J Postgrad Med
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The usual terrible triad of the elbow consists of posterior dislocation of the elbow, radial head fracture and coronoid fracture. We describe a new variant of the terrible triad of the elbow consisting of fracture of the capitellum involving the full length of the trochlea and posterolateral dislocation of the elbow associated with coronoid fracture (type 1 Regan-Morrey). ⋯ The elbow was stable after stabilization of the capitellum fracture through a collateral approach. Coronoid fragment was left alone, as it was a very small fragment.
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Telemedicine research addressing user satisfaction abounds in academic literature. Results from patient satisfaction studies indicate exceptionally high levels of perceived satisfaction, often above the rates of expected satisfaction for traditional forms of health delivery. Results from provider satisfaction studies are also generally quite positive; however, data from providers point to higher concerns with delivery barriers and challenges. ⋯ First, many of the studies exhibit serious methodological weaknesses related to design and data collection instruments. In addition, the construct of satisfaction is largely undefined and is not clear. Even recognizing these caveats, the results of the study do offer some evidence that patient satisfaction will not impede the deployment of telemedicine, but provider satisfaction merits additional study.
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Randomized Controlled Trial
Opioid sparing during endotracheal intubation using McCoy laryngoscope in neurosurgical patients: the comparison of haemodynamic changes with Macintosh blade in a randomized trial.
There is conflicting data in literature to show that the McCoy laryngoscope is less stressful and opioids can actually be avoided during laryngoscopy and intubation with the use of this laryngoscope. ⋯ McCoy laryngoscope blade is less stressful and fentanyl pretreatment is not necessary to attenuate haemodynamic responses with its use in ASA I and II patients.
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Telemedicine has the potential to help facilitate the delivery of health services to rural areas. In the right circumstances, telemedicine may also be useful for the delivery of education and teaching programmes and the facilitation of administrative meetings. In this paper reference is made to a variety of telemedicine applications in Australia and other countries including telepaediatrics, home telehealth, critical care telemedicine for new born babies, telemedicine in developing countries, health screening via e-mail, and teleradiology. ⋯ An overriding imperative is to focus on the clinical problem first with careful consideration given to the significant organisational changes which are associated with the introduction of a new service or alternative method of service delivery. For telemedicine to be effective it is also important that all sites involved are adequately resourced in terms of staff, equipment, telecommunications, technical support and training. In addition, there are a number of logistical factors which are important when considering the development of a telemedicine service including site selection, clinician empowerment, telemedicine management, technological requirements, user training, telemedicine evaluation, and information sharing through publication.