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Biomedical subjects

S Kristensen

Publications and source records attributed to S Kristensen.

At least 55 records · Page 3Linked to original sources

Cervical involvement of diffuse idiopathic skeletal hyperostosis with dysphagia and rhinolalia.

Osteophytosis in degenerative joint diseases of the cervical spine may result in dysphagia. Recently, diffuse idiopathic skeletal hyperostosis (DISH) or Forestier's disease has also been identified as a cause of dysphagia. A case of DISH with cervical involvement producing dysphagia and rhinolalia is presented. The symptomatology, radiographic features and treatment of DISH involving the cervical region are discussed. The diagnosis of DISH is exclusively radiographic. Recognition of this disorder, unfamiliar to many clinicians, may avoid an unnecessary biopsy procedure of a suspected pharyngeal tumor. Once the diagnosis of DISH is made, a supplemental barium esophagram should be performed to exclude possible coexisting neoplasms. Endoscopy has a definite risk for inducing an inadvertent esophageal perforation and should be avoided, if at all possible. A conservative therapeutic approach is advocated by the authors.

Aged↗

Relief of pain and trismus in patients treated with naproxen or acetylsalicylic acid after tonsillectomy.

The pain-relieving efficacy of naproxen and acetylsalicylic acid (ASA) in tonsillectomized patients was compared in a double blind parallel clinical trial comprising 83 patients, among whom 42 were treated with naproxen and 41 with ASA. The patients were treated post-operatively for two days with either naproxen suppositories 500 mg. twice, or ASA effervescent tablets 1000 mg. three times, daily. The therapeutic gain was evaluated by recording the intensity of pain, reduced ability to open the mouth (trismus), consumption of supplementary analgesic (parcetamol), and pain-related sleep disturbances. The statistical analysis of the results revealed no differences in pain intensity, consumption of additional analgesics or pain-related sleep disturbances in the two treatment groups. A considerable degree of trismus was demonstrated in most of the tonsillectomized patients. This reduced ability to open the mouth was gradually overcome in the naproxen group while it remained unchanged in the ASA group, however, no statistical significant difference could be demonstrated. Additionally, no significant positive correlation between pain intensity and trismus was proven. The pain-relieving effect, however, was unsatisfactory in both the naproxen and the ASA group, and clinical controlled trial studies of alternative analgetics in tonsillectomized patients are still to be encouraged.

Adolescent↗

Septic cavernous and lateral sinus thrombosis: modern diagnostic and therapeutic principles.

The incidence of both lateral and cavernous sinus thrombophlebitis has been significantly reduced in the antibiotic era. Since septic cavernous sinus thrombosis (CST) is mainly a complication of facial abscesses and septic lateral sinus thrombosis (LST) is almost invariably due to chronic otitis media, both conditions are of clinical relevance to the otolaryngologist. The predominant bacterium in septic CST is Staphylococcus aureus whereas in septic LST the bacteriology is very similar to that found in chronic otitis media. The diagnosis of septic CST can be established in most cases after thorough clinical examination, and contrast computerized tomography (CT) using the coronal projection usually confirms the clinical diagnosis. The signs and clinical course of septic LST are non-specific and the final diagnosis rests upon radiological investigations including CT-scan. The treatment of both conditions consists of broad-spectrum antibiotics, including beta-lactamase resistant penicillin in cases of septic CST. Most cases of septic LST also require surgical intervention. Two cases of septic intracranial sinus thrombosis are presented. The need for early diagnosis and treatment of this potentially lethal condition is emphasized.

Adolescent↗

Occupational hearing impairment in pig breeders.

Individuals employed at pig breeding facilities are exposed to potentially harmful noise from several sources. In a building housing about 1,100 pigs, the animals themselves were found to produce a sustained noise level between 95 and 104 dBA during the feeding procedure. High-pressure cleaners used for cleaning the buildings generate between 98 and 105 dBA. We present a case of typical noise-induced hearing loss, which, with reasonable certainty, can be ascribed entirely to this kind of noise exposure. General use of hearing protectors in the profession is recommended.

Adult↗

Acute epiglottitis in adults: bacteriology and therapeutic principles.

Acute epiglottitis is seldom encountered in adults, but the condition is probably more frequent than reported in the literature. Nineteen cases of adult epiglottitis were analysed retrospectively. In 53% of the patients, the symptoms were present for less than 24 h prior to hospitalization. Sore throat and dysphagia were invariably present. Three patients presented with stridor and 2 with complete airway obstruction. Throat cultures from 5 patients grew beta-haemolytic streptococci and from 2 Haemophilus influenzae type B was grown. Two tracheotomies and 1 nasotracheal intubation were performed. One death occurred. It is emphasized that any adult with an acute sore throat and dysphagia should undergo indirect laryngoscopy and that blood cultures should always be part of the routine bacteriological investigation. Cooperation and understanding among otolaryngologists and anaesthesiologists is of paramount importance in the management of acute adult epiglottitis, as nasotracheal intubation and cricothyroidotomy appear to be the methods of choice in securing an airway. Ampicillin and chloramphenicol are recommended in the medical treatment.

Adolescent↗

[Trismus].

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Adult↗

Aggressive cementifying fibroma of the maxilla.

The cementifying fibroma is a benign fibro-osseous lesion. Its usual location is in the mandible while rare sites of involvement have been the maxilla and ectopic locations. These tumors are generally believed to originate from the connective tissue of the periodontal ligament. Clinically, lesions are usually asymptomatic, slow-growing, and well-circumscribed. However, in very few cases, particularly in younger patients, these tumors have demonstrated and apparent aggressive course of development. We describe a case of an aggressive cementifying fibroma of the maxilla in a middle-aged male. The pathogenesis of the tumor is discussed, and the need for appropriate surgical management is emphasized.

Humans↗