Pneumomediastinum and pneumothorax during emergency tracheotomy under spontaneous ventilation: Macklin meets Müeller?

Potentially serious complications associated to emergency tracheotomy continue being a matter of concern. We review the pathogenesis of gas leakage in this setting and discuss about the possible mechanisms involved in its cause. We present two cases of pneumomediastinum, subcutaneous emphysema and pneumothorax in the context of emergency tracheotomy under spontaneous ventilation, finally resolved by chest drainage.

iContraception(®): a software tool to assist professionals in choosing contraceptive methods according to WHO medical eligibility criteria.

Objective: To design software to assist health care providers with contraceptive counselling.

Methods: The Model-View-Controller software architecture pattern was used. Decision logic was incorporated to automatically compute the safety category of each contraceptive option.

Critical analysis of robotic surgery for laryngeal tumours.

In recent years, transoral robotic surgery (TORS) with the Da Vinci robot has been used for the removal of laryngeal cancers with the objective to improve functional and aesthetic outcomes without worsening survival. The advantages of TORS are described in this article. However, its disadvantages, mainly high cost amongst others, do not make robotic surgery the current treatment of choice for laryngeal tumours; transoral laser surgery is superior in most cases.

[Moral autonomy and conscientious objection in the surgical management of Jehova's witnesses].

According to current Spanish law, patients are guaranteed the right to make decisions on the medical treatment they receive. However, this exercise of autonomy in health care causes ethical conflicts which are hard to resolve. Health workers' duty to assist patients and the concept of personal rights may lead health professionals to prescribe actions which are contrary to the patient's wishes.

Cellular immune responses and occult infection in seronegative heterosexual partners of chronic hepatitis C patients.

It is unknown whether hepatitis C virus (HCV)-specific cellular immune responses can develop in seronegative sexual partners of chronically HCV-infected patients and whether they have occult infection. Thirty-one heterosexual partners of patients with chronic HCV were studied, fifteen of them with HCV transmission risks. Ten healthy individuals and 17 anti-HCV seropositive patients, without viremia, were used as controls.

A role for substance P in cancer promotion and progression: a mechanism to counteract intracellular death signals following oncogene activation or DNA damage.

In the present review we discuss a central role for substance P (SP) in carcinogenesis. We suggest that one mechanism to induce mitogenesis of tumor cells is the activation of neurokinin-1 receptor (NK1R) through SP, linking cancer promotion and progression to a neurokinin-mediated environment. After reviewing the role of both SP and its receptor NK1R in normal and neoplastic cells we propose the use of neurokinin-1 receptor antagonists as a novel and promising approach for treating patients with cancer.

[Prospective comparative study of different amino acid and lipid solutions in parenteral nutrition of patients undergoing bone marrow transplantation].

Unlabelled: The patient who will undergo a bone marrow transplant (BMT) has a high protein catabolism in the time period after the infusion of the marrow, and therefore there is a need for an adequate nutritional support. The objective of our study is to analyze the behavior of nutritional assessment parameters, the lipid metabolism, the number of days of mucositis, the number of infections, the number of days to recovery, and the number of hospitalization days when using different parenteral nutrition solutions: 22.5% and 45% branched chain amino acid solutions, and lipid solutions with long chain triglycerides (LCT), vs.

[Communication between primary care and specialists].

Objective: To assess how well referral and referral-back documents for rheumatology patients going back and forth between a health area's Primary Care and the specialist clinics are filled in.

Design: A descriptive retrospective study. Sevilla Central Health area.

[Hypertrophy of lingual ectopic thyroid gland in pregnancy. A clinical case].

A 28-year-old female, diagnosed two years ago of euthyroid lingual thyroid, has been asymptomatic under observation without treatment until her first pregnancy. During her first pregnancy the lingual thyroid tissue increases of size and produces dysphagia, pain and oral hemorrhages. We realize a thyroid hormone treatment (thyroxine) with regular results.

[Unusual congenital laryngeal anomalies: a review of 13 cases].

In this study we presents: 6 subglottic stenosis, 2 subglottic hemangiomas, 2 laryngeal webs, 2 laryngeal cysts and 1 laryngoesophageal cleft. Were diagnosed during laryngotracheobronchoscopies performed to 220 newborns and small children that showed as main finding: stridor, voice change or aspiration syndrome. The stenosis, hemangiomas and cleft were resolved spontaneously.

[Laryngomalacia: a review of 42 cases].

In the period from 1981 to 1990, in the Children's Hospital from Sevilla were performed 220 direct laryngoscopies and bronchoscopies to newborns and infants that showed as a main finding: stridor voice change or aspiration syndromes. In the 30 percent the main cause was a congenital laryngeal anomalies. Laryngomalacia is the most common congenital laryngeal anomaly with 42 cases.

[Apropos a case of rhinoscleroma].

Rhinoscleroma is a chronic granulomatosis disease of the respiratory tract. It's endemic to Central America and Eastern Europe. It's a rare disease in our country.

[Congenital choanal atresia: transpalatal approach].

From 1975-1990, we have diagnosed and treated 17 cases of choanal atresia. The clinical findings, diagnosis and surgical management by transpalatal means, are reviewed.

[Acute mediastinitis with fatal outcome secondary to odontogenic infection].

This article describes a patient who developed a deep neck and mediastinal infection that was initiated by a odontogenic infection. The history of the patient's illness and the surgical procedures are reviewed and the anatomic and microbial considerations of deep neck infections are discussed. Despite antibiotic therapy, cervicomediastinal drainage, tracheostomy and treatment for septic shock, the patient expired.