrils. The larynx is the most common site of localized amyloidosis in the head and neck region and constitutes less than 1% of benign laryngeal lesions. Hoarseness is the most common symptom. Objective: Prospective clinical evaluation of patients with localized laryngeal amyloidosis. Clinical cases: Presented are 4 cases of patients with localized laryngeal amyloidosis who were treated at the Otolaryngology and Head and Neck Surgery Department at the “Dr. José Eleuterio González” University Hospital in Monterrey, Mexico. Three patients underwent phonomicrosurgery by direct microlaryngoscopy with the removal of the amyloid implantation using a cold knife excision with great results. In each patient the major site of involvement was the supraglottis with a small focus on the false vocal cord. A medical work-up, including a complete blood count (CBC), a basic metabolic panel, urinalysis, liver function test, chest X-ray and physical examination were performed to rule out the presence of systemic disease; no amyloidosis or signs of systemic disease were found. Congo red staining conirms the diagnosis of amyloidosis in all surgical specimens. Conclusions: In laryngeal amyloidosis, the treatment should be directed toward the improvement of the voice and the maintenance of the airway

Olfactory dysfunction in young smokers J.

To establish the prevalence of olfactory dysfunction in smoking and non-smoking students of our Faculty who attend the Department of Otolaryngology (ENT) of our Hospital. Materials and method: Students (smokers and non-smokers) that do and do not suffer from olfactory dysfunction. We applied a questionnaire and a pocket smell test for screening all of the students. Results: We evaluated 207 students, between 18 and 30 years old; 50.7% (n=105) were women and 49.3% (n=102) were men. The smokers among them smoked up to 6 packs per year. One hundred twenty three students were non-smokers and 84 students were smokers. Of the 84 students who were smokers, 67 (79.7%) answered the Pocket Smell Test correctly (3/3) and 17 (20.2%) students had one or more errors. We had 123 non-smoker students and 103 (83.7%) students answered the Pocket Smell Test correctly and 20 (16.2%) answered with one or more errors. The prevalence of olfactory dysfunction in young smokers with a 95% conidence interval would be 32.8%. Conclusions: This study informed us about olfactory dysfunctions in our student population and their smoking habits. We corroborate that the Pocket Smell Test is reliable with the questionnaire; nevertheless it is a screening test. We have a population of young people who smoke one cigarette per day and who didn’t have a signiicant alteration in their ability of smell at the time of the study. This is consistent with medical literature. More studies should be conducted in order to expand this information

Evolution over Time of Ventilatory Management and Outcome of Patients with Neurologic Disease∗

OBJECTIVES: To describe the changes in ventilator management over time in patients with neurologic disease at ICU admission and to estimate factors associated with 28-day hospital mortality. DESIGN: Secondary analysis of three prospective, observational, multicenter studies. SETTING: Cohort studies conducted in 2004, 2010, and 2016. PATIENTS: Adult patients who received mechanical ventilation for more than 12 hours. INTERVENTIONS: None. MEASUREMENTS AND MAIN RESULTS: Among the 20,929 patients enrolled, we included 4,152 (20%) mechanically ventilated patients due to different neurologic diseases. Hemorrhagic stroke and brain trauma were the most common pathologies associated with the need for mechanical ventilation. Although volume-cycled ventilation remained the preferred ventilation mode, there was a significant (p < 0.001) increment in the use of pressure support ventilation. The proportion of patients receiving a protective lung ventilation strategy was increased over time: 47% in 2004, 63% in 2010, and 65% in 2016 (p < 0.001), as well as the duration of protective ventilation strategies: 406 days per 1,000 mechanical ventilation days in 2004, 523 days per 1,000 mechanical ventilation days in 2010, and 585 days per 1,000 mechanical ventilation days in 2016 (p < 0.001). There were no differences in the length of stay in the ICU, mortality in the ICU, and mortality in hospital from 2004 to 2016. Independent risk factors for 28-day mortality were age greater than 75 years, Simplified Acute Physiology Score II greater than 50, the occurrence of organ dysfunction within first 48 hours after brain injury, and specific neurologic diseases such as hemorrhagic stroke, ischemic stroke, and brain trauma. CONCLUSIONS: More lung-protective ventilatory strategies have been implemented over years in neurologic patients with no effect on pulmonary complications or on survival. We found several prognostic factors on mortality such as advanced age, the severity of the disease, organ dysfunctions, and the etiology of neurologic disease