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1.
Ir Med J ; 108(4): 123-4, 2015 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-26016308

RESUMEN

Epistaxis affects up to 60% of people. The basic first aid management of epistaxis is clearly stated in the literature and guidelines. Anecdotal evidence would suggest that these principles are not understood by patients and are not being conveyed to patients by their doctors. The aim was to assess current knowledge of epistaxis first aid management and identify the principle source of education in epistaxis control. This was a single centre cross-sectional study. The study population included those presenting to otolaryngology outpatients with epistaxis. 20 patients participated in this study over a 7 month period. Five (25%) patients did not use compression during an episode of epistaxis. Nine (60%) patients that used the compression technique failed to compress the lower one-third of the nose. Only two (10%) of patients identified their GP as having taught them first aid for epistaxis. Knowledge of epistaxis management is poor. Education regarding the basic principles of first aid for epistaxis may reduce morbidity and unnecessary consultations from health professionals.


Asunto(s)
Epistaxis/prevención & control , Primeros Auxilios/métodos , Técnicas Hemostáticas , Educación del Paciente como Asunto , Adolescente , Adulto , Anciano , Niño , Preescolar , Estudios Transversales , Humanos , Lactante , Persona de Mediana Edad , Presión , Adulto Joven
2.
Ir J Med Sci ; 181(2): 221-4, 2012 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-22200968

RESUMEN

BACKGROUND: The Internet hosts a large number of high-quality medical resources and poses seemingly endless opportunities to inform, teach, and connect professionals and patients alike. However, it is difficult for the lay person to distinguish accurate from inaccurate information. AIM: This study was undertaken in an attempt to assess the quality of information on otolaryngology available on the Internet. METHODS: Sixty appropriate websites, using search engines Yahoo and Google, were evaluated for completeness and accuracy using three commonly performed ENT operations: tonsillectomy (T), septoplasty (S), and myringoplasty (M). RESULTS: A total of 60 websites were evaluated (NT = 20, NM = 20, NS = 20). A total of 86.7% targeted lay population and 13.3% targeted the medical professionals. 35% of the sites included all critical information that patients should know prior to undergoing surgery and over 94% of these were found to contain no inaccuracies. Negative bias towards medical profession was detected in 3% of websites. CONCLUSIONS: In the current climate, with informed consent being of profound importance, the Internet represents a useful tool for both patients and surgeons.


Asunto(s)
Información de Salud al Consumidor/normas , Internet/normas , Otolaringología , Humanos , Miringoplastia , Tabique Nasal/cirugía , Tonsilectomía
3.
Ir Med J ; 101(1): 14, 2008 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-18369017

RESUMEN

Effective canal wall down mastoid surgery requires attention to certain key principles. We reviewed all cases requiring revision surgery at the Royal Victoria Eye and Ear Hospital over a 6 year period 1999-2004. Intraoperative findings which contributed to the need for revision surgery were identified. During this 6 year period 291 canal wall down mastoidectomies were performed. Thirty-seven were revision procedures. Nineteen (51%) cases were found to have recurrent or residual cholesteatoma. Sixteen (43%) cases had a high facial ridge, thirteen (35%) cases had an open middle ear. Nine (24%) cases had an inadequate meatus, 2 (5%) cases had a cavity sump. This study illustrated that a high facial ridge, an open middle ear segment, an inadequate meatoplasty and recurrent cholesteatoma were common intraoperative findings in this revision group. Eighty-nine percent of revision cases had dry, healed and safe cavities on follow up. Poor performance of the open technique is the most important factor in failure.


Asunto(s)
Colesteatoma del Oído Medio/cirugía , Apófisis Mastoides/cirugía , Adolescente , Adulto , Anciano , Niño , Preescolar , Colesteatoma del Oído Medio/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Procedimientos Quirúrgicos Otológicos/métodos , Procedimientos Quirúrgicos Otológicos/estadística & datos numéricos , Recurrencia , Reoperación , Estudios Retrospectivos , Resultado del Tratamiento
4.
Clin Otolaryngol ; 32(3): 204-7, 2007 Jun.
Artículo en Inglés | MEDLINE | ID: mdl-17550515

RESUMEN

Prophylactic antimicrobial therapy is defined as the administration of an antimicrobial agent prior to contamination of previously sterile tissues or fluids, in an attempt to reduce the microbial burden of intraoperative contamination. Prophylactic antimicrobial therapy should cover the anticipated floral contamination, with therapeutic levels from incision to closure. There is level I evidence to support the use of prophylaxis in clean-contaminated head and neck procedures and tonsillectomy, while level II evidence fails to support the use of prophylaxis in clean head and neck procedures. The aim of this study was to evaluate the use, timing and appropriateness of antimicrobial prophylaxis perioperatively, in otorhinolaryngological/head and neck procedures. A total of 34/51 (66%) patients were administered antimicrobial agents prophylactically. Six of 19 patients (42%) who ought to have received prophylaxis did not, while six of 13 (46%) of those who did not require it received it. Administration was unsuitably timed in 14 of 34 (41%) operations. This study demonstrates unnecessary administration of antimicrobial agents perioperatively, subclinical intraoperative antimicrobial levels for prophylaxis and inconsistent documentation regarding prophylaxis in otorhinolaryngological/head and neck procedures in a general ENT unit.


Asunto(s)
Profilaxis Antibiótica , Enfermedades Otorrinolaringológicas/cirugía , Infección de la Herida Quirúrgica/prevención & control , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Niño , Preescolar , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estudios Prospectivos , Procedimientos Innecesarios
6.
Ir Med J ; 96(2): 50-1, 2003 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-12674155

RESUMEN

This article describes the technique of manipulation of nasal bones under local anaesthesia. With increased demand on day ward and in patient hospital beds there is a growing need to treat fractured nasal bones under local anaesthesia at the ENT clinic. Ten patients were treated in this fashion in the out patient setting. All had X rays confirming a fracture of the nasal bones. All ten had an obvious cosmetic deformity of the nose as a result of the fracture. All ten patients underwent satisfactory reduction under local anaesthesia and without the need for intra nasal manipulation to elevate overlapping bones. Reduction of nasal bones in the clinic under local anaesthesia should become the accepted practice where there is a deformity but no overlap of the nasal bones.


Asunto(s)
Anestésicos Locales , Fracturas Óseas/terapia , Manipulaciones Musculoesqueléticas , Hueso Nasal/lesiones , Femenino , Humanos , Masculino , Procedimientos Ortopédicos
7.
J Laryngol Otol ; 116(4): 285-7, 2002 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-11945190

RESUMEN

One hundred and eight parotidectomies performed by a single consultant were reviewed. Eighty-five patients had primary parotid disease, 23 patients had extra-parotid primaries. Pleomorphic adenoma was the most common histological diagnosis. In patients with primary parotid disease, a post-operative temporary facial nerve palsy was noted in 15 patients, with a further four developing a permanent palsy. Patients with metastatic disease to the parotid had a poor prognosis.


Asunto(s)
Adenoma Pleomórfico/cirugía , Glándula Parótida/cirugía , Neoplasias de la Parótida/secundario , Neoplasias de la Parótida/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Traumatismos del Nervio Facial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades de las Parótidas/cirugía , Complicaciones Posoperatorias , Pronóstico , Estudios Retrospectivos
8.
J Laryngol Otol ; 115(7): 590-2, 2001 Jul.
Artículo en Inglés | MEDLINE | ID: mdl-11485599

RESUMEN

We present a case report of a lady with a laryngocele and a squamous cell carcinoma of the larynx. The pathogenesis of the relationship between these two entities is discussed and the literature reviewed. This association means a carcinoma must be outruled if a laryngocele is detected clinically or radiologically.


Asunto(s)
Carcinoma de Células Escamosas/complicaciones , Divertículo/complicaciones , Enfermedades de la Laringe/complicaciones , Anciano , Anciano de 80 o más Años , Carcinoma de Células Escamosas/diagnóstico por imagen , Divertículo/diagnóstico por imagen , Femenino , Humanos , Enfermedades de la Laringe/diagnóstico por imagen , Neoplasias Laríngeas/complicaciones , Neoplasias Laríngeas/diagnóstico por imagen , Tomografía Computarizada por Rayos X
10.
J Laryngol Otol ; 115(11): 938-9, 2001 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11779318

RESUMEN

Post-pneumonectomy syndrome is an unusual condition, that can occur a variable period of time after a patient has had a pneumonectomy. Management of this syndrome has been described using a number of different techniques, often with considerable mortality. We present a case report where this condition was treated successfully by insertion of an expandable Nitinol stent. This is the first time this technique has been described to treat this condition, and we feel it may be the procedure of choice in managing these patients.


Asunto(s)
Bronquios , Disnea/patología , Neumonectomía/efectos adversos , Stents , Aleaciones , Broncografía , Constricción Patológica/diagnóstico por imagen , Constricción Patológica/etiología , Constricción Patológica/terapia , Disnea/diagnóstico por imagen , Disnea/terapia , Femenino , Humanos , Persona de Mediana Edad , Síndrome , Factores de Tiempo , Tomografía Computarizada por Rayos X
11.
J Laryngol Otol ; 114(11): 878-80, 2000 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-11144842

RESUMEN

The incidence of laryngeal tuberculosis is increasing worldwide. To ensure early diagnosis it is important for physicians and otolaryngologists to recognize its cardinal signs and symptoms. We present two recent cases of laryngeal tuberculosis that presented to our department. We outline potential pitfalls in diagnosis, and highlight the importance of obtaining a tissue diagnosis. The literature is reviewed, and the treatment options outlined.


Asunto(s)
Tuberculosis Laríngea/diagnóstico por imagen , Broncoscopía , Diagnóstico Diferencial , Humanos , Neoplasias Laríngeas/diagnóstico , Masculino , Persona de Mediana Edad , Radiografía
12.
Eur J Surg Oncol ; 23(6): 509-12, 1997 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-9484920

RESUMEN

Small cell carcinoma of the oesophagus is an uncommon malignancy. Only 272 cases have been reported to date. Inconsistency in therapeutic approaches reflects the paucity of individual experience and the unsatisfactory response to current management strategies. We report 11 cases drawn from a series of 1012 cases of oesophageal malignancy and perform a statistical analysis on treatment and survival data of 189 cases drawn from the world literature. Small cell carcinoma of the oesophagus was seen to have an incidence of 1%. Seven of 11 patients were female. A variety of therapeutic modalities were employed, and the median survival was 6.6 months. Statistical analysis of these and worldwide data showed a significant survival advantage for patients who received multimodality therapy.


Asunto(s)
Carcinoma de Células Pequeñas , Neoplasias Esofágicas , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma de Células Pequeñas/diagnóstico , Carcinoma de Células Pequeñas/terapia , Terapia Combinada , Neoplasias Esofágicas/diagnóstico , Neoplasias Esofágicas/terapia , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del Tratamiento
13.
Diagn Cytopathol ; 12(1): 56-8, 1995 Feb.
Artículo en Inglés | MEDLINE | ID: mdl-7789248

RESUMEN

A 63-yr-old woman with systemic lupus erythematosus (SLE) diagnosed 12 mo previously and treated with prednisolone and cyclophosphamide presented with recent fever and dyspnoea. The etiology of a 3 cm diameter centrally cystic coin lesion in the lower lobe of the left lung was obscure. Blood cultures and sputum examination had been non-contributory, and the diagnosis of Nocardia asteroides infection was initially made by cytologic examination of material obtained by lung fine-needle aspiration (FNA). It is notoriously difficult to detect this organism by conventional sputum examination or with histologic sections, and it has rarely been detected by lung FNA. If this organism is demonstrated, appropriate microbiologic cultures for confirmation and susceptibility testing should be instituted. Long-term antimicrobial therapy is needed. In this case, complete resolution of the lung lesion followed 5 mo of therapy.


Asunto(s)
Enfermedades Pulmonares/patología , Pulmón/patología , Nocardiosis/patología , Biopsia con Aguja , Femenino , Humanos , Enfermedades Pulmonares/microbiología , Persona de Mediana Edad
14.
Diagn Cytopathol ; 10(4): 320-5, 1994.
Artículo en Inglés | MEDLINE | ID: mdl-7924804

RESUMEN

The major diagnostic histopathological features of moderate to severe Alzheimer's disease (AD) are amyloid rich neurofibrillary tangles (NFTs) and neuritic plaques (NPs) containing beta A4 peptide. As the frequency of stereotactic brain biopsies is increasing, the diagnostic cytological features of AD are of relevance. Our study presents the brain smear features of five autopsied patients with moderate to severe AD both clinically and pathologically. NFTs and NPs were identified in 100% of smears. Amyloid neuropil threads (NTs), a more recently identified hallmark of AD, were also seen in all smears. Segmental beta A4 peptide deposition within vessels, clustering of plaques around capillaries, and NTs were more obvious by the smear technique than in histological sections.


Asunto(s)
Enfermedad de Alzheimer/patología , Encéfalo/patología , Citodiagnóstico/métodos , Humanos
15.
Aust N Z J Surg ; 57(4): 239-42, 1987 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-3477222

RESUMEN

At the Queen Victoria Medical Centre between 1981 and 1984, 2920 fine needle aspirates of the breast were examined with an overall diagnostic accuracy of 97% and a sensitivity of 80%. This high diagnostic accuracy combined with the ease and complication-free nature of the procedure has meant that fine needle aspiration (FNA) has become an important part of the investigation and management of breast disease within the breast service of the Queen Victoria Medical Centre.


Asunto(s)
Mama/patología , Australia , Biopsia con Aguja/instrumentación , Biopsia con Aguja/métodos , Enfermedades de la Mama/diagnóstico , Enfermedades de la Mama/patología , Diagnóstico Diferencial , Estudios de Evaluación como Asunto , Femenino , Humanos
16.
J Behav Med ; 8(1): 21-35, 1985 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-3981626

RESUMEN

This study investigated the relation between an individual's tendency to tolerate and/or report discomfort and the amount of life change experienced by that individual. The role of attention in this relation was also examined and manipulated through instruction. Eighty college freshman were selected and divided into three groups (high, medium, low) as a function of scores obtained on the College Schedule of Recent Experience (CSRE). Participants were asked to experience two known discomforting stimuli, the cold pressor and loud broad-band noise. Dependent measures included participant's tolerance time, report of discomfort, and amount of attention paid to each of the stimuli. Results indicated that "high"-life change groups tolerated the two discomforting stimuli significantly less than either the "low"- or the "medium"-life change groups. Neither discomfort ratings nor attention was significantly different across groups. Findings are discussed in relation to epidemiological studies of the life change and illness relation.


Asunto(s)
Acontecimientos que Cambian la Vida , Dolor/psicología , Adolescente , Adulto , Nivel de Alerta , Atención , Humanos , Masculino , Ruido/efectos adversos , Estimulación Luminosa , Umbral Sensorial
17.
Trustee ; 36(11): 33-4, 36, 1983 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-10265603

RESUMEN

The author has some practical and useful suggestions for chairpersons to help keep board meetings running smoothly and efficiently, from the physical arrangement of the room to the formulation of and adherence to agendas.


Asunto(s)
Consejo Directivo/organización & administración , Procesos de Grupo , Hospitales , Humanos
18.
Aust N Z J Psychiatry ; 13(4): 309-13, 1979 Dec.
Artículo en Inglés | MEDLINE | ID: mdl-295211
19.
Am J Physiol ; 231(4): 1018-23, 1976 Oct.
Artículo en Inglés | MEDLINE | ID: mdl-824957

RESUMEN

The rate of liver and muscle protein synthesis has been measured in 27 rats after feeding L-[U-14C]tyrosine in L-amino acid diets prepared as agar gels. Constant specific activity of the free tyrosine pool, as indicated by constant excretion of 14CO2, was reached within 2 h of feeding and was maintained for the remaining 6 h of the 8-h experiment. Muscle protein synthesis was decreased (P less than 0.05) in rats fed a 0.3% methionine diet compared with rats fed this diet supplemented with 0.51% cystine (fractional rate of synthesis, ks: 0.098 vs. 0.121). No effect (P greater than 0.05) of these diets on liver protein synthesis was observed (ks: 0.603 vs. 0.532). Protein synthetic rate was also determined by the constant-intravenous infusion technique in 17 rats fed unlabeled diets. The two techniques gave similar estimates. Restraint of the rats or the infusion of saline had no measurable effect on the rate of protein synthesis in rats fed labeled diets. This feeding technique is essentially equivalent to the constant-infusion technique and offers an easier, more physiological approach to achieving a steady state.


Asunto(s)
Hígado/metabolismo , Músculos/metabolismo , Biosíntesis de Proteínas , Tirosina/metabolismo , Radioisótopos de Carbono , Cistina/administración & dosificación , Dieta , Metionina/administración & dosificación , Proteínas Musculares/biosíntesis , Oxidación-Reducción , Nutrición Parenteral , Unión Proteica , Tirosina/administración & dosificación
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