PURPOSE: The study analyses outcomes of the surgical treatment of odontogenic sinusitis that concurrently address sinusitis and its dental source. METHODS: A total of 364 adult patients were included, representing 13% of all patients we have operated on for any rhinosinusitis over the past 18 years. The diagnosis was based on both ENT and dental examinations including CT imaging. Patients were divided into three groups: (1) FESS with dental surgery without antrotomy, (2) FESS with intraoral antrotomy, and (3) intraoral surgery without FESS. The mean postoperative follow-up was 15 months. RESULTS: First group involved 64%, second group 31%, and third group 6% of the cases. The one-stage combined ENT and dental approach was used in 94% of cases (group 1 and 2) with a success rate of 97%. Concerning FESS, maxillary sinus surgery with middle meatal antrostomy only was performed in 54% of patients. Oroantral communication flap closure was performed in 56% of patients (success rate 98%). Healing was achieved within 3 months. The majority (87%) of patients were operated on unilaterally for unilateral findings. Over the past 18 years, a 6% increase of implant-related odontogenic sinusitis was observed. CONCLUSION: Odontogenic sinusitis is common, tending to be unilateral and chronic. Its dental source needs to be uncovered and treated and should not be underestimated. Close cooperation between ENT and dental specialists has a crucial role in achieving optimal outcomes. The one-stage combined surgical approach proves to be a reliable, safe, fast and effective treatment.

• MeSH
• dospělí MeSH
• endoskopie metody   MeSH
• lidé MeSH
• prospektivní studie MeSH
• sinus maxillaris chirurgie   MeSH
• sinusitida * komplikace   chirurgie   MeSH
• zánět čelistní dutiny * diagnostické zobrazování   etiologie   chirurgie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• Publikační typ
• časopisecké články MeSH

• MeSH
• dítě MeSH
• kvalita života MeSH
• poskytování zdravotní péče MeSH
• veřejné zdravotnictví MeSH
• Check Tag
• dítě MeSH
• Publikační typ
• vysokoškolské kvalifikační práce MeSH
• Geografické názvy
• Skandinávie a severské státy MeSH

• Konspekt
• Veřejné zdraví a hygiena
• NLK Obory
• management, organizace a řízení zdravotnictví
• veřejné zdravotnictví
• pediatrie

• MeSH
• trypanozomiáza MeSH
• tuberkulóza MeSH
• Publikační typ
• zprávy MeSH
• Geografické názvy
• střední Afrika MeSH

• Konspekt
• Patologie. Klinická medicína
• NLK Obory
• pneumologie a ftizeologie
• cestovní a tropická medicína

Background: Allergies have long been observed in Inborn Errors of Immunity (IEI) and might even be the first presentation resulting in delayed diagnosis or misdiagnosis in some cases. However, data on the prevalence of allergic diseases among IEI patients are limited and contradictory. Objective: To provide a worldwide view of allergic diseases, across a broad spectrum of IEI, and their impact on the timely diagnosis of IEI. Methods: This is a worldwide study, conceived by the World Allergy Organization (WAO) Inborn Errors of Immunity Committee. A questionnaire was developed and pilot-tested and was sent via email to collect data from 61 immunology centers known to treat pediatric and/or adult IEI patients in 41 countries. In addition, a query was submitted to The United States Immunodeficiency Network (USIDNET) at its website. Results: Thirty centers in 23 countries caring for a total 8450 IEI patients responded. The USIDNET dataset included 2332 patients. Data from responders showed that a median (IQR) of 16.3% (10-28.8%) of patients experienced allergic diseases during the course of their IEI as follows: 3.6% (1.3-11.3%) had bronchial asthma, 3.6% (1.9-9.1%) atopic dermatitis, 3.0% (1.0-7.8%) allergic rhinitis, and 1.3% (0.5-3.3%) food allergy. As per the USIDNET data, the frequency of allergy among IEI patients was 68.8% (bronchial asthma in 46.9%). The percentage of IEI patients who presented initially with allergic disorders was 8% (5-25%) and diagnosis delay was reported in 7.5% (0.9-20.6%). Predominantly antibody deficiencies had the highest frequency of allergic disease followed by combined immunodeficiency with a frequency of 40.3% (19.2-62.5%) and 20.0% (10-32%) respectively. As per the data of centers, anaphylaxis occurred in 25/8450 patients (0.3%) whereas per USIDNET dataset, it occurred in 249/2332 (10.6%); drugs and food allergy were the main causes in both datasets. Conclusions: This multinational study brings to focus the relation between allergic diseases and IEI. Major allergies do occur in IEI patients but were less frequent than the general population. Initial presentation with allergy could adversely affect the timely diagnosis of IEI. There is a need for policies to raise awareness and educate primary care and other referring specialties on the association of allergic diseases with IEI. This study provides a network among centers for future prospective studies in the field.

• Publikační typ
• časopisecké články MeSH

Cíl. Poukázat na problematiku trombóz mozkového žilního řečiště, zvláště nit-rolebních splavů, která díky své relativní vzácnosti, variabilní klinické symptomatologii i díky nutnosti užití speciálních MR technik, bývá opomíjena či pozdě diagnostikována. Metoda. V Nemocnici Na Homolce (NNH) bylo hospitalizováno v rozmezí 2005-2006 11 pacientů s nitrolební žilní trombózou (NŽT), což odpovídá statistice pro specializované centrum. Všichni pacienti absolvovali nejméně jedno MR vyšetření. Byly použity techniky 3D TOF, PC a standardní MR zobrazení nativní i postkontrastní. Podrobná anamnéza zahrnovala údaje o hormonální antikoncepci (HA), rodinnou anamnézu (RA) s trombózami před 40 rokem věku a obecně trombofilní stavy. Bylo provedeno podrobné biochemické a genetické vyšetření na přítomnost latentních trombofilních faktorů a mutací. Výsledky a závěr. Soubor činí 10 žen a 1 muž. Osm žen užívalo HA, průměrný věk byl 33 let, rozmezí 19-50 let. Jeden pacient absolvoval operaci 14 dnů před vznikem trombózy, 3x byl v RA údaj o časné trombóze. Srážlivý faktor VIII byl zvýšen 6x, 8 pacientů bylo heterozygotů pro trombofilní mutaci MTHFR. Leidenská mutace nebyla prokázána. Klinicky dominovala cefalea (7x), epileptický záchvat se vyskytl 4x, hemiparéza 3x. MR prokázalo trombózu alespoň jednoho splavu u všech pacientů. Úskalí MR diagnostiky jsou časté anatomické variace splavů, imitace průtoku ?flow void" u čerstvé trombózy zvi. na T2 vážených obrazech, imitace toku u su-bakutní trombózy (methemoglobin) na TOF angiografiích. Zde má význam užití PC angiografie. Dále pak pomalý a turbulentní tok, který imituje trombózu a parciální uzávěry splavu. Parenchymové komplikace zahrnují edém, ischémii a červenou malacii, eventuálně jejich kombinaci. Vyskytují se i leze imitující mozkový nádor.

Aim. To discuss the topic of intracranial venous thrombosis, and in particular thrombosis of the dural sinuses. Its infrequent occurrence, variable clinical symptomatology and the need to use special MR techniques, which make diagnosis difficult and sometimes late. Methods. Eleven patients were admitted to Na Homolce Hospital (NHH) between 2005 and 2006 with a diagnosis of intracranial venous thrombosis (IVT). This number correlates with the statistical incidence for a specialized center. All patients underwent at least one MRI scan. 3D TOF, PC and standard MR imaging (non-contrast and contrast-enhanced) were employed. The detailed clinical history included information about hormonal contraception, any family history of thrombosis before the age of 40 and thrombophilic conditions in general. Detailed biochemical and genetic examinations to detect latent thrombophilic factors and mutation were employed. Results and conclusion. The group of patients included 10 females and one male. Eight females used hormonal contraception at the time of the thrombosis. The average age was 33 years, range 19-50 years. One patient had undergone surgery two weeks before the event. The VIII coagulation factor was elevated in six patients while eight patients were heterozygotes for the MTHFR thrombophilic mutation. Leiden mutation was not detected. Clinically, headache was the most frequent symptom (7x) followed by an epileptic seizure (4x) and hemiparesis was present in three patients. MR proved the thrombosis of at least one sinus in all cases. The pitfalls involved in the diagnostics include anatomical variations of the venous system, imitation of the flow-void sign in T2-weighted images in acute thromboses, imitation of the flow in subacute thromboses (methemoglobin) in TOF angiographies. PC angiography plays an important role in these cases. Furthermore, slow and turbulent flow may imitate a partial or complete thrombosis. Tissue complications include edema, stroke and red malatia or their combination. Some lesions may imitate brain tumors.

• MeSH
• biologické markery krev   MeSH
• diagnostické zobrazování metody   využití   MeSH
• diferenciální diagnóza MeSH
• financování organizované MeSH
• genetické markery genetika   MeSH
• intrakraniální embolie a trombóza diagnóza   patofyziologie   MeSH
• lidé MeSH
• magnetická rezonanční tomografie využití   MeSH
• počítačová rentgenová tomografie využití   MeSH
• rizikové faktory MeSH
• trombóza nitrolebních žilních splavů diagnóza   etiologie   patofyziologie   MeSH
• Check Tag
• lidé MeSH