The Medical journal of Australia
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Comparative Study Clinical Trial
Dry chemistry pathology in general practice. An assessment of utilisation, perceptions and impact on patient care. Non-Laboratory Pathology Working Party of the National Health Technology Advisory Panel.
To examine the impact of the introduction of dry chemistry pathology in general practice. ⋯ General practices varied greatly in their use of the analysers. This experience of dry chemistry pathology in general practice suggests that its application is limited.
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To determine the outcome in patients with subarachnoid haemorrhage from a ruptured aneurysm, particularly in those in whom the diagnosis was delayed. ⋯ Earlier diagnosis, allowing early definitive surgical treatment, may improve the outcome in aneurysmal subarachnoid haemorrhage. The results of a computed tomography scan are diagnostic only if they are positive--a negative result must be interpreted in conjunction with the clinical picture.
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Comparative Study
A two-year survey of aneurysmal subarachnoid haemorrhage.
To analyse the demographic characteristics and outcomes of patients with rupture of an intracranial aneurysm--to make a comparison with other published results, and to determine whether improvements in management can be made. ⋯ A speedier referral of these patients to a neurosurgical unit may lead to an improvement in outcome.
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Ventilator support is commonly withdrawn from unconscious patients who cannot breathe when it is reasonably certain that their condition is permanent and further medical treatment is futile. However, there is no consistent practice with permanently unconscious patients who can breathe but cannot swallow, despite the fact that ongoing treatment of these patients is similarly futile. ⋯ A review of the medical, legal and ethical literature shows that there is much disagreement about when and how to withdraw tube feeding from patients with severe brain damage. Criteria for withdrawal of treatment should include the permanent unconsciousness of the patient, the permanent absence of a life-sustaining function, the elapse of sufficient time to be certain about the prognosis, the concurrence of at least one independent and qualified medical specialist, and the informed consent of the patient's family or other legally qualified agents.