Background:One of the main issues with pressurized metered dose inhalers(pmDI)is that some patients find it difficult to use it ***:This study was carried out to compare the effect of traditional verbal counseling and...
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Background:One of the main issues with pressurized metered dose inhalers(pmDI)is that some patients find it difficult to use it ***:This study was carried out to compare the effect of traditional verbal counseling and that of adding an inhalation training device,such as Flo-Tone or Clip-Tone,along with a smartphone application on the incidence of inhalation technique mistakes and the pulmonary function of asthmatic adults and ***:The lung function of those in the advanced counseling group significantly improved on the second visit(pmproved on the third visit(pmean number of mistakes in regard to the steps in inhalation technique decreased significantly(pmartphone applications in addition to traditional verbal counseling for teaching asthmatic adults and children the correct inhalation technique steps using pmDI resulted in a significant improvement in pulmonary function and a significant reduction in the number of inhalation technique mistakes,compared to traditional verbal counseling alone.
AIm: To analyzes the clinical, paraclinical, therapeutical and evolutive features of nasopharyngeal carcinoma(NPC).mETHODS: All the patients treated for a nasopharyngeal carcinoma between 2000 and 2013 in the Ear-Nose...
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AIm: To analyzes the clinical, paraclinical, therapeutical and evolutive features of nasopharyngeal carcinoma(NPC).mETHODS: All the patients treated for a nasopharyngeal carcinoma between 2000 and 2013 in the Ear-NoseThroat Department of the military Hospital of Tunis, Tunisia were collected in this study. Eighty-three patients signed a written consent prior to study enrollment. The gender ratio(m/W) was 6.5 with a median age of 49 years(range 16-85). The median follow up time was 37 mo(18 to 108 mo). The evolution, during and after the end of therapy, was assessed on clinical biological and radiological exams. Different parameters were analyzed and compared to other series: complications of chemo and radiotherapy, recurrence of the disease, metastasis and overall survival ***: Of the 83 patients of our study, 15% had T1 tumors, 20% had T2, 23% had T3 and 41% had T4 disease. At the time of diagnosis, 14% of the patients had a cranial nerve deficit. Only 12 patients had exclusive radiotherapy and the remaining of our patients had concomitant radio chemotherapy. Iatrogenic complications were diagnosed in 53% of the cases: radioepithelitis(28%), radiodermatitis(9%), xerostomia(17%), osteoradionecrosis(3%), cerebral radionecrosis(1%) and a pancytopenia(17%). The follow-up period varied from 18 to 108 mo(average: 37 mo). During the first six months after treatment, a persistence of the disease was found in 11% of patients, while a recurrence of the cancer was diagnosed in 6% and distant metastasis developed in 14% of the patients. Fifteen patients needed remedial chemotherapy for a relapse or metastasis and five had palliative chemotherapy for very advanced cases. We report 3 cases of death during the follow-up. CONCLUSION: Despite its excellent radio-chemotherapy response, and general good prognosis, a careful follow-up of patients with NPC is necessary to detect and manage any iatrogenic complication, locoregional recurrence or metastasis of the disease.
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