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Biomedical subjects

M Wayoff

Publications and source records attributed to M Wayoff.

At least 37 records · Page 2Linked to original sources
PubMed1990

[Trimetazidine and degenerative deafness. Effect on hearing and integration].

This study was conducted in order to assess the activity of trimetazidine dosed at 60 mg/day in patients presenting degenerative loss of hearing. Ten centers participated in this multicenter double-blind placebo-controlled trial which spanned 6 months. Included were 251 patients (118 women, 133 men) presenting with pure perception bilateral symmetrical deafness concerning predominantly the acute frequency range. 228 patients terminated the study, including 115 in the trimetazidine group and 113 in the placebo group. The evolution over a 6-month treatment period was significantly better with trimetazidine as regards the following parameters: audibility as assessed by pure-tone audiometry, namely at the acute frequency range (p = 0.002), intelligibility as assessed by speech audiometry (p = 0.008), subjective evaluation of hearing loss and its impact on the patient's social life. Results confirm the value of trimetazidine hearing loss management, based on clinical, subjective criteria as well as audiometric ones. Parameters reflecting best trimetazidine's efficacy were intelligibility and the psychological/behavioral impact of the impairment, allowing for better social integration of the subject.

Aged↗
PubMed1990

[Spontaneous rhinorrhea of a rare etiology (apropos of empty sella turcica)].

The authors report a case of non traumatic rhinorrhea due to an empty sella turcica. Such an intra sellar arachnoidocele compress the pituitary gland against the posterior wall, erode the floor and lead to CSF rhinorrhea through the sphenoidal sinus. Diagnosis and treatment are best accomplished by a team approach involving otolaryngologist, neurosurgeon and neuroradiologist. CT Scan and IRM explain the diagnosis. Treatment can be accomplished by a transeptal transphenoidal approach with localization and repair of the leak in the absence of increased intracranial pressure.

Adult↗
PubMed1990

Nonallergic rhinitis with eosinophilia syndrome a precursor of the triad: nasal polyposis, intrinsic asthma, and intolerance to aspirin.

Fifty-two cases of perennial rhinitis were studied, leading to the diagnosis of seven cases of nonallergic rhinitis with eosinophilia syndrome (NARES) a frequency of 13.5%. Symptoms of nasal hyperreactivity involving sneezing, rhinorrhea, nasal obstruction and pruritus were more severe than in other types of rhinitis. The frequency of hyposmia was very specific to NARES. Nasal endoscopy and sinus CT revealed an evolution towards nasal polyposis in four patients. The nasal challenge to house dust mites showed the absence of any increase in local eosinophilia. Bronchial hyperreactivity to carbachol occurred in one case. There was no case of intolerance to aspirin. There was particular adrenergic hyperreactivity among the seven patients, evidenced by study of the reactivity of the cardiovascular alpha and beta receptors. The authors emphasize the features that are shared by NARES and by the triad, which suggest that NARES is the early phase of the triad. They advance the pathogenic hypothesis of an autonomic nervous system dysregulation with a predominating adrenergic hyperreactivity. Inflammatory effects of local release of neurotransmitters induce a switch from a neurogenic to a self-sustaining inflammation. Tissue eosinophilia is regulated by chemical attractants and activating substances of various origins and plays a major part in the chronic inflammatory state.

Adolescent↗
PubMed1989

[NARES syndrome. A developing link in the Fernand-Widal triad].

The NARES is a new entity in rhinology. The incidence is more than 15% among all types of rhinitis. The clinical picture is a somewhat variable nasal hyper-reactivity, with frequent hyposmia. Three cases are recorded, which fit for classical criteria of diagnosis: negative allergic tests, more than 20% of local eosinophilia. The authors point out the absence of variation of eosinophilia after nasal challenge with an extract of house dust mite D. Ptéronyssinus. Nasal endoscopy and the computerized tomography show a propensity towards micropolyposis in 2 cases. A bronchial hyper-reactivity to carbamylcholine is detected twice. A cutaneous intolerance to aspirin is proved in one case. A state of adrenergic hyper-reactivity is established in the three patients. The authors suggest that NARES is precursor of the aspirin triad. A dysfunction of the autonomic nervous system, characterized by an adrenergic hyper-reactivity, leads to a neurogenic inflammation of the nasal mucosa. Eosinophils are attracted, and infiltrate the mucosa. Then the eosinophil-derived chemical mediators maintain a chronic inflammatory state. The best therapeutical means are discussed.

Adult↗
PubMed1989

[Surgical importance of the nasal valve].

The nasal valve is anatomically well defined, but, on a clinical point of view, it is more appropriate to talk about the nasal valve area. If the valve itself represents a three-step dynamic structure, its air-flow regulating function may be disturbed by minor adjacent structures deformations. It is of utmost importance to recognize the nasal valve dysfunction among patients with nasal obstruction complaints and to avoid any iatrogenic action at this level during rhinoplastic procedures. The various abnormalities of the nasal valve area described. Some general rules are outlined to repair this very delicate structure. In severe cases, good results are difficult to be reached. It is far better to adopt preventive rhinoplastic procedures.

Airway Obstruction↗
PubMed1989

Immunohistological characteristics of nasal polyps. A comparison with healthy mucosa and chronic sinusitis.

Immunohistological investigations were performed on a series of samples from 37 patients with nasal polyps, 22 with chronic sinusitis, and 15 controls with healthy nasal and sinusal mucosa. Mean numbers of plasma- and mast cells were not different in the various groups. Immunoglobulin isotypes were always predominantly IgA and IgM; IgE were scarce. Deposited immune complexes were always absent. A statistically significant difference, however, was observed in the number of eosinophils within the mucosa. Patients with nasal polyps had up to ten times more eosinophils per surface unit than patients with sinusitis or healthy mucosa.

Adolescent↗
PubMed1988

[Non-allergic eosinophilic rhinitis. From clinical diagnosis to pathogenic study].

Non allergic rhinitis with eosinophilia syndrome is not an uncommon diagnosis, since eosinophilia in nasal secretions from 20% up to 90% of total cells, is detected in 15% of rhinitis. Nasal symptoms include sneezing paroxysms, profuse watery rhinorrhea, in adults or in children. All immunological tests are negative. Tomodensitometry may detect evolution towards sinusal polyposis, and bronchial challenges with carbamylcholine may detect bronchial hyper-reactivity. We conclude to the possibility for NARES to be a link between common vasomotor rhinitis and nasal polyposis with asthma and intolerance to aspirin. The diagnosis needs to be firmly established by the study of nasal eosinophilia during a nasal challenge with a perennial allergen (house dust mite). The first has to be unchanged, and the second has to be negative. As eosinophils are potent pro-inflammatory cells endowed with cytotoxicity, precise studies upon the characteristics of eosinophils in the nasal secretions and in the pituitary mucosa of patients with NARES, have to be carried on.

Adult↗
PubMed1988

[Sensitivity to an amoxicillin-clavulanic acid combination, of deep tonsillar flora isolated in chronic tonsillitis].

Deep tonsillar flora were identified in tonsils removed from 48 patients, children and adults, with chronic tonsillitis and recurrent sore throats or obstructive hypertrophy. Most specimens (38/48) cultured multiple germs (2 to 5 different species) with aerobic and anaerobic Gram+ and Gram-forms, some being beta-lactamase producers. Of the total of 135 strains isolated, 104 were aerobic and 31 anaerobic. The species of aerobic germs most frequently isolated were: Apart from alpha-hemolytic streptococci of undertermined group (38 strains), Haemophilus sp. : 14 (including 3 beta-lactamase + strains), Staphylococcus aureus: 15 (including 11 beta-lactamase + strains), Streptococcus A : 10, Enterobacteriaceae : 6, Neisseria sp. : 8 (including 1 beta-lactamase + strain). And among the anaerobic germs: Peptococcus : 3, Veillonella alc : 10, Fusobacterium nucleatum : 9, Bacteroides melaninogenicus : 6, Other Bacteroides : 2. Of the 127 strains tested, 102 were sensitive to amoxicillin and 121 to amoxicillin and clavulanic acid combination. The presence of a beta-lactamase producing bacterium in 1 of 3 specimens suggests the risk of failure of treatment with penicillin, prescribed classically for this type of affection.

Adolescent↗
PubMed1987

[New tympanomastoid repair in open technics: Galea's flap].

After an anatomical review, the authors describe the method for obtaining the temporo-parietal facial flap and its particularities in the rehabilitation of the canal down technic. The main indications of this flap are: the rehabilitation of unstable cavities, a Palva's flap alternation, a solution to the filling up after petrectomy or enlarged canal down technic.

Ear, Middle↗
PubMed1987

[Sinusal-dental tomography and dental origin of chronic sinusitis].

Always frequent and often misleading, chronic sinusitis are multifactorial. Consequently, the role of teeth apical infection is largely underestimated. The difficulties of interpretation of the sinus radiographic imaging are well established, particularly in the study of the dental with sinus border. The clinical circumstances in which the responsibility of teeth can be involved, are studied. Diagnosis insufficiency are frequent, and inadequate procedures can be undertaken. The particular conditions to obtain good polycyclicidal tomographs pictures are described and demonstrated. In special cases, with the eventual contribution of the bacterial-sensitivity evaluation, these sinusal-dental tomographs allow a relevant diagnosis.

Chronic Disease↗
PubMed1986

[Current status of the treatment of nasal septal perforations].

If the most part of the patients with septal perforation have an history of previous surgery, only few of them present symptoms and require surgical repair in spite of the various techniques described in the literature. Bilateral naso-septal mucosal flaps with temporalis fascia interposition graft give the best results. That's why the use of more complicated process remain the exception. Owing to the dubiousness of these reconstructions, it seems advisable to point out the value of preventive actions in order to preserve the nasal physiology.

Humans↗