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Query: UMLS:C0262471 (ENT)
5,307 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Infection from human immunodeficiency virus (HIV) is well known for the particular host susceptibility to a variety of opportunistic infections and unusual malignant neoplasms. Although no tumor develops exclusively in concomitance with HIV infection, malignancies in these patients have different clinical behaviour, response to treatment and prognosis than the pattern observed in HIV negative hosts. Kaposi's sarcoma (EKS) and non-Hodgkin's lymphoma (NHL) are tumors per se diagnostic of AIDS in patients with HIV infection. From 1987 to 1991, 210 HIV positive patients underwent ENT examination without symptom-related selection: 128 were intravenous drug users, 50 homosexual males, 22 heterosexuals, 4 intravenous male homosexual drug users, 3 blood recipients and 3 subjects without known risk factors. Sixteen were allocated in group II, 37 in III, 9 in IV A, 2 in IV B, 31 in IV C1, 37 in IV C2, 48 in IV D and 30 in IV E. Fourteen had head and neck EKS localization. All were males, with a median age of 40 of which 11/14 were homosexuals. The concomitant involvement of skin and mucosa was the most common manifestation and the palate was the most frequently affected mucosal site. Twenty-four had NHL localized within the head and neck: 21 males and 4 females with a average age of 38, 10 intravenous drug users, 9 homosexual males, 3 heterosexuals, 1 blood recipient, 1 subject without known risk factors. Extranodal localization was the most frequent characteristic while the gums were the most commonly involved site. The main characteristics of head and neck manifestations of EKS and NHL are reported with references to literature. The majority of HIV infected patients with EKS or NHL have ENT localizations, perhaps because lymphatic tissue, a HIV target, is well represented in this area and contamination by infectious agents (such as Epstein-Barr virus and cytomegalovirus, probably involved in the pathogenesis of EKS and NHL) can easily occur in the head and neck. The otolaryngologist should be aware of the various, and sometimes misleading, characteristics of these diseases.
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PMID:[The cervicofacial manifestations of Kaposi's sarcoma and of non-Hodgkin's lymphomas in HIV-infected patients]. 141 19

The acquired immune deficiency syndrome (AIDS) presents a global problem of XX century medicine. The speed with which this pathology spreads is great and the number of AIDS patients is increasing in geometric progression. At present AIDS is a real threat to the health and life of millions of people. It is very difficult to clinically diagnose AIDS because it manifests in the form of various tumors and opportunistic infections, with lesions localized on the skin and mucosa or in the viscera (lungs, brain, esophagus, gastro-intestinal tract). The most typical AIDS manifestations are: preumocystosis, oropharyngeal and esophagal candidosis, herpes simplex, herpes zoster, Kaposi's sarcoma, "hairy" leukoplakia, extranodal non-Hodgkin's lymphoma, etc. In the case of HIV infection and AIDS many lesions are located in ENT. This means that ENT doctors are to be well aware of their clinical manifestations to be able to detect this pathology.
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PMID:[AIDS in otorhinolaryngological practice]. 204 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)
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PMID:[Cystic lymphoepithelial lesions in the head and neck area in HIV-infected patients]. 801 Oct 27

Positron emission tomography with 18fluor-2-deoxy-D-glucose (FDG-PET) is increasingly used in clinical practice, especially in oncology. However, in the Netherlands, guidelines for its routine use are lacking, probably due to the limited availability and costs of PET technology. The increasing demand for evidence of a positive effect on patient management (and outcome) following the introduction of new diagnostic tests, also plays an important role. For non-small cell lung cancer (NSCLC) such evidence is now available. In a prospective randomised multicentre study performed in the Comprehensive Cancer Centre in Amsterdam, FDG-PET reduced the number of futile thoracotomies in patients with suspected NSCLC by 50%. This and other studies resulted in a regional guideline (formulated by pulmonologists, surgeons, radiotherapists, radiologists and nuclear medicine physicians) for the use of FDG-PET in patients with (suspected) NSCLC. Several, predominantly multicentre, studies to evaluate the effectiveness of FDG-PET in subgroups of patients with colorectal cancer, breast cancer, oesophageal cancer, ENT tumours, non-Hodgkin's lymphoma and NSCLC (early in the diagnostic workup), are currently being undertaken in the Netherlands. The results of these might facilitate a cost-effective positioning of PET technology for routine patient care in the Netherlands. A recent report from the Comprehensive Cancer Centre in the south of the Netherlands, based on scenarios in Belgium and the United States, indicates that the availability of PET facilities should increase substantially over the next decade, so as to ensure access to all patients who may benefit from this technology.
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PMID:[Positron emission tomography in the Netherlands: need to expand the capacity]. 1238 64

Both the incidence and prevalence of human immunodeficiency virus infection are increasing in the world. Diseases of ENT districts are more frequent in human immunodeficiency virus-infected patients and involve all the otolaryngological sites. The otorhinolaryngological manifestations in association with HIV infection are mainly atypical, so common in the clinical practice, really aspecific and very frequent in ENT daily routine (such as sinusitis, otitis, etc.) and, therefore, immunodeficiency may not be suspected. In other cases, ENT evidence is more peculiar or unusual, such as opportunistic infections, rare neoplasm and tumours with an unusual course, giving a very high suspect of a human immunodeficiency virus-related infection. The most frequent malignant neoplasm is Kaposi's Sarcoma which is extremely rare in non-human immunodeficiency virus-infected subjects; the second most frequent is non-Hodgkin's lymphoma with 50% in extranodal sites (oral and maxillary sinus). Following a review of the literature, modifications caused by current antiretroviral treatment on head and neck manifestations of human immunodeficiency virus infection have been evaluated. Highly active antiretroviral therapy is a new therapeutic strategy, based on poly-chemo-therapeutic schemes, providing simultaneously two or more anti-retroviral drugs. We have used highly active antiretroviral therapy in human immunodeficiency virus infection since 1997, substituting previous mono-chemotherapy based on Zidovudine or Didanosine alone. Highly active antiretroviral therapy is extremely efficient in reducing the viral load of human immunodeficiency virus and increasing CD4+ T-lymphocyte count. These biological effects are associated with an improvement in immune functions. To evaluate the effects of highly active antiretroviral therapy on otorhinolaryngological manifestations in human immunodeficiency virus infection, we performed a retrospective study on 470 adults, observed over 14 years (1989-2002) and constantly receiving the same treatment, with follow-up from 7 to 80 months. A total of 250 subjects underwent mono-antiretroviral chemotherapy (1989-1996), while 220 underwent highly active antiretroviral therapy (1997-2002). The results of the retrospective study showed that highly active antiretroviral therapy has greatly improved the control of the immune-deficiency (increasing the range of CD4+), reducing the number of otorhinolaryngological manifestations (also tumours). On the other hand, 2 patients presented sudden unilateral hearing loss following treatment: toxicity due to association of new drugs cannot be excluded.
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PMID:Human immunodeficiency virus infection: personal experience in changes in head and neck manifestations due to recent antiretroviral therapies. 1608 Mar 13

The study aimed at finding out the clinicopathologic, ophthalmic and visual profiles, management and outcome of mucoceles of the paranasal sinuses in Nigerians. The study was a retrospective review of 20 cases of mucoceles who presented to the ENT clinic and referred to the eye clinic of the University College Hospital Ibadan, Nigeria. These included nine males and 11 females with a male:female ratio of approximately 1:1. Mucoceles commonly involved more than one sinus on the same side. The sinuses commonly involved were the frontoethmoidal sinuses, frontal sinus and maxillary sinuses. The preoperative visual acuity in 16 (80%) patients was 6/4-6/9, three (15%) had between 6/9-6/18, and one (5%) patient was CF ("count fingers") in the affected eyes. The majority (90%) of our patients presented with multiple ophthalmic features; however, proptosis was the most popular and ophthalmic presentation and occurred in 15 (75%) patients. Proptosis was nonaxial in all cases with inferior, lateral or inferolateral displacement. Degree of proptosis ranged from 1-20 mm. Other presentations were squint (leading to diplopia) observed in one (5%) patient and epiphora in another [one (5%)] patient. Poor vision appeared to be the main problem in one (5%) patient, while in another [one (5%)] patient, the affected eye was completely immobilized. One (5%) patient presented with orbital cellulitis. Common radiological findings included classical expansive appearance with loss of the normal scalloping appearance with dehiscence of the wall of the affected sinus as was observed in nine (45%) of our patients. All 20 patients had excision of mucoceles (frontoethmoidectomies). At surgery, 11 (55%) patients had a combination of dehiscence of medial and/or posterior walls, and/or floor of the orbit. Materials evacuated were mucopurulent in 15 (75%) cases, moldy in three (15%) and cheesy in two (10%). Nine (45%) patients had intact walls. Three (15%) patients developed orbital cellulitis as postoperative complication. Postoperatively, proptosis regressed spontaneously within one week of surgery in 17 (85%) patients. By six weeks, all the patients had a complete regression of proptosis and visual acuity returned to preoperative visual acuity level except the patient with preoperative visual acuity of CF. This patient later deteriorated and became NPL (no perception of light) in the affected eye. This was a peculiar case in that operative findings in this patient were suggestive of another coexisting pathology, which was later confirmed to be a non-Hodgkin's lymphoma of the orbit. After two months, only three (15%) reported back for follow-up. The study concluded that proptosis is a common feature of mucoceles of the paranasal sinuses and that visual affectation was rather uncommon. Also whilst mucopurulent materials formed the content of most mucoceles, surgical intervention caused proptosis to regress dramatically. However, due to the high default rate in our study, no categorical statement can be made about recurrence rate of these swellings.
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PMID:Clinicopathologic, ophthalmic, visual profiles and management of mucoceles in blacks. 1653 80