Annals of the Royal College of Surgeons of England
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Ann R Coll Surg Engl · Jul 2003
Surgical management of primary hyperparathyroidism - results of a national survey.
During the last decade, the surgical management of primary hyperparathyroidism has been limited to those patients with symptoms or complications of the disease and most surgeons have advocated routine bilateral neck exploration. Several recent articles, however, have supported the role of early surgical intervention and minimally invasive surgery for these patients. The aim of this study was to define the current surgical management of primary hyperparathyroidism in the UK and Ireland. ⋯ This survey demonstrates marked variation in pre-operative localisation and surgical management of patients with primary hyperparathyroidism. The majority of surgeons in the UK and Ireland currently perform bilateral neck exploration with or without pre-operative localisation.
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Ann R Coll Surg Engl · Jul 2003
Case ReportsIntubated, ventilating patients with complete tracheal transection: a diagnostic challenge.
Tracheal transection is a rare injury after blunt trauma. The presence of complete tracheal transection in the intubated, ventilating patient is even more rare and constitutes a major diagnostic challenge. The liberal use of computed tomography (CT) scans as an adjunct to endoscopy is paramount.
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Ann R Coll Surg Engl · Jul 2003
An audit of post-splenectomy prophylaxis--are we following the guidelines?
Asplenic individuals have major difficulties coping with specific infections (e.g. Streptococcus pneumoniae). This is an audit to look at a district general hospital's compliance with published guidelines for immunisations and antibiotic prophylaxis post-splenectomy. ⋯ Results are comparable with other published studies, but are still unsatisfactory for many splenectomy patients. Vaccination rates must be improved and more information given to patients and GPs to allow for appropriate follow-up care.
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Ultrasound is a non-invasive, non-ionising radiation modality which is highly successful at soft tissue imaging. Groin pain from an occult hernia can be a difficult clinical diagnosis made easier by good imaging. The aim of this study was to demonstrate the accuracy of ultrasound in diagnosing and typing the groin hernia, which could lead to its justification of use in the imaging of the occult hernia. ⋯ This study confirms that ultrasound can accurately diagnose groin hernias and this may justify its use in the assessment of the occult hernia.
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Ann R Coll Surg Engl · May 2003
Expect the best, prepare for the worst: surgeon and patient expectation of the outcome of primary total hip and knee replacement.
A cross-sectional study of 100 surgeons and 370 patients awaiting primary total hip or knee replacement was carried out. Oxford hip or knee score questionnaires were sent to the surgeons and patients. They were asked to predict the level of symptoms expected 6 months following surgery. ⋯ There was a significant difference between the patients' and surgeons' expectations of the results of total knee and hip replacement surgery. The surgeons expected better results than the patients. We believe that this is the first study that directly compares surgeon and patient expectations of lower limb arthroplasty.