Influence of proton pump inhibitor therapy on occurrence of voice prosthesis complications.

Purpose: It has been shown that the reflux of the gastric content to the proximal oesophagus influences incidence of voice prosthesis (VP) complications in laryngectomized patients. We conducted prospective randomised study to investigate the relationship between pepsin concentration in saliva and occurrence of VP complications before and after 3 months of proton pump inhibitor (PPI) therapy.

Methods: 60 laryngectomized patients with VP and 30 controls were included in the study.

Obstructive sleep apnoea as a late complication after tracheostomy.

Background: Obstructive sleep apnoea occurs consequent to partial or complete upper airway obstruction, caused mostly by the collapse of upper airway musculature. Drug-induced sleep endoscopy represents the 'gold standard' in identifying the obstruction site, from the palatal level to laryngeal entry. Breathing impairment in sleep caused by the collapse of cervical trachea after previous tracheostomy has not yet been described in the literature.

Tongue metastasis as an initial presentation of renal cell carcinoma.

Aim Distal metastases to oral cavity are very rare. Adenocarcinoma, renal cell carcinoma (RCC) and squamous cell carcinoma are the most common metastatic tumours. The aim of this study was to assess the diagnostic relevance of metastatic renal cell carcinoma on tongue manifestations in large patient series.

Acoustic Reflex and House-Brackmann Rating Scale as Prognostic Indicators of Peripheral Facial Palsy in Neuroborreliosis.

Lyme borreliosis is a vector-borne infectious disease characterized by three disease stages. In the areas endemic for borreliosis, every acute facial palsy indicates serologic testing and implies specific approach to the disease. Th e aim of the study was to identify and confirm the value of acoustic refl ex and House-Brackman (HB) grading scale as prognostic indicators of facial palsy in neuroborreliosis.

Expression of polysialic acid in primary laryngeal squamous cell carcinoma.

Aims: Expression of polySia is associated with metastatic dissemination and progression of various malignant diseases. In particular, it may contribute to tumorigenesis by a negative modulatory effect on cellular signaling cascades responsible for cellular migration, differentiation and proliferation. In this study, we investigated the expression of polySia in primary metastatic and non-metastatic laryngeal squamous cell carcinoma (LSCC) tumor tissues and its potential impact on the LSCC progression.

Small nonfunctional parathyroid cysts: single institution experience.

Parathyroid cysts (PCs) account for less than 1% of all parathyroid lesions and are most commonly located along thyroid lobes, rarely at ectopic sites. PCs are important because they can pose a differential diagnostic challenge against other cystic formations of the neck. PCs can be functional (elevated serum parathyroid hormone level) and nonfunctional.

[[GUIDELINES FOR THE PREVENTION, MONITORING AND THERAPY OF CHRONIC KIDNEY DISEASE-METABOLIC BONE DISEASE IN PATIENTS WITH CHRONIC KIDNEY DISEASE].].

Chronic kidney disease (CKD) is a systemic disease with numerous complications associated with increased morbidity and mortality. Chronic kidney disease-metabolic bone disease (CKD-MBD) starts at early stages of CKD with phosphorus accumulation and consequent initiation of numerous events that result with the development of secondary hyperparathyroidism with changes on bones and extraskeletal tissues. The most important and clinically most relevant consequences of CKD-MBD are vascular calcifications which contribute to cardiovascular mortality.

Postoperative quality of life after two different methods of tonsillectomy.

Background And Objectives: Tonsillectomy is a very painful procedure. Pain may be severe, and patients are often unable to perform in school or eat regular food for a number of days after the surgery. The aim of this study was to compare the quality of life after undergoing two different surgical techniques of tonsillectomy, harmonic scalpel and classic tonsillectomy with bipolar cauterization.

Apocrine carcinoma of the scalp with aggressive clinical course--a case report and review of the literature.

Primary cutaneus apocrine carcinoma is a rare malignancy with about 50 cases reported in the literature. Axilla is the most common site of occurrence, but locations like scalp, anogenital region, ear canal, chest, wrist, finger and eyelid have been described. The neoplasm presents itself as an asymptomatic, slow-growing, solid or cystic mass that varies in color.

Harmonic scalpel surgical treatment of the tongue angioleomyoma--case report and review of the literature.

Angioleiomyoma is benign soft tissue tumor composed of smooth muscle cells and vascular endothelium, characterized with slow growth, unspecific symptoms and rare malignant transformation. It is very rare in the head and neck region and complete surgical excision is the gold standard for diagnosis and treatment. We present a very rare case of angoleomyoma of the tounge base treated with partial glosectomy with harmonic scalpel which shortened surgical procedure, reduced bleeding and postoperative complications.

Analysis of saliva pepsin level in patients with tracheoesophageal fistula and voice prosthesis complications.

The aim of this crossectional study was to investigate the relationship between pepsin concentration in saliva and the occurrence of tracheoesophageal fistula (TEF) complications and voice prosthesis (VP) complications, after total laryngectomy and VP implantation. We assessed the concentrations of pepsin in the saliva of 41 laryngectomized patients and correlated it with the incidence of TEF complications (periprostethic leakage, atrophy, esophageal mucosa hypertrophy, granulations, fistula enlargement, and VP dislocation), VP complications (transprosthetic leakage, Candida infection) and voice quality. Pepsin levels were measured by enzyme-linked immunoadsorbent assay (ELISA).

Morphometry in differential diagnosis of pathologically altered parathyroid glands: adenoma and hyperplasia.

Simple morphological identification of a sample as parathyroid gland tissue is not always sufficient for optimal patient treatment. Instead, patients with parathyroid gland lesions that increase the risk of disease relapse should be identified. To assess the possibility of differentiating adenoma from hyperplasia in preoperative material by use of computerized morphometric analysis in order to enable better preoperative work-up in patients with hyperparathyroidism.

Twenty one months of frontal sinus stenting.

The success of a frontal sinus endoscopic or external operation depends on the postoperative stenosis of the frontal sinus ostium. Formation of a stenosis can be prevented by placing a stent in the frontal sinus ostium. The period optimal for leaving the stent in the sinus ostium is yet to be established, but experts recommend a maximum six months period.

The significance of Helicobacter pylori in patients with nasal polyposis.

Aim: To determine the presence of Helicobacter pylori in nasal polyps and the transmission of H. pylori from stomach to nasal polyps.

Methods: In a prospective, controlled clinical research, 35 subjects with nasal polyps and 30 controls with concha bullosa (CB) were involved, and had been subjected to endoscopic sinus surgery (ESS).

Necrotizing fasciitis of the neck after total laryngectomy.

Necrotizing fasciitis (NF) is an unusual, life threatening, rapidly advancing infection characterized by widespread fascial and subcutaneous tissue necrosis and gangrene of the skin. It most commonly affects the extremities, abdominal wall and perineum, whereas cervical NF is rare. NF of the head and neck is often caused by both aerobic and anaerobic microorganisms found in the upper aerodigestive tract.

Absence of Helicobacter pylori in healthy laryngeal mucosa.

Objectives: To evaluate the presence of Helicobacter pylori in healthy laryngeal mucosa.

Design: Prospective analysis of Helicobacter pylori colonisation in healthy laryngeal mucosa, using the 13C urea breath test and polymerase chain reaction analysis.

Subjects: Twenty randomly chosen men (28-78 years) without laryngeal pathology or gastrointestinal disease were investigated.

Gastric adenocarcinoma metastases to the alveolar mucosa of the mandible: a case report and review of the literature.

Malignant tumours rarely metastasize to the oral cavity. When they do, such metastases may arise from various locations including the lung, breast, kidney, prostate and colon. Soft tissue oral metastasis from gastric adenocarcinoma is extremely rare, and limited information exists regarding the presentation and work-up of metastatic gastric carcinoma into the oral soft tissue.

Posttraumatic subperiosteal orbital hematoma.

Background: Subperiosteal orbital hematoma (SOH) is a rare finding after midface trauma, causing compartment syndrome within the orbit. It should be consideration in the differential diagnosis of any case of proptosis and vertical globe displacement.

Patients: We present two patients with SOH treated by surgical evacuation and drainage.

Mechanical ventilation in chronic obstructive pulmonary disease patients, noninvasive vs. invasive method (randomized prospective study).

Acute respiratory failure due to chronic obstructive pulmonary disease (COPD) presents an increasing problem throughout the world. The aim of this study was to compare invasive and non-invasive mechanical ventilation (MV) for patients with COPD. A prospective, randomized trial was performed in a multidisciplinary intensive care unit for the period of 36 months and included 156 patients with COPD.

Duke Treadmill Score in prioritizing patients for coronary angiography: retrospective study of a Croatian regional hospital.

Aim of the study was to determine the potential of Duke Treadmill Score (DTS) in prioritizing patients for coronary angiography in a transitional country clinical setting. We analyzed 114patients with suspected stable coronary artery disease who underwent exercise treadmill testing, and coronary angiography in Slavonski Brod General Hospital. DTS was calculated from treadmill test as: exercise time--(5 x ST deviation in mm)--(4 x exercise angina).

Pulmonary compliance values provide prognosis in mechanically ventilated patients--a randomized prospective study.

Our aim was to evaluate the influence of static pulmonary compliance (Cst) on the choice of Mechanical Ventilation(MV) method and treatment outcome. A prospective, randomized trial conducted out at the multidisciplinary Intensive Care Unit (ICU) included 387 patients, randomized in two groups: noninvasive MV group and invasive MV group. Furthermore, each group was divided in two groups: Cst < or = 0.

Prognostic significance of DNA cytometry in combination with AgNOR investigation.

Conclusion: While most results concerning DNA and nucleolar organizer region (AgNOR) parameters fit with previous studies, the percentage of aneuploidy looks like a promising prognostic parameter. The observed intratumoral heterogeneity could represent a possible source of conflicting and inconsistent results.

Objectives: The aims of our study were to determine the prognostic relevance of different DNA and AgNOR parameters in laryngeal squamous cell carcinoma (SCC) and compare these findings with established prognostic factors including tumor stage and grade, as well as the detection of possible intratumoral heterogeneity.

Chronic obstructive pulmonary disease and weaning of difficult-to-wean patients from mechanical ventilation: randomized prospective study.

Aim: To compare T-tube and pressure support ventilation (PSV) as two methods of mechanical ventilation weaning of patients with chronic obstructive pulmonary disease (COPD) after failed extubation.

Methods: A prospective randomized trial carried out at the multidisciplinary intensive care unit (ICU) over 2 years included 136 patients with COPD who required mechanical ventilation longer than 24 hours. The patients who could be weaned from mechanical ventilation were randomized to either a T-tube or PSV 2-hour spontaneous breathing trial.

[Injuries of the neck: wartime and peacetime experiences].

Introduction: There are many diagnostic and therapeutic dilemmas as well as variations in the treatment of neck trauma.

Aim: Our own experiences offer a protocol of treatment for neck trauma.

Patients And Methods: During the 1991-2003 period, 139 patients with neck trauma were treated at Dr.