Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery
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Otolaryngol Head Neck Surg · Aug 2008
ReviewEvaluation of meta-analyses in the otolaryngological literature.
To evaluate the quality of meta-analyses written on otolaryngological topics and define areas that can be improved upon in future studies. ⋯ The quality of meta-analyses on otolaryngological topics is moderate. Future meta-analyses can be improved upon by following evidence-based guidelines for the reporting of meta-analyses, which include the use of a validity assessment tool, and consulting with an author familiar with meta-analysis methodology.
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Otolaryngol Head Neck Surg · Aug 2008
Randomized Controlled Trial Comparative StudyA comparison of postoperative pain and complications in tonsillectomy using BiClamp forceps and electrocautery tonsillectomy.
To compare the efficacy and safety of BiClamp forceps tonsillectomy (BT) with standard electrocautery tonsillectomy (ET) in terms of postoperative pain and complication rates. ⋯ The use of BiClamp forceps in tonsillectomy reduces the intraoperative blood loss and postoperative pain score, and facilitates an early return to normal diet and activity.
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Otolaryngol Head Neck Surg · Aug 2008
ReviewMaking difficult ethical decisions in patient care during natural disasters and other mass casualty events.
Recent experiences in the United States with unprecedented terrorist attacks (9/11) and a devastating natural disaster (Hurricane Katrina) have demonstrated that the medical care of mass casualties during such disasters poses ethical problems not normally experienced in civilian health care. It is important to 1) identify the unique ethical challenges facing physicians who feel an obligation to care for victims of such disasters and 2) develop a national consensus on ethical guidelines as a resource for ethical decision making in medical disaster relief. ⋯ It is necessary to develop a national consensus on the ethical guidelines for physicians who care for patients, victims, and casualties of disasters, and to formulate a virtue-based, yet practical, ethical approach to medical care under such extreme conditions. An educational curriculum for medical students, residents, and practicing physicians is required to best prepare all physicians who might be called upon, in the future, to triage patients, allocate resources, and make difficult decisions about treatment priorities and comfort care. It is not appropriate to address these questions at the time of the disaster, but rather in advance, as part of the ethics education of the medical profession. Important issues for resolution include inpatient and casualty triage and prioritization, medical liability, altered standards of care, justice and equity, informed consent and patient autonomy, expanding scope of practice in disaster medicine, and the moral and ethical responsibilities of physicians to care for disaster victims.