Biomedical subjects

A Tsikoudas

Publications and source records attributed to A Tsikoudas.

11 recordsLinked to original sources

PubMed2006

Reinke's oedema, hormones and hormone replacement therapy.

OBJECTIVE: To study the implications of hormone replacement therapy (HRT) treatment in the pathogenesis of Reinke's oedema (via a possible pseudo-hypothyroidism effect), and also to study why the disease affects a predominantly post-menopausal female population. DESIGN: Prospective case series study. SETTING: Two teaching hospitals and two district general hospitals in Scotland, UK. SUBJECTS: Thirty-three patients diagnosed with Reinke's oedema who presented in the out-patient department before or after treatment. RESULTS: Thyroid function tests were normal in all but two cases. Only three patients were receiving HRT treatment. CONCLUSIONS: The study produced no evidence to support a relationship between HRT treatment and the pathogenesis of Reinke's oedema; this supports previous studies which concluded that thyroid function was not related to the development of Reinke's oedema. Some new ideas regarding hormonal factors in Reinke's oedema are discussed.

Adult↗

PubMed2004

The management of acute oesophageal obstruction from a food bolus. Can we be more conservative?

The objective was to assess the number of patients with acute oesophageal bolus obstruction that resolves spontaneously and to aid the identification of the best practice. This prospective and retrospective case series study at a teaching hospital and a district general hospital in Scotland, UK, involved 37 patients with acute oesophageal obstruction from a food bolus who were observed for 24 h from the beginning of symptoms. The bolus passed spontaneously in 54% of the patients during the observational period. A short observational period following the admission of patients with acute food bolus obstruction is reasonable as it may reduce exposure to surgical morbidity and decrease inpatient stay.

Acute Disease↗

PubMed2002

Are topical antibiotics necessary in the management of otitis externa?

Otitis externa is an inflammatory disorder of the skin of the outer ear canal frequently associated with bacterial or fungal infection. It is normally treated with aural toilet and topical preparations containing antibiotic/antifungal and steroid preparations. A group of 39 patients presenting with otitis externa were randomized in a double-blind manner into those receiving drops containing an aminoglycoside and steroid preparation and those receiving the same preparation without the aminoglycoside. All patients were reviewed on days 0, 3, 7 and 11 of a 14-day course of drops and their response to medication monitored. Patients documented their symptoms at each appointment and clinical response was also measured by a blinded observer. The study suggests that an aminoglycoside antibiotic conveys no significant benefit in this condition.

Administration, Topical↗

PubMed2002

Allergic otitis externa.

Chronic otitis externa is a common condition, which is usually successfully treated by topical medications and aural toilet. In cases that persist despite conventional treatment, a diagnosis of allergic otitis externa should be considered. Sensitization to otic medications (secondary contact otitis) is not uncommon. Topical aminoglycosides are the most common sensitizers although many components of topical preparations can cause sensitization. Patients who may have developed allergic otitis externa should undergo patch testing. Otolaryngologists should consider using topical antibiotics with a low allergenic potential and avoiding neomycin when treating patients with otitis externa. Primary contact otitis may occur to metals used in earrings and also to hearing aid moulds. Treatment of both primary and secondary contact otitis consists of identifying the allergen, avoiding further contact and use of simple preparations avoiding common sensitizers.

Chronic Disease↗

PubMed2002

Laryngeal gout.

A review of the literature reveals only 12 reported cases of laryngeal gout. We describe three further cases of laryngeal gout, the largest series ever published. The first case is previously undescribed acute gouty cricoarytenoiditis resulting in acute airway embarrassment requiring tracheotomy, and then we describe two cases of chronic tophaceous involvement of the thyroid lamina with computed tomography (CT) images of this process. The paucity of literature on this subject may not only be due to rarity but also lack of clinical awareness. Gouty involvement of the larynx must be considered in any patient with a history of gout who presents with hoarseness, odynophagia, dysphagia, stridor or neck lump. Acute airway compromise may require tracheotomy, whereas chronic airway problems may necessitate endoscopic tophi removal, lateralization procedures or even permanent tracheostomy.

Aged↗

PubMed2002

The cause of death in patients with head and neck squamous cell carcinoma.

For patients with head and neck squamous cell carcinoma the cause of death is not well described in world literature. We report data on 106 patients diagnosed with head and neck squamous cell carcinoma who subsequently died. The literature related to this topic is discussed, and recommendations are made for data collection.

Adult↗

PubMed2001

The delivery of topical nasal sprays and drops to the middle meatus: a semiquantitative analysis.

The distribution of nasal drugs specifically to the middle meatus is of vital importance in the treatment of rhinosinusitis and nasal polyposis. It is widely assumed that the intranasal distribution is superior with nasal drops rather than spray delivery. However, a comparison of nasal spray and drop delivery specifically to this area has not been studied before. This study aims to compare semiquantitatively the intranasal distribution of nasal sprays and drops to the middle meatus in vivo. A novel method was used whereby a neurosurgical patty was placed in the middle meatus. Topical nasal drops and aqueous sprays dyed with methylene blue (0.1% v/v) were administered in a standardized fashion in normal volunteers. The subsequent absorption of administered dye was classified on a four-point scale. A randomized prospective cross-over design was used for the study. We found that there was no difference in the delivery of nasal drug to the middle meatus between either method of drug administration (P > 0.2). The perceived superiority of nasal drops may therefore be as a result of the acknowledged systemic effect of betamethasone drops.

Administration, Intranasal↗

PubMed2001

Primary sinonasal amyloidosis.

Primary amyloidosis localized to the sinonasal tract is extremely rare with only 20 reported cases in the English literature. We describe a further case and review the literature.

Amyloidosis↗

PubMed1999

Olfactory groove meningiomas.

Olfactory groove meningioma is a rare clinical entity. The principal symptoms associated with olfactory groove meningiomas are anosmia and headache which lead the patient to the ENT specialist. Frontal sinusitis, migraine and neuralgia are most frequent incorrect diagnoses. This retrospective study of 13 consecutive patients who underwent excision of Olfactory Groove meningiomas in the North Staffordshire Royal Infirmary, Department of Neurosurgery over a 20-year period was undertaken to study the presenting features, duration of symptoms, results of surgery, and long-term follow-up. Symptoms were present for less than 6 months to 3 years. Although excision was thought to be complete reoccurrences occurred in four patients. The morbidity of surgery was significant.

Adult↗

PubMedDate not supplied

Inflammatory myositis: a rare differential diagnosis of a neck lump.

Inflammatory myositis is an extremely rare benign inflammatory condition of skeletal muscle. It usually affects the extremities, and there are only 10 cases reported in the head and neck region. Its significance is that in this region it can be clinically mistaken for a neoplasm. We describe a case and review the literature.

Adult↗

PubMedDate not supplied

Management pathways and the surgical diagnosis of tuberculous lymphadenitis: can they be improved? The Bradford experience.

OBJECTIVE: To study the diagnostic pathway for tuberculous lymphadenitis from initial referral to the commencement of antituberculous therapy with the object of identifying potentially avoidable delays. DESIGN: Retrospective case series study. SETTING: District General Hospital, England, UK. SUBJECTS: Thirty-four patients with head and neck tuberculous lymphadenitis diagnosed by a positive histological specimen over the 3-year period 1998-2000. RESULTS: There were no clear pathways for referral and management. There were substantial variations in the management between different specialties and even sometimes within the same specialty. There was evidence of poor communication between various teams. CONCLUSIONS: The study shows that for the management of head and neck tuberculous lymphadenitis, there is a need for a 'hospital' or 'trust' approach. It also reinforces the arguments for a dedicated 'neck lump clinic' with easy access both from the general practitioners and from other specialties within the hospital and for a protocol for handling biopsy specimens from nodes.

Adult↗