Manifestações otirinolaringológicas de doenças granulomatosas : granulomatose de Wegner e sarcoídose do Cavum

Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2014

Predictors of Nasal Obstruction: Quantification and Assessment Using Multiple Grading Scales

Objective. To evaluate the association between nasal obstruction and (1) demographic factors, (2) medical history, (3) physical tests, and (4) nasal exam findings. Study Design. CASE SERIES: Methods. Chart review at a tertiary medical center. Results. Two hundred-forty consecutive patients (52.1 ± 17.5 years old, with a Nasal Obstruction Symptom Evaluation (NOSE) score of 32.0 ± 24.1) were included. Demographic factors and inferior turbinate sizes were not associated with NOSE score or Nasal Obstruction Visual Analog Scale (NO-VAS). A significant association was found between higher NOSE score on univariate analysis and positive history of nasal trauma (p = 0.0136), allergic rhinitis (p < 0.0001), use of nasal steroids (p = 0.0108), higher grade of external nasal deformity (p = 0.0149), higher internal nasal septal deviation grade (p = 0.0024), and narrow internal nasal valve angle (p < 0.0001). Multivariate analysis identified the following as independent predictors of high NOSE score: NO-VAS: ≥50 (Odds Ratio (OR) = 17.6 (95% CI 5.83-61.6), p < 0.0001), external nasal deformity: grades 2-4 (OR = 4.63 (95% CI 1.14-19.9), p = 0.0339), and allergic rhinitis: yes (OR = 5.5 (95% CI 1.77-18.7), p = 0.0041). Conclusion. Allergic rhinitis, NO-VAS score ≥ 50, and external nasal deformity (grades 2-4) were statistically significant independent predictors of high NOSE scores on multivariate analysis. Inferior turbinate size was not associated with NOSE scores or NO-VAS.

(Table T1) Pore-water strontium content, and Sr isotope composition and ages of pore waters and sedimentary carbonates of ODP Leg 171B sites

Strontium concentrations and 87Sr/86Sr values were measured on pore-water and sedimentary carbonate samples from sediments recovered at Sites 1049-1053 on the Blake Spur during Ocean Drilling Program Leg 171B. These sites form a 40-km-long depth transect extending along the crest of the Blake Spur from near the upper edge of the Blake Escarpment (a steep cliff composed of Mesozoic carbonates) westward toward the interior of the Blake-Bahama Platform. Although these sites were selected for paleoceanographic purposes, they also form a hydrologic transect across the upper eastern flank of the Blake-Bahama Platform. Here, we use pore-water strontium concentrations and isotopes as a proxy to define patterns of fluid movement through the flanks of this platform. Pore-water strontium concentration increases with depth at all sites implying that strontium has been added during sediment burial and diagenesis. The isotopic values decrease from seawater-like values in the shallow samples (~0.70913) to values as low as 0.707342 in one of the deepest samples (~625 meters below seafloor). The change in pore-water strontium isotopic values is independent of the strontium isotopic compositions predicted from the host sediment age and measured on bulk carbonate in some samples. In most cases the difference between predicted sediment strontium isotopic composition and measured value is less than ±2 about the mean of the measured strontium value. Both the increase in concentration and the decrease in the strontium isotope values with increasing depth indicate that strontium was expelled from older carbonates. The strontium concentration and isotope profiles vary between sites according to their proximity to the Blake-Bahama Platform edge. Profiles from Site 1049 (nearest the platform edge) show the greatest amount of mixing with modern seawater, whereas the site most distal to the platform edge (Site 1052) shows the most significant influence of older, deeper carbonates on the pore-water strontium isotopic composition.