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https://www.readbyqxmd.com/read/29453209/recurrent-epistaxis-leading-to-diagnosis-of-primary-sinonasal-melanoma
#1
Karine Tawagi, Rita Akaraz-Avedissian, Irina Burman-Solovyeva
A 48-year-old man presented to urgent care with recurrent epistaxis over 6 months. Initially, nosebleeds were controlled with packing or cautery. Ultimately, he was referred to ear, nose and throat department and underwent nasal endoscopy which revealed polypoid tissue. A biopsy of the polyp showed non-specific inflammation with no evidence of malignancy. Follow-up maxillofacial CT revealed a large mass lesion in the right maxillary sinus, right nasal fossa, much of the ethmoids and right sphenoid, with destruction of adjacent bony structures...
February 16, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29451965/pazopanib-effective-for-bevacizumab-unresponsive-epistaxis-in-hereditary-hemorrhagic-telangiectasia
#2
Joseph G Parambil, Troy D Woodard, Omer N Koc
Hereditary hemorrhagic telangiectasia (HHT) most commonly manifests with nasal mucosal telangiectasias, and vascular endothelial growth factor (VEGF) plays a significant role in this angiodysplasia. We describe a patient with HHT with epistaxis recalcitrant to several endonasal procedures and six cycles of intravenous bevacizumab, for which he was dependent on iron infusions and packed red blood cells transfusions. He then started pazopanib at 100 mg with dramatic improvements in epistaxis and normalization of hemoglobin and iron levels, without replenishment needs for 12 months...
February 16, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29449739/nasal-metastasis-as-the-first-manifestation-of-a-metachronous-bilateral-renal-cell-carcinoma
#3
A Serra, R Caltabiano, A Giorlandino, A Musumeci, A Conti, G Zanghì, A Maniaci, S Cocuzza
Renal cell carcinoma is one of the most common tumours to spread by extranodal metastases to the head and neck. Metastatic renal cell carcinoma to the head and neck area has been demonstrated mostly in the paranasal sinuses, parotid gland, the mandible, larynx and hypopharinx. Renal cell carcinoma should be excluded whenever a metastatic lesion is encountered in the head and neck area, even if the metastatic lesion is the first clinical presentation. The diagnosis of metastatic RCC should be suspected in any patient with even a remote history of renal cell carcinoma...
December 2017: Pathologica
https://www.readbyqxmd.com/read/29444719/the-significance-of-atherosclerosis-in-hypertensive-patients-with-epistaxis
#4
S Elwany, A A Ibrahim, A I Soliman, R Bazak, H A Ibrahim
BACKGROUND: The relationship between hypertension and epistaxis is controversial and poorly understood. The present research investigated atherosclerosis as a potential risk factor in hypertensive patients with epistaxis. METHODS: A prospective study of 141 hypertensive patients with epistaxis was conducted. The laboratory tests included full blood count, lipid profile and coagulation profile. All patients underwent funduscopic examination of the eye and were classified in terms of four retinopathy grades...
February 15, 2018: Journal of Laryngology and Otology
https://www.readbyqxmd.com/read/29438211/seasonal-variation-of-epistaxis-in-germany
#5
David Ulrich Seidel, Andreas M Sesterhenn, Karel Kostev
AIM: The goal of the present study was to analyze the seasonal variation of epistaxis in ear, nose, and throat (ENT) practices in Germany in 2016. METHODS: The present study sample included patients who received a first epistaxis diagnosis from physicians in 114 ENT practices in Germany between January 2016 and December 2016. The number of epistaxis patients per practice was calculated for each month. A logistic regression model, adjusted for age and sex, was used to calculate the association between epistaxis diagnosis and the month...
February 12, 2018: Journal of Craniofacial Surgery
https://www.readbyqxmd.com/read/29437014/drug-induced-epistaxis-an-often-neglected-adverse-effect
#6
Sara Meirinho, Ricardo Relvas, Gilberto Alves
BACKGROUND: Epistaxis is an active nose bleeding with a population occurrence of approximately 60%. Although epistaxis is a common clinical complaint, the majority of the cases are benign and caused by local induced factors (e.g., trauma and local inflammation). Nevertheless, it is also recognised that epistaxis can be induced after some drugs intake. AIMS: Due to the increasing use of drugs or drug combinations that potentially may induce epistaxis, this review aims to alert healthcare professionals for this often neglected adverse drug effect and its possible complications...
February 12, 2018: Current Drug Safety
https://www.readbyqxmd.com/read/29426784/breaking-paradigms-in-severe-epistaxis-the-importance-of-looking-for-the-s-point
#7
Eduardo Macoto Kosugi, Leonardo Balsalobre, João Mangussi Gomes, Miguel Soares Tepedino, Daniel Marcus San da Silva, Erika Mucciolo Cabernite, Diego Hermann, Aldo Cassol Stamm
INTRODUCTION: Since the introduction of nasal endoscopy into the field of Otorhinolaryngology, the treatment paradigm for cases of severe epistaxis has shifted toward early and precise identification of the bleeding site. Although severe epistaxis is usually considered to arise from posterior bleeding, an arterial vascular pedicle in the superior portion of the nasal septum, around the axilla projection of the middle turbinate, posterior to the septal body, frequently has been observed...
January 20, 2018: Brazilian Journal of Otorhinolaryngology
https://www.readbyqxmd.com/read/29421841/-endonasal-endoscopic-surgery-of-choanal-atresia-long-term-results
#8
Laura Holtmann, Kerstin Stähr, Julian Kirchner, Stephan Lang, Stefan Mattheis
INTRODUCTION:  Choanal atresia is a rare abnormality. As neonates depend on transnasal respiration, bilateral choanal atresia causes an acute emergency. Transnasal endoscopic resection of congenital choanal atresia is a well-established therapy. However, the surgical technique has not yet been standardized. METHODS:  A retrospective chart review was performed with a follow-up examination between 9 to 87 months after surgery. 11 patients (7 with unilateral atresia, 4 with bilateral atresia) were included...
February 8, 2018: Laryngo- Rhino- Otologie
https://www.readbyqxmd.com/read/29418039/topical-tranexamic-acid-for-epistaxis-in-patients-on-antiplatelet-drugs-a-new-use-for-an-old-drug
#9
Michael S Runyon
"The remedy is worse than the disease." - Francis Bacon While Bacon may not have been referring specifically to antiplatelet drugs, one cannot blame the emergency physician expressing this same sentiment while caring for a patient presenting with epistaxis while on one of these medications. Achieving hemostasis in these cases can be challenging for the very best emergency physician, and a miserable experience for the most stoic of patients. In this issue of Academic Emergency Medicine, Zahed, et al. This article is protected by copyright...
February 8, 2018: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29417586/office-based-esophageal-dilation-in-head-and-neck-cancer-safety-feasibility-and-cost-analysis
#10
Rebecca J Howell, Melissa A Schopper, John Paul Giliberto, Ryan M Collar, Sid M Khosla
OBJECTIVE: To review experience, safety, and cost of office-based esophageal dilation in patients with history of head and neck cancer (HNCA). METHODS: The medical records of patients undergoing esophageal dilation in the office were retrospectively reviewed between August 2015 and May 2017. Patients were given nasal topical anesthesia. Next, a transnasal esophagoscopy (TNE) was performed. If the patient tolerated TNE, we proceeded with esophageal dilation using Seldinger technique with the CRE™ Boston Scientific (Boston Scientific Corp...
February 8, 2018: Laryngoscope
https://www.readbyqxmd.com/read/29413277/prospective-multicenter-phase-2-trial-of-induction-chemotherapy-followed-by-bio-chemoradiotherapy-for-locally-advanced-recurrent-nasopharyngeal-carcinoma
#11
Wai-Tong Ng, Roger K C Ngan, Dora L W Kwong, Stewart Y Tung, Kam-Tong Yuen, Michael K M Kam, Henry C K Sze, Harry H Y Yiu, Lucy L K Chan, Maria L Lung, Anne W M Lee
PURPOSE: To evaluate, in a phase 2 study, whether induction docetaxel, cisplatin, and fluorouracil (TPF) followed by weekly docetaxel and cetuximab in concurrence with intensity modulated radiation therapy can improve the treatment outcome for patients with advanced locally recurrent nasopharyngeal carcinoma (rNPC). METHODS AND MATERIALS: Thirty-three patients with rNPC (T3-T4, N0-N1, M0) were recruited. Of these, 19 patients (57.6%) had stage rT3 recurrence, and the rest had stage rT4...
March 1, 2018: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/29409702/telangiectatic-matting-is-associated-with-hypersensitivity-and-a-bleeding-tendency
#12
Pooja Kadam, Jerrick Lim, Ian Paver, David E Connor, Kurosh Parsi
OBJECTIVE: The aim was to investigate the pathogenesis of telangiectatic matting (TM) and identify possible risk factors. METHODS: This study had two parts. The clinical records of consecutive patients were retrospectively analysed to identify risk factors for TM. In the second part, the haemostatic and coagulation profile of the subset of patients with TM were analysed and compared with controls using standard coagulation tests, platelet function and a global assay of coagulation (rotational thromboelastometry, ROTEM)...
February 3, 2018: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29395350/intravenous-bevacizumab-for-refractory-hereditary-hemorrhagic-telangiectasia-related-epistaxis-and-gastrointestinal-bleeding
#13
Vivek N Iyer, Dinesh R Apala, Bibek S Pannu, Aditya Kotecha, Waleed Brinjikji, Michael D Leise, Patrick S Kamath, Sanjay Misra, Kebede H Begna, Rodrigo Cartin-Ceba, Hilary M DuBrock, Michael J Krowka, Erin K O'Brien, Rajiv K Pruthi, Darrell R Schroeder, Karen L Swanson
OBJECTIVE: To present a multiyear clinical experience with intravenous bevacizumab for the management of severe gastrointestinal bleeding and/or epistaxis in patients with hereditary hemorrhagic telangiectasia (HHT). PATIENTS AND METHODS: All patients treated with intravenous bevacizumab for severe hereditary hemorrhagic telangiectasia-related bleeding from June 1, 2013, through January 31, 2017, were included in this report. Severity of epistaxis (determined using the Epistaxis Severity Score questionnaire); hemoglobin, iron, and ferritin levels; and quality of life data were collected serially in all patients...
January 9, 2018: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/29393992/medical-treatment-of-epistaxis-in-hereditary-hemorrhagic-telangiectasia-an-evidence-based-review
#14
Ashleigh A Halderman, Matthew W Ryan, Christopher Clark, Raj Sindwani, Douglas D Reh, David M Poetker, Rosangela Invernizzi, Bradley F Marple
BACKGROUND: Hereditary hemorrhagic telangiectasia (HHT) is an autosomal dominant hereditary disorder resulting in vascular dysplasia and formation of arteriovenous malformations. Recurrent epistaxis is a hallmark of the disease. An array of medical therapies are used in this patient population, but robust evidence-based recommendations regarding the medical treatment of epistaxis are lacking. This systematic review was performed to look at the current literature and make meaningful evidence-based recommendations...
February 2, 2018: International Forum of Allergy & Rhinology
https://www.readbyqxmd.com/read/29392066/pretreatment-prediction-of-the-outcomes-of-intranasal-steroid-sprays-in-cases-with-inferior-turbinate-hypertrophy
#15
Abdullah Karataş
Objective: Intranasal steroid sprays (INSS) are frequently prescribed for treating inferior turbinate hypertrophy (ITH). Complications due to the long-term application of INSS such as crusting, epistaxis, nasal mucosa dryness, and septal perforation may occur. Predicting patients who would benefit from INSS early might lower treatment costs and complication rates. We examined the predictive value of nasal decongestant response rates for the outcomes of INSS in ITH. Methods: Fifty patients with bilateral ITH were included in two groups: patients benefiting from INSS and those not benefiting...
September 2017: Turkish Archives of Otorhinolaryngology
https://www.readbyqxmd.com/read/29390976/probiotics-and-infective-endocarditis-in-patients-with-hereditary-hemorrhagic-telangiectasia-a-clinical-case-and-a-review-of-the-literature
#16
Evangelo Boumis, Alessandro Capone, Vincenzo Galati, Carolina Venditti, Nicola Petrosillo
BACKGROUND: In the last decades, probiotics have been widely used as food supplements because of their putative beneficial health effects. They are generally considered safe but rare reports of serious infections caused by bacteria included in the definition of probiotics raise concerns on their potential pathogenic role in patients with particular predisposing factors. Patients with hereditary hemorrhagic telangiectasia (HHT) are exposed to infections because of telangiectasias and arteriovenous malformations (AVMs)...
February 1, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29390379/successful-coronary-stenting-in-a-patient-with-factor-v-deficiency-in-the-absence-of-fresh-frozen-plasma-transfusion-case-report
#17
Seongil Choi, MooKon Song
RATIONALE: Drug-eluting stent (DES) implantation in a patient with factor V deficiency (F5D) is very complex. No antithrombotic therapy study has been reported for F5D patients who undergo a coronary stenting procedure. PATIENT CONCERNS: A 73-year-old woman presented with chest discomfort and exertional dyspnea. Coronary stenting was performed successfully using DES stents. DIAGNOSES: The D-dimer, prothrombin time, and partial thromboplastin time prolongation persisted from admission until 24 hours after coronary stenting...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29381836/skin-induration-in-a-patient-with-aplastic-anemia
#18
Liudmila Kastsianok, Prabha Ranganathan
One month prior to rheumatology evaluation he was admitted to the hospital for progressive worsening of shortness of breath on exertion, epistaxis, and gingival bleeding. He had fatigue, poor appetite, and an unintentional weight loss of about 30 pounds over the preceding two years. He denied symptoms of chest pain, orthopnea, paroxysmal nocturnal dyspnea, or leg swelling. This article is protected by copyright. All rights reserved.
January 30, 2018: Arthritis Care & Research
https://www.readbyqxmd.com/read/29362165/preoperative-detailed-coagulation-tests-are-required-in-patients-with-noonan-syndrome
#19
Anne Morice, Annie Harroche, Pascale Cairet, Roman H Khonsari
PURPOSE: Patients with Noonan syndrome often require surgery at young ages. They are at high risk of perioperative bleeding from coagulation defects that might not have been detected by routine screening. These risks are rarely described in the oral and maxillofacial surgery (OMS) literature. The aim of this study was to evaluate the perioperative bleeding risks associated with Noonan syndrome and to propose preoperative guidelines. MATERIALS AND METHODS: This report describes a retrospective case series of patients with Noonan syndrome who underwent OMS procedures during a continuous observational period (2013 through 2016) in the authors' center...
December 29, 2017: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29358267/does-clinical-exposure-matter-pilot-assessment-of-patient-visits-in-an-urban-family-medicine-residency-program
#20
Karl Iglar, Stuart Murdoch, Christopher Meaney, Paul Krueger
OBJECTIVE: To determine the number of patient visits, patient demographic information, and diagnoses in an urban ambulatory care setting in a family medicine residency program, and assess the correlation between the number of patient visits and residents' in-training examination (ITE) scores. DESIGN: Retrospective analysis of data from resident practice profiles, electronic medical records, and residents' final ITE scores. SETTING: Family medicine teaching unit in a community hospital in Barrie, Ont...
January 2018: Canadian Family Physician Médecin de Famille Canadien
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