OTOLARYNGOLOGY

Author: ELHENDI WASIM.
Year: 2004.
University: SANTIAGO DE COMPOSTELA [www.usc.es].
Place of defense: FACULTAD DE MEDICINA UNIVERSIDAD DE SANTIAGO DE COMPOSTELA.
Place of preparation: UNIVERSIDAD DE SANTIAGO DE COMPOSTELA.

Summary: INTRODUCTION: The objective of the current study results is included, in addition to the clinical approach and objective measures, the patient's self-perception of his voice alteration. We believe that there is a clear need to develop a method that is more satisfactory, theoretically justified, clinically realistic, and proven reliability for measuring the voice function and the evaluation of treatment outcomes. OBJECTIVES:-epidemiological study of patients with vocal nodules (NV) and disfonías function (DF) in the Community Galician and evaluate the effectiveness of therapy in rehabilitating these patologias - Analyzing the results of two objective measures (laringoestroboscopia and analysis of acoustic voice) and two subjective measures (the disability index vocal (HIV) and the Quality of Life Index (QLI)) and study the correlation between the results of these measures and clinical outcome, and the correlation between them, selecting from among them all the best methods for the study of función.vocal and especially for the evaluation of results after treatment. MATERIALY METHODS: We conducted a study on 162 for a period of 5 years (97 NV, 65 DF) treated with rehabilitation, practicing objective and subjective measures before and after treatment. Thereafter patients are ranked according to the perceptive evaluation of foniatra based on the scale GRBAS in 2 groups (clinical improvement-no clinical improvement) and the results were stratified epidemiological, objective and subjective factors such as clinical RESULTS AND CONCLUSIONS: We found that these pathologies have a higher prevalence in young women (30-50 years) and in professions that involve attention to the public and professionals in the voice. The pathological history are most frequently associated psychological disturbances, allergic diseases and gastro-esophageal reflux, and the characteristics of the most vocal behavior are found: the misuse and abuse voice, singing, tension neck, carraspeo and rising the intensity of voice. The average length of the table was approximately 4 years. Patients who had no improvement clinic more frequently: personality. Ansioso-, depressive, gastro-esophageal reflux; cervical strain and poor articulation of the word. Instead we found no sex, type of breathing, smoking or how ínicio. As for the larin2oestrboscopia found that: All of the patients had no damage at least one of the four aspects estroboscópicos analyzed. After-treatment are an improvement of the four parameters analyzed (whether or not to have submitted clinical improvement). We found a relationship -estadísticamente significant clinical outcome and the four aspects aualizados in the case of NV and solamenente with the closure glótico in the case of the DF. As for the analysis of acoustic voice, we emphasize that: Before tratamientoencontramos, coinciding with various authors, a non-significant decline of Buddha, an increase nosignificativo of SdFo and a significant increase in the jiitter, shimmer and NNE After treatment found a significant decrease jitter and shimmer in the case of NV and a significant decrease shimmer in the case of the DF We found no relationship between the clinical and pre-treatment values or with the evolution of 5 arguments after treatment. With regard to measures subietivas, we should note that - vocal disorders. Pose a major disability both organic, functional and emotional after the tra 8 serve as obstacles 47c rehabilitative found significant improvement. We found a significant relationship between clinical outcome and scores QLI, HI v Subscales functional, organizational and emotional in the case of NV, and only the subscale functional in the case of the DF. As for the effectiveness of treatment vocal rehabilitation are an improvement of 77.3% in the case of NV and 87.7% for the DF. We conclude that there is a need to standardize a protocol multidimensional basic measures for the evaluation of the role and voice for measuring treatment outcomes voice that must necessarily include the patient's own subjective assessment of the progress of their disease.

Author: GONZÁLEZ PEREZ RUPERTO.
Year: 2004.
University: LA LAGUNA [www.ull.es].
Place of defense: FACULTAD DE MEDICINA.
Place of preparation: HOSPITAL UNIVERSITARIO DOCE DE OCTUBRE.

Summary: Intolerance analgesic non-steroidal anti-inflammatory (NSAID) with respiratory demonstrations is defined as an inflammatory disease of the lining, combined with asthma attacks and / or rhinoconjunctivitis after intake aspirin and other NSAIDs. Diagnosis is made by medical history and test oral TPO provocation and the long duration of the tests has forced to develop new protocols safer and that we provide adequate levels of profitability diagnostic. The central aim of the thesis is validating the nasal provocation test with acetilsalicilato lysine (TPN ASL) as a new alternative method of diagnosis in intolerance ANINES with respiratory manifestations. Analyzed results on a sample of 55 individuals, we concluded that the proposed ASL TPN is a valid approach, safe and effective for the diagnosis of NSAIDs intolerance and given the órgano-especificidad of this disease should be considered in choosing those patients with symptoms rinoconjuntivales secondary to NSAIDs.

Author: CANEL LOSADA MARTA.
Year: 2005.
University: OVIEDO [www.uniovi.es].
Place of defense: SERVICIOS CIENTIFICO TECNOLOGICOS.
Place of preparation: FACULTAD DE MEDICINA.

Summary: Despite advances in prevention, early detection and treatment, cancer remains a major cause of premature death worldwide. It is generally accepted that the formation and preservation of adequate unions cell to the extracellular matrix is essential for the maintenance of the differentiation of epithelial cells and their destabilization facilitates des-diferenciación cellular and acquisition of invasive capacity, with the emergence carcinomas. The joints are a type of focal joints between the cell and the extracellular matrix via cell surface receptors called integrins. The accession focal kinase ( "Focal Adhesion Kinase: FAK) is an essential component of the intracellular signaling path-dependent integrins. The role of FAK in cell physiology has been extensively studied in healthy cells unprocessed, where it has been observed that regulates biological processes that are key in the pathogenesis of cancer, including cell proliferation, survival, migration and cell invasion. In carcinomas epidermoides head and neck (HNSCC), there are preliminary observations suggest that overexpression of FAK in tumor cells. The overall objective of this thesis work has been investigating the pathophysiological significance of overexpression of FAK in HNSCC and contribute in this way to a better understanding of the mechanisms and consequences of its activity. For this purpose, first investigated the expression of FAK protein in samples of HNSCC, from patients treated surgically, as well as nodal metastases originating in the same and healthy tissues adjacent to the tumor. The overexpression of FAK proved to be a common and early event in HNSCC is maintained during all stages of tumor progression. Also, it was determined the number of copies of the gene fak in a subset of samples used in protein analysis. It is frequently found in HNSCC an increase in the number of copies of the gene fak. In the same way, the structural gene amplification in the same region chromosome 8q24 appeared to be common in this type of tumor. It then evaluated the prognostic significance or possible diagnosis of these genetic alterations. The gain of gene fak was the only one that showed a statistically significant correlation with the worst prognosis, advanced tumor stage and more frequent recurrences of the disease. Subsequently, it was determined that the expression of FAK may be independent of the number of copies of the gene fak, and the gain in the number of copies of the gene is not the mechanism that governs the overexpression of FAK in HNSCC. In addition, our data suggest that a genomic region at least gain 5.77 Mpb around fak, limited by khdrbs3 and ptp4a3, could have a significant prognostic value in HNSCC. On the other hand, overexpression of FAK protein in these carcinomas were found associated with the presence of lymph metastasis. Then, they tried to explore the role of FAK kinase in cellular processes key to the development of an invasive phenotype in HNSCC. For this purpose, we developed a model in vitro, in which the inhibition of the expression and / or activity of FAK in cell lines derived from HNSCC, we determined that FAK appears to have a role in the regulation of adhesion and cell motility , cellular processes that are key to the lymphatic spread of the tumor cells. However, FAK not proved to be too important in controlling the proliferation in the cell line derived from HNSCC, SCC-40. In conclusion, the deregulation of FAK, other than structural amplification during the progression of HNSCC could have an active role in the 8 desarro 2fc ment, maintenance and, perhaps, a process of this kind of invasive tumors.

Author: CRISTIAN DRAGOS STEFANESCU.
Year: 2006.
University: COMPLUTENSE DE MADRID [www.ucm.es].
Place of defense: FACULTAD DE MEDICNA.
Place of preparation: FACULTAD DE MEDICINA - UNIVERSIDAD COMPLUTENSE DE MADRID.

Summary: About 45% of adults suffer from occasional snore and at least 25% are roncadores usual. There have been more than 300 inventions in the USA promising solution to snoring. The truth is that none of them work. The somnoplastia is a simple technique which is practiced under local anesthesia in an outpatient basis and with high efficiency. The evidence on the effectiveness of somnoplatia is limited because there are not many studies randomized, placebo controlled. In addition, when the effectiveness of the technique is valued by records objectives of snoring, there are conflicting results. With this goal, a study on the effectiveness of romnoplastia for snoring. Secondary objectives were to identify complications. Valuing objective study of snoring and identify predictors of success.