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Int J Surg Case Rep 2019 Apr 16;58:70-73. Epub 2019 Apr 16.

ENT Department, 20 August Hospital, CHU Ibn Rochd, Casablanca, Morocco.

Background: Epitheliod hemandioendothelioma (EHE) is a rare vascular tumor which was first reported by Weiss and Enzinger in 1982. It can be seen in many locations whose paranasal sinus is extremly rare. Its main treatment is surgery. Read More

Ear Nose Throat J 2019 Apr 23:145561319841227. Epub 2019 Apr 23.

2 Imaging Center, Beijing Children's Hospital, Capital Medical University, Xi Cheng District, Beijing, People's Republic of China.

In this article, we explore the disease spectrum and clinical characteristics of and the diagnosis and endoscopic approach to treating isolated sphenoid sinus disease (ISSD) in children. To these ends, we review a case series of 19 patients (mean age: 8.1 ± 4. Read More

Ear Nose Throat J 2019 Apr 23:145561318823616. Epub 2019 Apr 23.

1 Department of Otolaryngology, Institute of Wonkwang Medical Science, Wonkwang University School of Medicine, Iksan, Chonbuk, Korea.

Int Forum Allergy Rhinol 2019 Apr 23. Epub 2019 Apr 23.

Department of Otolaryngology-Head and Neck Surgery, Henry Ford Hospital, Detroit, MI.

Background: Postoperative arterial epistaxis and sphenoid sinus stenosis after sphenoidotomies for endoscopic sinus surgery (ESS) and transsphenoidal approaches (TSAs) are uncommon. One potential source of epistaxis after sphenoidotomy is the sphenopalatine artery's posterior septal branch (PSB). PSB injury, in addition to other factors, could increase the risk of sphenoid stenosis. Read More

Am J Case Rep 2019 Apr 21;20:562-566. Epub 2019 Apr 21.

Department of Medicine, Hamad General Hospital, Hamad Medical Corporation, Doha, Qatar.

BACKGROUND Pseudomonal infection is the most common cause of malignant otitis externa (MOE), which typically affects elderly diabetic patients. Fungi are a rare cause of MOE. MOE can be life-threatening if not recognized and treated promptly. Read More

J Pediatr 2019 Apr 16. Epub 2019 Apr 16.

Toronto Dermatology Center, Toronto, Ontario, Canada.

J Vector Borne Dis 2018 Oct-Dec;55(4):310-314

Department of General Medicine, Christian Medical College, Vellore, Tamil Nadu, India.

Background & Objectives: Dengue fever (DF) is a common cause of acute febrile illness. Skin involvement is seen in more than half of the patients. This study was aimed to compare the clinical profile and outcome in DF patients with or without skin involvement. Read More

J Adolesc Young Adult Oncol 2019 Apr 17. Epub 2019 Apr 17.

3 Department of Medical Oncology, All India Institute of Medical Sciences, New Delhi, India.

Sinonasal anaplastic lymphoma kinase (ALK)-positive anaplastic large cell lymphoma (ALCL) without nodal involvement is extremely rare and the rarity of this tumor often leads to diagnostic dilemma. It has been predominantly reported in pediatric, adolescent and young adult patients, mostly of Asian origin. A 21-year-old female patient presented with history of epistaxis for 1 year. Read More

Exp Ther Med 2019 May 20;17(5):4279-4284. Epub 2019 Mar 20.

Department of Ultrasonography, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400042, P.R. China.

Arteriovenous fistula (AVF) thrombosis is a common complication in patients undergoing hemodialysis, and early intervention is required. Urokinase has been used as a thrombolytic agent for declotting the thrombosed access. However, the optimal route for infusing urokinase remains to be determined. Read More

Hematol Oncol Stem Cell Ther 2019 Apr 6. Epub 2019 Apr 6.

Department of Hematopathology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Kharghar, Navi Mumbai, India.

Acute Promyelocytic Leukemia (APML) is a malignancy of cells in myeloid lineage. It is a neoplasm described by proliferation and accumulation of immature neutrophils called promyelocytes in the bone marrow, inhibiting normal cell production, which results in lower numbers of blood cells circulating the body. A minor but significant proportion of patients with APML harbor complex and cryptic rearrangements. Read More

Actas Dermosifiliogr 2019 Apr 8. Epub 2019 Apr 8.

Facultad de Medicina, Departamento de Dermatología, Universidad Autónoma de Nuevo León, Hospital Universitario «Dr. José E. González», Monterrey, Nuevo León, México. Electronic address:

Osler-Weber-Rendu syndrome, also known as hereditary hemorrhagic telangiectasia, is a rare autosomal dominant disorder with an estimated worldwide prevalence of 1 case per 10,000 population. Its clinical manifestations are the result of arteriovenous malformations characterized by telangiectases that can affect the skin, mucous membranes, and solid organs and cause life-threatening conditions, such as liver disease, systemic emboli, and heart failure. Timely diagnosis is thus essential in order to prevent disease-related complications and offer genetic counseling to families. Read More

JAMA Facial Plast Surg 2019 Apr 11. Epub 2019 Apr 11.

Department of Otolaryngology-Head and Neck Surgery, Vanderbilt University School of Medicine, Nashville, Tennessee.

Importance: Numerous techniques are used for septal perforation repair, yet success rates remain variable. Few studies have evaluated the effectiveness of interposition grafts of polydioxanone plates combined with a temporoparietal fascia graft for septal perforation repair.

Objective: To investigate and describe the use of interposition grafts of polydioxanone plates combined with a temporoparietal fascia graft for septal perforation repair and the expansion of this technique to patients with more challenging comorbidities, including granulomatosis with polyangiitis. Read More

Laryngoscope 2019 Apr 8. Epub 2019 Apr 8.

Babina Diagnostics, Imphal, India.

Anastomosing hemangioma (AH) is an uncommon benign vascular neoplasm first described in the genitourinary tract. Symptomatically and histologically mimicking malignant angiosarcoma, a few rare cases have been described in the nonrenal genitourinary tract. Here, we report a 37-year-old man with a nasal AH and epistaxis. Read More

J Clin Neurosci 2019 Apr 4. Epub 2019 Apr 4.

Department of Otolaryngology, Head and Neck Surgery, Westmead Hospital, University of Sydney, Australia.

Several authors have reported advantages of the purely endoscopic (PE) approach over traditional purely microscopic (PM) techniques for many sinus and anterior skull base procedures. However, in pituitary surgery, the PE approach carries a number of limitations. Experienced microscopically-trained neurosurgeons are required to master the endoscopic technique which has a steep learning curve due to its one-handed nature and optically-distorted 2-dimensional view. Read More

Br J Hosp Med (Lond) 2019 Apr;80(4):iv

Consultant, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.

Cureus 2018 Sep 14;10(9):e3305. Epub 2018 Sep 14.

Internal Medicine, West Virginia University School of Medicine, Morgantown, USA.

Hereditary hemorrhagic telangiectasia (HHT) is described as a vascular defect, causing recurrent visceral and mucocutaneous bleeding. It is an autosomal dominant disease and has variable expressivity. The phenotypic presentation is dependent on the type of gene defect. Read More

J Craniofac Surg 2019 Mar 27. Epub 2019 Mar 27.

Division of Oral and Maxillofacial Surgery, College of Dentistry, University of Kentucky, Lexington, KY.

Nasotracheal intubation is routinely used in patients undergoing oral and maxillofacial surgery when intermaxillary fixation is needed either intraoperatively or postoperative. Various complications can occur such as epistaxis, turbinectomy, retropharyngeal dissection, tympanites, and nasal alar pressure sores or necrosis, especially when there is a prolonged nasotracheal intubation. The first report of a nasal alar necrosis after prolonged nasotracheal intubation was published by Hatcher et al in 1968. Read More

Acad Emerg Med 2019 Apr 1. Epub 2019 Apr 1.

Brooke Army Medical Center, Department of Emergency Medicine.

Epistaxis is a common reason for patients to present to the Emergency Department (ED), reflecting 1 out of every 200 ED visits in the United States. While many cases of epistaxis are self-limiting, those requiring medical treatment can be associated with significant time and healthcare costs. This article is protected by copyright. Read More

Acta Otorhinolaryngol Ital 2019 Mar 25. Epub 2019 Mar 25.

Department of Head-Neck Surgery, Otolaryngology, Head-Neck and Oral Surgery Unit, Morgagni Pierantoni Hospital, Forlì, Italy.

Am Fam Physician 2019 Apr;99(7):408

Marco Island, FL, USA.

J Laryngol Otol 2019 Apr 1:1-4. Epub 2019 Apr 1.

Department of Clinical Medicine,Xinxiang Medical University,Henan,China.

Objective: To determine the frequency distribution of bleeding sites in idiopathic hidden arterial epistaxis.

Methods: In this retrospective cohort study, 107 patients with hidden arterial epistaxis were endoscopically examined for sites of bleeding.

Results: All sites of hidden arterial epistaxis were identified by endoscopic examination. Read More

Am J Case Rep 2019 Mar 30;20:412-418. Epub 2019 Mar 30.

School of Medicine and Health Sciences, Tecnologico de Monterrey, Guadalajara, Jalisco, Mexico.

BACKGROUND Angiocentric centrofacial lymphomas, now known as nasal-type extranodal natural killer T-cell lymphomas, are neoplasms of highly destructive characteristics that mainly affect the nasal cavity and palate. The most frequent clinical presentation includes fever, weight loss, nasal obstruction, epistaxis, nasal or facial edema, as well as necrotic ulcers in the nasal cavity, gums, and palate. It has been found to have an important association with the Epstein-Barr virus. Read More

Otolaryngol Pol 2018 Nov;73(1):1-5

Uniwersytet Jagielloński Collegium Medicum Wydział Lekarski Katedra i Klinika Otolaryngologii.

Advanced age is often burdened with many deficits that are a consequence of the aging process, unfavorable lifestyle and multi-morbidity. They contribute to increased morbidity and disability of the older people. Laryngological problems often concern seniors, particularly progressing with age hearing impairment, dizziness, balance disorders, epistaxis, nasopharyngeal diseases, larynx, sinuses, and salivary glands disorders. Read More

Oman Med J 2019 Mar;34(2):156-159

ENT Department, Sohar Hospital, Sohar, Oman.

Intranasal lobular hemangioma of the inferior turbinate is a rare occurrence in children. A 12-year-old girl presented with a two-month history of multiple epistaxis episodes. Contrast-enhanced computed tomography showed a large nasal mass in the right nasal cavity. Read More

JAMA 2019 03;321(12):1176-1186

Division of Cardiothoracic Surgery, Duke University Medical Center, Durham, North Carolina.

Importance: Left ventricular assist device (LVAD) therapy improves myocardial function, but few patients recover sufficiently for explant, which has focused attention on stem cells to augment cardiac recovery.

Objective: To assess efficacy and adverse effects of intramyocardial injections of mesenchymal precursor cells (MPCs) during LVAD implant.

Design, Setting, And Participants: A randomized phase 2 clinical trial involving patients with advanced heart failure, undergoing LVAD implant, at 19 North American centers (July 2015-August 2017). Read More

Laryngoscope 2019 Mar 25. Epub 2019 Mar 25.

CIBER of Rare Diseases National Center, Madrid, Spain.

Objectives: Epistaxis is the most frequent clinical manifestation of hereditary hemorrhagic telangiectasia (HHT). Several topical, systemic, and surgical treatments have been tried, but none have been completely effective. The aim of the present study is to evaluate whether a combined treatment sclerotherapy and topical therapy with propranolol 0. Read More

Rhinology 2019 Mar 25. Epub 2019 Mar 25.

Department of ORL-Head and Neck Surgery, Odense University Hospital, Denmark.

Background: Hereditary Haemorrhagic Telangiectasia (HHT) is an autosomal dominant genetic disorder, with a wide variety of clinical manifestations due to the presence of multiple arteriovenous manifestations. Severe bleeding from the gastrointestinal (GI) tract and/or epistaxis presents a significant problem in a subgroup of patients and systemic bevacizumab, an angiogenesis inhibitor, has been suggested to benefit these patients.

Objective: To perform a review of the literature concerning the efficacy of systemic bevacizumab in treatment of bleeding from the nose or GI tract in patients with HHT, including patients from our own HHT-center. Read More

Rev Esp Patol 2019 Apr - Jun;52(2):87-91. Epub 2018 Oct 22.

Department of Haematology, Hospital Universitario de Canarias, Universidad de La Laguna, Tenerife, Spain.

We present a case of a nasal rhabdomyosarcoma (RMS) in a 27-year-old male with epistaxis and nasal obstruction due to a mass, which was subjected to prophylactic tumor embolization. However, histopathological study on the nasal biopsy was impossible due to necrotic changes. As blast cells were present in peripheral blood samples, a bone marrow biopsy was recommended in order to reach a definitive diagnosis. Read More

Eur Arch Otorhinolaryngol 2019 Mar 20. Epub 2019 Mar 20.

Department of Otolaryngology, City Hospital, Dudley Road, Birmingham, UK.

Purpose: To assess the effectiveness and complications of bilateral nasal septal cautery using silver nitrate in anterior nasal epistaxis.

Methods: This prospective study was carried out on 180 consecutive patients presenting with epistaxis to a general ENT clinic. Local anaesthetic cautery was performed using 5% lidocaine hydrochloride and 0. Read More

Front Oncol 2019 6;9:110. Epub 2019 Mar 6.

Division of Nuclear Medicine, Department of Radiology, Saint Louis University, Saint Louis, MO, United States.

Pediatric nasopharyngeal carcinoma is a rare malignancy strongly associated with Epstein-Barr virus infection. Patients typically present with non-specific symptoms of epistaxis or serous otitis from eustachian tube obstruction and therefore diagnosis is often delayed. We present a case of a previously healthy 17 year old female who initially complained of migraines which was resistant to oral medication. Read More

Case Rep Hematol 2019 12;2019:1312630. Epub 2019 Feb 12.

Department of Otolaryngology Head and Neck Surgery, The University of Tennessee Health Sciences Center, Memphis, USA.

We report a case of a 65-year-old female who presented with right-sided headaches, blurring of vision in the right eye, cold-induced epistaxis, and facial numbness in the trigeminal nerve distribution. Laboratory studies revealed a significant number of myeloblasts on peripheral smear with granulated cytoplasm, irregular nuclei, and prominent vacuoles. Magnetic resonance imaging (MRI) of the brain demonstrated a T1-enhancing 1. Read More

Eur Arch Otorhinolaryngol 2019 Mar 19. Epub 2019 Mar 19.

Department of Otolaryngology, University Hospital of Ghent, Corneel Heymanslaan 10, 9000, Ghent, Belgium.

Purpose: To investigate the clinical profile and outcomes of different treatment strategies in patients hospitalized for spontaneous severe epistaxis.

Methods: This is a retrospective descriptive study of a case series of patients hospitalized for epistaxis in the University Hospital of Ghent between 2005 and 2012.

Results: 124 patients with, respectively, 132 episodes were included. Read More

HNO 2019 Mar 19. Epub 2019 Mar 19.

Institut für Neuroradiologie, HELIOS-Klinikum Berlin-Buch, Schwanebecker Chaussee 50, 13125, Berlin, Deutschland.

Epistaxis is a common ear, nose, and throat emergency, but rarely a direct cause for hospital admission. Patients who receive inpatient treatment usually suffer from recurrent posterior epistaxis. Despite otolaryngologic measures such as posterior packing or surgery, bleeding may recur or continue or the source may not be surgically accessible. Read More

Ear Nose Throat J 2019 Feb 12;98(2):85-88. Epub 2019 Feb 12.

1 Department of Otolaryngology-Head and Neck Surgery, Glasgow Royal Infirmary, Glasgow, United Kingdom.

Background:: Endoscopic sphenopalatine artery ligation (ESPAL) is the intervention of choice for refractory epistaxis in specialist ear, nose and throat (ENT)units and should be within the repertoire of competencies for all ENT trainees. Following its recent incorporation within the United Kingdom competency-based training syllabus as an explicit outcome standard, the ESPAL is not uncommonly being delivered by trainees under appropriate supervision. We assessed the efficacy and outcome of ESPAL in epistaxis management within our teaching hospitals. Read More

Clin J Oncol Nurs 2019 Apr;23(2):212-216

Weill Cornell Medicine.

The thrombopoietin receptor agonists, eltrombopag and romiplostim, are second-line agents used to treat chronic immune thrombocytopenia purpura (ITP) in adults and children. ITP is a rare autoimmune disease and hematologic disorder characterized by reduced platelet counts that can result in significant symptoms, such as bleeding, bruising, epistaxis, petechiae, wet purpura, or blood in the urine or stool. This article reviews ITP treatment for adult and pediatric patients, including the use of the oral agent eltrombopag and the injectible agent romiplostim, nursing considerations, and patient education. Read More

Eur Arch Otorhinolaryngol 2019 Mar 16. Epub 2019 Mar 16.

Department of Pathology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India.

Purpose: Phosphaturic mesenchymal tumour (PMT) of the paranasal sinuses is a rare tumour that is associated with oncogenous osteomalacia causing predominant musculoskeletal symptoms. We present a series of eight patients diagnosed to have PMT of the paranasal sinuses with varied presentation and highlight the appropriate evaluation required to arrive at the diagnosis.

Methods: Retrospective review of eight patients diagnosed to have PMT-causing tumour-induced osteomalacia with follow-up data. Read More

Am J Emerg Med 2019 Mar 11. Epub 2019 Mar 11.

Department of Otorhinolaryngology, The Affiliated Yiwu Central Hospital, 699 Jiangdong Road, Yiwu City 322000, Zhejiang Province, China. Electronic address:

J Fr Ophtalmol 2019 Mar 11;42(3):248-254. Epub 2019 Mar 11.

Department of ophthalmology, Hôpital Necker-Enfants malades, 149, rue de Sèvres, 75015 Paris, France.

Study Objective: To study the intraoperative deployment of a pre-loaded probe for a "pushed" monocanalicular nasolacrimal intubation.

Study Design: Non-randomized study of consecutive cases.

Materials And Methods: Description: A classical Monoka™ silicone stent with the silicone tube attached at right angles to the punctal plug is contained entirely inside an introducer connected to a piston. Read More

Oper Neurosurg (Hagerstown) 2019 Mar 14. Epub 2019 Mar 14.

Department of Neurosurgery, Clinical Neurosciences Center, University of Utah, Salt Lake City, Utah.

Petrous internal carotid artery (ICA) aneurysms are rare, complicated lesions to treat. The management paradigms include observation, endovascular exclusion, or surgical trapping with or without revascularization. The case described in this video involved a 67-yr-old woman with a known history of chronic lymphocytic leukemia, who presented after a mechanical ground-level fall. Read More

Epidemiol Infect 2019 Jan;147:e106

Nuffield Department of Clinical Medicine,University of Oxford,Oxford,UK.

Louse-borne relapsing fever (LBRF) is an epidemic disease with a fascinating history from Hippocrates' times, through the 6th century 'Yellow Plague', to epidemics in Ireland, Scotland and England in the 19th century and two large Afro-Middle Eastern pandemics in the 20th century. An endemic focus persists in Ethiopia and adjacent territories in the Horn of Africa. Since 2015, awareness of LBRF in Europe, as a re-emerging disease, has been increased dramatically by the discovery of this infection in dozens of refugees arriving from Africa. Read More

Hamostaseologie 2019 Mar 13. Epub 2019 Mar 13.

Division of Hematology, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, Maryland, United States.

Immune thrombocytopenia (ITP) occurs with an incidence rate of 1.6 to 3.9 per 100,000 patient-years, which increases with age and has a slight female preponderance. Read More

Int J Pediatr Otorhinolaryngol 2019 Mar 4;121:41-45. Epub 2019 Mar 4.

Department of Clinical Medicine, Xinxiang Medical University, Xinxiang City, 453003, Henan Provice, China.

Objective: To compare the outcomes of adolescent patients with recurrent anterior epistaxis (RAE) treated with either silver nitrate cauterization or microwave ablation (MWA).

Study Design: and methods: In this prospective, randomized study, one hundred 13-18-year-old adolescents with RAE were assigned to two groups: the MWA group (n = 50) or the silver nitrate cauterization group (n = 50). Both groups were followed up for 12 months. Read More

Platelets 2019 8;30(4):535-539. Epub 2019 Mar 8.

a Servicio de Hematología y Oncología Médica, Hospital Universitario Morales Meseguer, Centro Regional de Hemodonación , Universidad de Murcia , Murcia , Spain.

This manuscript reviews pathogenic variants in RASGRP2, which are the cause of a relatively new autosomal recessive and nonsyndromic inherited platelet function disorder, referred to as platelet-type bleeding disorder-18 (BDPLT18)(OMIM:615888). To date, 18 unrelated BDPLT18 pedigrees have been reported, harboring 19 different homozygous or compound heterozygous RASGRP2 variants. Patients with this disease present with lifelong moderate to severe bleeding, with epistaxis as the most common and relevant bleeding symptom. Read More

J Korean Assoc Oral Maxillofac Surg 2019 Feb 26;45(1):43-47. Epub 2019 Feb 26.

ENT Clinic, S.M. alle Scotte University Hospital of Siena, Siena, Italy.

The characteristics of extra-nasopharyngeal angiofibromas tend to be different from angiofibromas of the nasopharynx according to patient gender, patient age, prevalence, affected site, pathogenesis, and clinical and epidemiological features. We report a case of an extra-nasopharyngeal angiofibroma in a 28-year-old man referred to the ENT Clinic for right-sided epistaxis, airflow impairment and nasal swelling. The right nostril was completely occluded works by a reddish-yellow mass that bled easily. Read More

Clin Ther 2019 Mar 4;41(3):518-529. Epub 2019 Mar 4.

Department of Medical Oncology, Jiangsu Cancer Hospital & Jiangsu Institute of Cancer Research & The Affiliated Cancer Hospital of Nanjing Medical University, Nanjing, China. Electronic address:

Purpose: Bevacizumab plus platinum-based doublet chemotherapy is recommended by the National Comprehensive Cancer Network as a category 1 regimen and is widely used in patients with advanced nonsquamous non-small-cell lung cancer (NS-NSCLC). In China, a common first-line chemotherapy for NS-NSCLC is the pemetrexed-platinum doublet regimen (Pem-Pt). However, limited evaluation exists to show the effectiveness of the Pem-Pt + bevacizumab (Bev) regimen in advanced NS-NSCLC. Read More

J Craniofac Surg 2019 Feb 9. Epub 2019 Feb 9.

Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Ostrava.

Background: The authors present a series of 5 patients with anterior epistaxis in which a transcaruncular endoscopic approach was used for the anterior ethmoidal artery coagulation (AEA).

Methods: Six AEA coagulations (5 unilateral, 1 bilateral) using the transcaruncular endoscopic approach were performed in 5 patients with anterior epistaxis resistant to conservative measures. An incision was made between the plica semilunaris of conjunctiva and the lacrimal caruncle. Read More

Paediatr Child Health 2019 Feb 15;24(1):54-55. Epub 2019 Feb 15.

Canadian Paediatric Society, Acute Care Committee, Ottawa, Ontario.

This practice point applies to children aged 90 days through 17 years who have typical, newly diagnosed primary immune thrombocytopenia (ITP). Current recommendations on management and information from recent studies are summarized with the goal of decreasing variable practice among providers and improving patient-centred care. Options for initially managing young patients with ITP who experience bruising, petechiae, or occasional mild epistaxis not interfering with daily living include observation without pharmacotherapy as a first-line option. Read More

Br J Neurosurg 2019 Mar 4:1-4. Epub 2019 Mar 4.

a Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán , Mexico City , Mexico.

Diffuse cerebral angiomatosis is a rare disorder of the brain and only 5 cases have been reported to date. We report a 16-year-old female patient who presented to the emergency department with seizures. The patient had no hereditary syndromes, no epistaxis, no skin lesions and no telangiectasia. Read More