Articles: patients.
-
Epidural fibrosis is seen as a common phenomenon among postlumbar laminectomy syndrome patients, contributing to approximately 60% of symptom recurrence. Percutaneous epidural lysis of adhesions has been described as a modality to effectively manage chronic low back pain secondary to epidural fibrosis. Forty-five patients were randomly assigned, with fifteen patients in the control group, or Group I, who were treated with conservative modalities of treatments, including medication, physical therapy, and an exercise program; and, thirty patients in Group II, who were treated with percutaneous epidural adhesiolysis and hypertonic saline neurolysis. ⋯ The study also showed that overall health status improved significantly in the treatment group in all parameters with average pain, physical health, mental health, functional status, psychological status and narcotic intake. Analysis also showed that this is a cost-effective treatment, with cost for 1-year improvement of quality of life at $2693. In conclusion, epidural adhesiolysis with hypertonic saline neurolysis performed on a 1-day basis is an effective modality of treatment in managing chronic low back pain in patients who failed to respond to fluoroscopically directed epidural steroid injections and also were demonstrated not to have facet joint mediated pain.
-
This study was designed to investigate the clinical efficacy of fluoroscopically guided therapeutic cervical selective nerve root blocks (SNRBs) in patients with whiplash induced cervical radicular pain. Study design was restrospective with independent clinical review. Twenty two patients were included. ⋯ Good or excellent results were observed in 14% of patients. In higher functioning individuals a significantly greater (F=.0427) improvement in pain of 48.9% was observed. In these initial findings suggest that fluoroscopically guided therapeutic SNRBs, except possibly for higher functioning individuals, are not effective in the treatment of whiplash induced cervical radicular pain.
-
Pediatr Crit Care Me · Apr 2001
The costs associated with nosocomial bloodstream infections in the pediatric intensive care unit.
To assess the operational and subsidiary costs and length of stay (LOS) attributable to nosocomial bloodstream infections (BSI) in a pediatric intensive care unit (PICU). DESIGN: Matched case-control study. SETTING: Sixteen bed PICU in a 250-bed tertiary-care pediatric hospital. PATIENTS: Cases with BSI were prospectively identified from PICU patients who developed a nosocomial BSI from August 1996 to July 1998. Controls were PICU patients who were matched for age, severity of illness, diagnosis, and admission date who did not develop a nosocomial BSI. ⋯ The costs and LOS associated with nosocomial BSI in patients admitted to the PICU were significantly higher than controls.
-
To review the physiology and cardiovascular effects of the commonly used intravenous electrolytes. ⋯ Intravenous potassium chloride, calcium chloride, magnesium sulphate, sodium and potassium phosphate, sodium bicarbonate and hypertonic saline can be used effectively to alter the haemodynamic status and manage cardiac arrhythmias. However, their indications are selective and complications may occur, so careful administration and monitoring are required with their use.
-
J Assoc Acad Minor Phys · Mar 2001
Comparative StudyDescribing and predicting frequent users of an emergency department.
The objective of this study was to examine the pattern of emergency department (ED) utilization among a cohort of ED users over a 3-year period and to identify factors predicting use. Billing records were used to track one hospital's cohort of adult frequent ED users (> or = 3 visits/per year) over a 3-year period. Frequent and (< 3 visits/per year) infrequent users were compared by age, gender, marital status, insurance status, and hospitalization rates. ⋯ Other factors (including age, gender, marital status, insurance status, and hospitalization following an ED visit) were not significant independent predictors of frequent ED use. Our data revealed that the past history of frequent ED use is predictive of future frequent ED use. Studies are needed on effective interventions to determine the reasons for continued frequent ED use.