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1.
PJ Commerford 《Cardiovascular journal of Africa》2015,26(4):151-Aug;26(4):151
2.
3.
S Mukherjee K Abhinav PJ Revington 《Annals of the Royal College of Surgeons of England》2015,97(1):66-72
IntroductionThe aim of this study was to determine the incidence and patterns of cervical spine injury (CSI) associated with maxillofacial fractures at a UK trauma centre.MethodsA retrospective analysis was conducted of 714 maxillofacial fracture patients presenting to a single trauma centre between 2006 and 2012.ResultsOf the 714 maxillofacial fracture patients, 2.2% had associated CSI including a fracture, cord contusion or disc herniation. In comparison, 1.0% of patients without maxillofacial trauma sustained a CSI (odds ratio: 2.2, p=0.01). The majority (88%) of CSI cases of were caused by a road traffic accident (RTA) with the remainder due to falls. While 8.8% of RTA related maxillofacial trauma patients sustained a CSI, only 2.0% of fall related patients did (p=0.03, not significant). Most (70%) of the CSIs occurred at C1/C2 or C6/C7 levels. Overall, 455, 220 and 39 patients suffered non-mandibular, isolated mandibular and mixed mandibular/non-mandibular fractures respectively. Their respective incidences of CSI were 1.5%, 1.8% and 12.8% (p=0.005, significant). Twelve patients with concomitant CSI had their maxillofacial fractures treated within twenty-four hours and all were treated within four days.ConclusionsThe presence of maxillofacial trauma mandates exclusion and prompt management of cervical spine injury, particularly in RTA and trauma cases involving combined facial fracture patterns. This approach will facilitate management of maxillofacial fractures within an optimum time period. 相似文献
4.
B. Lawler Registrar PJ Sambrook Senior Lecturer † AN Goss Professor Director ‡ 《Australian dental journal》2005,50(S2):S54-S59
Usually dentists in Australia give patients oral antibiotics after dentoalveolar surgery as a prophylaxis against wound infection. When this practice is compared to the principle of antibiotic prophylaxis in major surgery it is found to be at variance in a number of ways. In major surgery, the risk of infection should be high, and the consequences of infection severe or catastrophic, before antibiotic prophylaxis is ordered. If it is provided then a high dose of an appropriate spectrum antibiotic must be present in the blood prior to the first incision. Other factors which need to be considered are the degree of tissue trauma, the extent of host compromise, other medical comorbidities and length of hospitalization. Standardized protocols of administration have been determined and evaluated for most major surgical procedures. Dentoalveolar surgery is undoubtedly a skilled and technically challenging procedure. However, in contrast to major surgical procedures, it has a less than five per cent infection rate and rarely has severe adverse consequences. Dentoalveolar surgery should be of short duration with minimal tissue damage and performed in the dental chair under local anaesthesia. Controlled studies for both mandibular third molar surgery and placement of dental implants show little or no evidence of benefit from antibiotic prophylaxis and there is an adverse risk from the antibiotic. This review concludes that there is no case for antibiotic prophylaxis for most dentoalveolar surgery in fit patients. In the few cases where it can be considered, a single high pre-operative dose should be given. 相似文献
5.
6.
Andreas Jovanovic Engelbert A. J. M. Schulten Pieter J. Kostense Gordon B. Snow Isaac van der Waal 《Journal of oral pathology & medicine》1993,22(10):459-462
The aim of the present study was to evaluate the possible relationship between tobacco smoking and alcohol drinking and the anatomical sites of squamous cell carcinoma (SCC) of the lip and oral cavity. For this purpose, a case-case study has been performed in 690 patients. The study was focused on the relative risk (RR) or developing SCC at various (sub)sites, for smokers and drinkers of alcohol (divided into moderate and heavy users) relative to non-smokers and non-drinkers. Estimates of ratios of these relative risks were obtained. The relative risk associated with tobacco smoking, adjusted for the use of alcohol, appeared to be highest for SCC in the retromolar area, followed by the floor of mouth, whereas the lowest RR was found in the cheek mucosa. For alcohol drinking, adjusted for tobacco smoking, RR of SCC of the floor of mouth was significantly higher than for the tongue, whereas the RR of SCC of the cheek appeared to be lowest. Furthermore, this study suggests that the contrasts between relative risks, observed by anatomical site of oral SCC, are more pronounced for tobacco smoking than for the use of alcohol. The possible local and systemic factors responsible for these variations of susceptibility for tobacco and alcohol within the oral cavity are discussed. 相似文献
7.
Microbiological culture analysis of the tongue anaerobic microflora in subjects with and without halitosis 总被引:1,自引:0,他引:1
AC Donaldson D McKenzie MP Riggio PJ Hodge H Rolph A Flanagan J Bagg 《Oral diseases》2005,11(S1):61-63
Objective: Determination of the microflora present on the tongue dorsum of subjects with and without halitosis using conventional microbiological culture methods.
Methods: Twenty-one halitosis and 20 control patients were recruited using a strict clinical protocol. Samples were collected from the posterior dorsum of the tongue using a sterile brush. Each sample was vortex mixed for 30 s and serial 10-fold dilutions to 10−7 were carried out. Samples were plated onto fastidious anaerobe agar (FAA) and FAA enriched with vancomycin. These were incubated under anaerobic conditions for 10 days at 37°C. Strict anaerobes were identified by metronidazole sensitivity and bacteria were identified to genus level by a combination of colony morphology, Gram staining and biochemical and enzymatic tests (rapid ID 32 A).
Results: The predominant species in test and control groups were Veillonella sp. and Prevotella sp. Greater species diversity was found in the halitosis samples compared with controls. The halitosis samples contained an increased incidence of unidentifiable Gram-negative rods, Gram-positive rods and Gram-negative coccobacilli.
Conclusions: There was no obvious association between halitosis and any specific bacterial genus. The increased species diversity found in halitosis samples suggests that halitosis may be the result of complex interactions between several bacterial species. The role of uncultivable bacteria may also be important in contributing to this process. 相似文献
Methods: Twenty-one halitosis and 20 control patients were recruited using a strict clinical protocol. Samples were collected from the posterior dorsum of the tongue using a sterile brush. Each sample was vortex mixed for 30 s and serial 10-fold dilutions to 10
Results: The predominant species in test and control groups were Veillonella sp. and Prevotella sp. Greater species diversity was found in the halitosis samples compared with controls. The halitosis samples contained an increased incidence of unidentifiable Gram-negative rods, Gram-positive rods and Gram-negative coccobacilli.
Conclusions: There was no obvious association between halitosis and any specific bacterial genus. The increased species diversity found in halitosis samples suggests that halitosis may be the result of complex interactions between several bacterial species. The role of uncultivable bacteria may also be important in contributing to this process. 相似文献
8.
G Pals V R?s?nen S G Meuwissen R R Frants P J Kostense A W Eriksson 《Scandinavian journal of clinical and laboratory investigation》1987,47(1):29-33
The determination of serum pepsinogen A (= pepsinogen I) levels is of clinical importance in the study of duodenal ulcer, atrophic gastritis and gastric cancer. In the present study two different quantitative immunological techniques for serum pepsinogen A were compared: a radioimmunoassay (RIA) (Helsinki) and an enzyme-linked immunosorbent assay (ELISA) (Amsterdam). Serum samples of 177 subjects with various gastric diseases were tested in a double blind study. The correlation was excellent (r = 0.954 in the range 0-760 micrograms/l and r = 0.971 in the range 0-100 micrograms/l). The functional relationship between ELISA (x) and RIA (y), determined by weighted model II regression, was y = 1.12x-0.54. Initially the use of goat anti-PGA in the ELISA resulted in falsely high values in about 10% of the individuals. This was caused by circulating antibodies cross-reacting with goat IgG. This artefact was eliminated by pre-incubation of all samples with non-immune goat serum. 相似文献
9.
The provision of renal replacement therapy for adults in England and Wales: recent trends and future directions 总被引:1,自引:7,他引:1
Roderick PJ; Ferris G; Feest TG 《QJM : monthly journal of the Association of Physicians》1998,91(8):581-587
We assessed the level of provision of renal replacement therapy for adults
in England and Wales. All autonomous main renal units in England (n = 52)
and Wales (n = 5) were surveyed in 1996. Data for England were compared to
the 1993 National Renal Review. The acceptance rate in England 1995 was 82
(80-85) per million population (p.m.p.) compared with 67 (65-70) p.m.p. in
1991-2. The rate in 1995 in Wales was 109 (98- 122) p.m.p. The prevalence
rate in England was 476 p.m.p. at end-1995 compared to 393 p.m.p. in 1993,
in Wales it was 487 p.m.p. The number of main renal units in England did
not rise between 1993 and 1995; capacity was increased by use of more
treatment shifts and temporary haemodialysis stations, and by opening more
satellite units. The main growth was in hospital haemodialysis. There was
an uneven geographical distribution of services. Patients accepted were
older with more comorbidity. The use of better-quality processes of
dialysis increased. The steady-state position for RRT will not be reached
for over a decade. Health authorities will face continued pressure to fund
increases in quantity and quality improvements. A stronger evidence base of
the effectiveness of therapies, and a national registry to monitor the
equity and cost-effectiveness of services are needed.
相似文献
10.
Esther van 't Riet Marjan Alssema Josina M. Rijkelijkhuizen Piet J. Kostense Giel Nijpels Jacqueline M. Dekker 《Diabetes care》2010,33(1):61-66