Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0262471 (ENT)
 5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The impaction of a cannabis-filled condom in the upper oesophagus of a 28-year-old prisoner is reported. The history was deceptive and smoking and drug abuse denied. The ENT surgeon being unaware of the identity of the drug faced tackling a possibly lethal foreign body, technically difficult to remove by the usual forceps method. (The Dormier basket is recommended for this task but we were unable to try it). Passage of the condom into the stomach occurred during attempted removal and its further progress was uneventful, indicating that gastroscopic removal of cannabis is unnecessary unless obstructive symptoms occur.
 ...
PMID:A narcotic foreign body in the throat. 191 53

Benign lymphoepithelial cysts (BLC) are rare disorders of salivary glands (0.6%). In patients infected by HIV, they are seen more often. In comparison to sporadic BLC, the patients are younger, the diameter of the cysts is up to 5 cm and they are often located bilaterally. At the Department of ENT, Head and Neck Surgery of the Ludwig-Maximilians-University, Munich, ten HIV-infected patients (two females) showed lymphoepithelial cysts (six times bilaterally). One of these revealed a metastasis of a small cell neoplasma near the cysts, another patient showed a non-Hodgkin's lymphoma of low grade malignancy (MALT-type), and one patient additionally had bilateral Warthin's tumours. The BLCs were mostly located in the parotid tail. In three cases, the cysts were found on the inferior border of the parotid and once at the submandibular gland. The age ranged from 27 to 71 years (medium 45.7 years). The mode of HIV infection was homosexuality five times, drug abuse twice, heterosexuality once, and blood products once. In two cases, the channel of transmission was unknown. The majority of the patients showed minor HIV illness (CDC II [n = 2]/CDC III [n = 4]); the rest had advanced immunodeficiency (CDC IV [n = 4]). All the cysts were examined by ultrasonography and NMR. According to the clinical findings and the general stage of health, BLCs were either enucleated (n = 8) or a superficial parotidectomy (n = 5) and selective biopsy of lymph nodes (n = 3) suspected to be malignant were performed.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Cystic lymphoepithelial lesions in the head and neck area in HIV-infected patients]. 801 Oct 27

Benzathine penicillin G is one of the antibiotics most often used in ENT practice. In spite of potential allergic or hypersensitivity complications, the restrictions for its administration are scant and its antibacterial spectrum often coincides with the pathogenic flora of the upper airways. A curious analytical interference secondary to its use was detected in two patients seen in our emergency unit. This phenomenon, not observed with other beta-lactamics or even other penicillins, consisted of a continuous false positive result in the urinary detection of amphetamine and its metabolites that lasted up to 50 days after the antibiotic was administered. This finding not only seems to be specific to the benzathine salt, but also to the enzymoimmunoanalysis used to detect drug abuse.
 ...
PMID:[Unusual analytical interference caused by benzathine penicillin G]. 995 Oct 93

The global epidemic of HIV infection remains appalling. By 2001, there were an estimated 1.4 million HIV-infected children, with 4.5 million deaths. In the UK, paediatric cases are clustered around population centres where there are high concentrations of infected immigrant adults, and to a lesser extent, areas where IV drug abuse is common. The highest incidence remains in London and the southeast. With the national redistribution of immigrant and refugee families, any doctor in any specialty may expect to be involved with children who are HIV positive, or have clinical AIDS. The majority of children are infected vertically, i.e. infection of the infant from an infected mother in the pre-, peri-, or post-natal periods. Rates of transmission vary from 15-20% in the developed countries. Children with HIV infection may have their primary presentation to ENT doctors, who should have appropriate thresholds for suspecting the diagnosis. The most common presenting features include persistent generalised lymphadenopathy, hepatosplenomegaly, chronic/recurrent diarrhoea, poor growth, and fever. Fifteen to twenty percent of untreated children will present with an AIDS-defining illness by 12 months, typically with Pneumocystis pneumonia at approximately 3-4 months of age. Seventy percent of perinatally infected children will exhibit some signs or symptoms by 12 months Without treatment, the median age to progression to AIDS is approximately 6 years, and 25-30% will have died by this age. The median age of death is approximately 9 years. Children may also present with repeated/unusual ear infections, sinus disease (inc. mastoiditis), tonsillitis, orbital/peri-orbital cellulitis, oral candidiasis, and dental infections. Infections with streptococcus pneumoniae and group A streptococcus are common, and often progress to severe systemic infection with an appreciable mortality. Infections may be due to unusual pathogens such as Pseudomonas, 'typical' and atypical Mycobacteria, Candida, Aspergillus, etc. Fungal infections of the sinuses (inc. Aspergillus and Rhizopus spp.) may be particularly devastating, with rapid spread to involve bone and the central nervous system. Another classical presentation, which may present to ENT doctors, is that of bilateral parotid enlargement, especially in children who are 'slow progressors', many of whom also have Lymphoid Interstitial Pneumonitis (LIP). A major attitudinal change has occurred due to advances in 3 main areas: (i) the multidisciplinary management of the infected mother (inc. counselling, antenatal screening, elective caesarean section, advising against breast feeding, etc.), (ii) the prevention of vertical transmission, using anti-retroviral therapy to the infected mother during pregnancy, and to the potentially infected infant in the first weeks of life, and (iii) major advances due to the advent of highly active anti-retroviral treatment. With effective use of these measures, transmission rates may be reduced to <2%. None of the measures though, affect a cure, and it will still be many years before the development of effective vaccines. ENT doctors may be referred children already known to be HIV-positive. Knowing how to talk to infected children (and their parents) is full of potential pitfalls, and requires careful forethought. Many infection-control policies have required considerable rethinking due to the AIDS epidemic. This has especially been the case with respect to needle-stick injuries, post-exposure prophylaxis, sterilization and re-use of equipment, and safe approaches to surgery.
 ...
PMID:HIV infection in children--impact upon ENT doctors. 1466 74

With increasing drug abuse of cocaine, the chances are growing that an anaesthetist comes into contact with an acutely intoxicated patient or chronic cocaine user while on call or during his daily routine. In South America chewing coca leaves is daily practise, while in the industrialised world the drug is sniffed, smoked or injected intravenously. Clinically, cocaine is used topically in ENT and ophthalmology due to its local analgesic and strong vasoconstrictive properties. Cocaine has a similar effect on the CNS as amphetamines and produces euphoria and hallucinations. Cocaine acts indirectly on sympathetic stimulation, release of dopamine and inhibition of catecholamine metabolism. It is metabolised in the liver and by serum esterases. Intoxication with cocaine leads to respiratory depression, arrhythmias, ventricular fibrillation and death. If an emergency operation during acute cocaine intoxication is necessary, all sympathomimetic anaesthetic drugs must be avoided. A deep anaesthesia must be provided to reduce the risk of cardiovascular complications. In the literature, anaesthesia is regarded as safe for patients with chronic cocaine misuse after abstinence of 24 hours. This case report shows that, even without acute intoxication, severe cardiovascular problems are possible in patients with chronic cocaine abuse. Hence, we recommend a cocaine-free interval of at least one week before elective surgical procedures.
 ...
PMID:[Intraoperative ventricular fibrillation in a patient with chronic cocaine abuse--a case report]. 1503

Syphilis is a multisystemic disease that may also affect the inner ear. The objective of this study was to investigate the frequency, clinical presentation and outcome of otosyphilis. A retrospective analysis of inpatients seen by a team of ENT specialists and dermatologists at a teaching hospital in Dresden, Germany, during 1986-2000. Six cases of otosyphilis had been diagnosed. None was related to risk factors such as HIV infection or drug abuse. We identified four female and two male patients, age range 25-58 years. Four patients suffered from syphilis stage II, one from syphilis stage and another from congenitial syphilis. ENT complaints included loss or impairment of hearing, tinnitus and nystagmus. All were treated with penicillin G. Adjuvant therapy included systemic corticosteroids oral pentoxifillin in two patients each. Improvement of ENT symptoms was achieved in all but one patient, who suffered from congenitial syphilis. This study confirms that otosyphilis is still a complication of syphilis in developed countries. The first line therapy is systemic penicillin G. There is a lack of controlled trials for adjuvant treatments such as corticosteroids and pentoxifillin. Clinical cooperation between dermatologists/venereologists and ENT specialists supports the best outcome.
 ...
PMID:Otosyphilis: report on six cases. 1519 56

Foreign body ingestion in dental and ENT practice is a commonly encountered emergency. In most cases, particularly in adults, there is a definite history of its ingestion, the nature of the foreign body is usually identifiable and the patient almost always presents immediately. We report an unusual case of an elderly patient with a six month history of progressive dysphagia referred to us by the physicians after investigations which were highly suggestive of a hypopharyngeal malignancy. Surprisingly when a biopsy was attempted, the hypopharyngeal mass turned out to be a dental plate. Dentists and otolaryngologists should be aware that pharyngeal foreign bodies can present without a positive history and can have a clinical presentation mimicking malignancy. A history of head injury, dementia, alcohol and drug abuse should be specifically excluded. A routine examination of a patient with dysphagia should include eliciting a specific history of wearing dentures and examination of teeth. In future designs for dental plates, bridges and crowns the use of a radio opaque material should be considered.
 ...
PMID:Hypopharyngeal foreign body masquerading as malignancy. 1985 77