Articles: patients.
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Skull Base Interd Ap · Nov 2003
Submental Orotracheal Intubation: An Alternative to Tracheotomy in Transfacial Cranial Base Surgery.
This retrospective study evaluated the safety and efficacy of submental intubation not only for trauma treatment but also for oncological cranial base surgery. The medical records of 24 patients who underwent submental intubation from 1996 to 2002 were reviewed. There were 6 procedures for craniofacial trauma, 12 transmaxillary approaches to the clivus for clivus chordomas, and 6 transmaxillary approaches to the cranial base for chondrosarcomas. ⋯ It avoids the complications associated with tracheostomy. It also permits considerable downward retraction of the maxilla after a Le Fort I osteotomy and is associated with good clival exposure. Furthermore, it does not interfere with maxillomandibular fixation at the end of the surgery.
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Annals of Saudi medicine · Nov 2003
Regional experience with newborn screening for sickle cell disease, other hemoglobinopathies and G6PD deficiency.
Newborn screening for sickle cell disease, other hemoglobinopathies and G6PD deficiency is one of the most important means of decreasing mortality and morbidity in high prevalence areas. Nine years experience in newborn screening in Qatif Central Hospital are summarized. ⋯ Prevention and early identification of sickle cell disease, other major hemoglobinopathies and G6PD deficiency remains the cornerstone of management of these diseases. The main barriers to successful neonatal screening for hemoglobinopathies are the level of the education and deficiency in manpower. We recommend including newborn screening for hemoglobinopathies and G6PD deficiency in the national hypothyroidism screening program in the eastern province and the establishment of a special center for hemoglobinopathies with a high standard of medical care in Qatif.
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When it comes to health care, everybody - medical professionals, policymakers and patients - wants to know what works and what does not. Every day clinicians debate, implicitly or explicitly, whether new research findings are convincing enough to change the way they practice. The quality of research varies, and so much information is being produced that it is impossible for anyone to know and evaluate it all. ⋯ Steps in designing and conducting meta-analysis involve describing the purpose of meta-analysis, designing a research question, searching for studies, specifying study selection (inclusion and exclusion) and appraisal criteria, deciding data extraction procedures (including statistical reanalysis), assessing combinability of studies, selecting an analytical strategy (use of models and sensitivity analysis), anticipating systematic errors (biases) and limitations, and presenting and disseminating results of the meta-analysis. The Cochrane Collaboration is significantly contributing to the development of this area of research and making a noticeable dent on the practice of evidence based medicine across the globe. Meta-analytic approaches have been used to resolve long standing controversies in the field of medicine, including dermatology.
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To compare the diagnostic accuracy of emergency department (ED) physicians with the World Health Organization (WHO) case definition in a large community-based SARS (severe acute respiratory syndrome) cohort. ⋯ Physician clinical judgement was more accurate than the WHO case definition. Reliance on the WHO case definition as a SARS screening tool may lead to an unacceptable rate of misdiagnosis. The SARS case definition must be revised if it is to be used as a screening tool in emergency departments and primary care settings.
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In recent years, cases of scurvy have mainly been described in populations at risk. The prevalence and risk factors for hypovitaminosis C among hospitalized patients in a department of internal medicine are largely unknown. ⋯ Hypovitaminosis C is frequent in hospitalized patients but should be interpreted according to the presence or absence of an acute phase response. The main risk factors are living conditions and excessive alcohol and tobacco consumption.