Eldely patients with epistaxis. Predisposing factors, seasonal distribution and treatment

Hippokratia 2001, 5 (3): 99-103

S Triaridis, A Triaridis, J Xanthopoulos, P Papadopoulos, K Karagiannidis, Ch Preponis

Abstract

Epistaxis is a common ENT problem with multifactorial etiology, It occurs in a1l age groups, most commonly in children (anterior, venous, shorr lived) and in elderly patients (posterior, arterial, prolonged). The incidence and severity of epistaxis increases v/ith advancing age. Furthermore, other health problems of the elderly patient or even social reasons are frequent causes of admission for overnight observation.
In this retrospective study 835 patients who presented in the ENT deparrment of our hospital with acute and chronic epistaxis, between December 1998 and December 2000 were included. The causes, the site and the nature of epistaxis, patients' age, seasonal distribution and predisposing factors were analyzed. Out of the 27053 patients who were examined in the ENT outpatient clinic, 835 (3.0 %) presented with epistaxis; 347 (41.5 %) of them were elderly patients. Most of the patients were treated successfu1ly with cautery and/or anterior nasal packing. Out of the 41 patients who required hospitalization, 18(44.0 %) were elderly patients (16 with anterior and posterior nasal packing and 2 wirh anterior only packing due to their poor general health condition).
A cause of epistaxis was found in about 25 % of patients: 79 patients (9.5 %) were hyperrensive, 37 (4.4 %) presented after trauma and 32 (3.8 %) were taking some kind of anticoagulation medication.
A higher incidence of noseb1eeding during winter months was found in elderly patients, whereas the seasonal distribution of epistaxis in younger patients has two peaks: during cold winter months and dry, hot summer months.

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Paraganglioma of the filum terminale. A case report and review of the literature

Hippokratia 2001, 5 (3): 104-109

S Angelidou, N Flaris, G Georgiou, D Pachatouridis, S Misirloglou, M Leontsini, F Tsitsopulos

Abstract

A case of paraganglioma of the filum terminale in a 45-year-old female patient is presnted. Paraganglioma of th filum terminale, is a nonchromaffin, non-functioning neuroendocrin neoplasm. These tumors represent 3.5% of the cauda equina lesions and they usually are slow growing and indolent. The first clinical manifestation in most of the cases is back pin and less frequently sensory and / or motor deficit. They are treated by total surgical excision and have a good prognosis in general. Long term of follow up and the absence of metastases are the only reliable predictors of benign biological behaviour.

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Foreign bodies in the throat and esophagus, in eldely patients

Hippokratia 2001, 5 (3): 110-114

S Triaridis, A Triaridis, V Gantsou, K Karagiannidis, I Bennis, Ch Preponis

Abstract

Acute dysphagia due to foreign body impaction in the upper gastrointestina! tract is a common emergency in otolaryngology. The commonest foreign bocdes in the throat are fish bones and occur usually in adults. Mosr of them can be removed under loca! anesthesia at the outpatient clinic. Esophageal foreign bodies occur in children and in elderly patients. The commonest objects impacted in the esophagus are coins in small children, and food boluses in elderly patients. Adult patients with a history of food bolus impact??n lacking sharp bones can be treated initially with spasmolyt?c drugs, which will relax the esophagus and perm?t the passage of the bolus. If there is sharp object or bone, an esophagoscopy is required. Although diagnosis is main!y based on history, latera! soft tissue of the neck, chest radiographs and contrast swallow, are useful to confirm the diagnosis and to locare the site of obstrucrion.
In this retrospective srudy we included 468 patienrs who presented in the ??? department of' our hospital with foreign bodies of the upper gastrointestinal tract, from December 1998 to December 2000. Eighty six (18.4 %) were ederly patienrs. The majority of the foreign bodies in these patienrs were removed under local anesthesia. Eleven elderly patients were admitted, spontaneous disimpaction of the bolus occurred in three of them and the remaining eight patients underwent rigid esophagoscopy. Out of the 128 esophagoscopies for foreign body rcmoval perf?rmed in our deparrment during the last decade, 32 (25%), were perf?rmed in elderly paricnrs and food bolus was the commonst impacted object (59.4%).

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Parasellar extension of pituitary adenomas and cerebelar ischaetnia: MRI evaluation

Hippokratia 2001, 5 (3) : 115-118

V Souftas, F Goutsaridou, M Emmanouilidou, S Chondromatidu, Ch Papastergiou, Ch Osantiridis, P Papapostolou, I Tsitouridis

Abstract

MRI and MRA of the brain were conducted in addition to MRI of the pittuitary gland to 93 patients with pit??itary macroadenoma of 3rd and 4rh extension degree, for the invesrigation of ischaemic lesions resulting frorn pressure ?r encasement of the internal carotids. ?? ischarnic lesions were detecred with potential corellation to the tumorous behaviour of the adenomas.

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Wilson's Disease: MRI evaluation

Hippokratia 200, ; 5(3): 119-123

F Goutsaridou, S Chondromatidiu, I Emmanouilidou, N Papapostolou, Ch Papastergiou, Ch Tsantiridis, E Tsitouridis

Abstract

Wilson's disease is an uncommon genetic disorder, which is inherited in an autosomal recessive fashion. lt is a disease of copper rnetabolism leading to an excessive deposition of copper, primarily in the liver and later, in many tissues, especially in the brain. Eleven (11) patients with Wilson's disease were evaluated by cranial MR – imaging. Two patients had normal findings in MR - images. There was brain atrophy in 9 patients. Nine patients had abnormal findings in basal ganglia, six patients had findings in midbrain while two of them presented the characteristic “panda sign". Whit matter lesions were present in five patients. N conclusion MR – imaging is the method of choice, for the evaluation of brain in patients with Wilson disease.

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The Greek version of KINDL questionnaire

Hippokratia 2001, 5 (3): 124-135

LE Vidali, A Vidalis, U Ravens-Sieberer, M Bullinger

Abstract

Many advances have occurred during the last two decades in the development of psychometric instruments for the evaluation of heath - related quality if life if adult population. Unlikely, the respective effort for children was in dead minimum, even though nobody doubted that these persons also, face health problems. The purpose of this work is the presentation of the Greek version of KINDLR questionnare that gives to scientist the use of evaluating the diagnostic and therapeutic manipulation applied to improve the quality of life of children 4 to 17 year old. This instrument evaluates the quality of life through a central analogy that covers general aspects of children’s life, whilst also accounts the special surcharge related to such age disease through adittioal analogies..

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