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排序方式: 共有1343条查询结果,搜索用时 15 毫秒
31.
Potter James Sat Parmar Khalid Hussain Prav Praveen 《The British journal of oral & maxillofacial surgery》2021,59(1):82-85
INTRODUCTIONTracheal stenosis is a late and usually non-life threatening complication of surgical and percutaneous tracheostomies (PDT) as well as delayed endotracheal extubation.METHODSWe undertook a retrospective review of all patients who underwent a surgical tracheostomy over a 10 year period. Patients were included in the study if they had CT or MRI imaging of the tracheostomy site both pre-operatively and six or more weeks post operatively. Patients whose imaging was not available were excluded (n = 3) as were those patients who still had a tracheostomy in situ (n = 8). In total 91 patients were included in the study. In the same period 1170 surgical tracheostomies were performed by the maxillofacial surgeons. The images were analysed by a radiologist and the degree of stenosis reported.RESULTSAll 91 patients underwent a tracheostomy with a window. 83 patients did not demonstrate any stenosis. Looking at the remaining 8 patients with stenosis: 6 patients had stenosis of less than 25%, 1 patient had stenosis between 25-50% and 1 patient had stenosis greater than 50%. Both patients with stenosis greater than 25% had more than one surgical tracheostomy.CONCULSIONWe have shown that the risk of stenosis is 8.8%, lower than often quoted in literature, and when it occurs it is likely to be symptomatic only in severe stenosis. Our main risk of stenosis was repeat surgical tracheostomies which also seems to be linked to a greater degree of stenosis. 相似文献
32.
AbstractBackground: Natural opiate users constitute a large proportion of opioid dependent individuals in India, and enjoy socio-cultural sanction in certain parts of the country. However, no study has assessed the pathways to care among this population in India.Objective: To assess the pathways to care among treatment-seeking natural opiate dependent individuals.Method: This cross sectional, explorative study was conducted at a tertiary care drug treatment centre located in North India. A total of 125 male participants aged >18?years, seeking treatment for natural opiate dependence from our outpatient clinic were included. A semi-structured proforma and WHO mental health encounter form was applied to assess socio-demographic, treatment details and pathways to care.Results: The mean age was 46.17 (±11.98) years. Poppy husk (phukki/doda/posht) was the most common primary natural opiate used (84%). First point of treatment contact was addiction psychiatrist (n?=?90; 72%) in majority. First time treatment seeking was either by self-referral (60.8%) or referral by relatives and friends (24.8%) with mean time lag of 18.63?years after the onset.Conclusion: Natural opiates dependent patients seek treatment late in the course of their illness, often directly from a tertiary addiction treatment centre. Barriers to seek treatment needs to be addressed. 相似文献
33.
R.D. Deshmukh D.J. Dhande K.S. Sachdeva A.N. Sreenivas A.M.V. Kumar M. Parmar 《The Indian journal of tuberculosis》2018,65(1):41-47
Background
Multidrug-resistant tuberculosis (MDR-TB) is emerging as a major public health problem globally. Treatment success rates in MDR-TB across the globe are not encouraging as completing MDR-TB treatment successfully is challenging due to high proportion of lost to follow up.Methods
Using qualitative methods and grounded theory approach, in-depth interviews were conducted with MDR-TB patients and treatment providers. The social cognitive framework was explored as a way to guide understanding of the factors affecting treatment adherence among MDR-TB patients.Results
Multiple factors influenced patient's decision to adhere to MDR-TB treatment. Self-motivation, awareness about disease and treatment, counselling support, family support, nutritional support and social support were important drivers for successful treatment. Providers related that motivational counselling, nutritional support, family support and social support encouraged treatment adherence.Conclusion
To improve MDR-TB treatment adherence, a patient-centric approach should be considered at the programmatic level. There is a need to formulate strategy that includes motivational counselling, nutritional supplementation and social support mobilisation for treatment adherence. Participants suggested a Patient Support Group led treatment care model for better adherence and treatment success rates in MDR-TB treatment. 相似文献34.
Bashir Q Khan H Orlowski RZ Amjad AI Shah N Parmar S Wei W Rondon G Weber DM Wang M Thomas SK Shah JJ Qureshi SR Dinh YT Popat U Anderlini P Hosing C Giralt S Champlin RE Qazilbash MH 《American journal of hematology》2012,87(3):272-276
A total of 149 patients with multiple myeloma (MM) who received allogeneic hematopoietic stem cell transplantation (allo-HCT) with myeloablative (MAC; n = 38) or reduced-intensity conditioning (RIC; n = 110) regimens at MD Anderson Cancer Center were evaluated. Of the total, 120 (81%) patients had relapsed or had refractory disease. Median age of MM patients was 50 (28-70) years with a followup time of 28.5 (3-164) months. The 100-day and 5-year treatment related mortality (TRM) rates were 17% and 47%, respectively. TRM was significantly lower with RIC regimens (13%) vs. 29% for MAC at 100 days (P = 0.012). The cumulative incidence of Grade II-IV acute graft-versus-host disease (GVHD) was 35% and chronic GVHD was 46%. PFS and OS at 5 years were 15% and 21%, respectively. In multivariate analysis, allo-HCT for primary remission consolidation was associated with longer PFS (HR 0.35; 95% CI, 0.18-0.67) and OS (HR 0.29; 95% CI 0.15-0.55), while absence of high-risk cytogenetics was associated with longer PFS only (HR 0.59; 95% CI 0.37-0.95). We observe that TRM has decreased with the use of RIC regimens, and long-term disease control can be expected in a subset of MM patients undergoing allo-HCT. Further studies should be conducted in carefully designed clinical trials in this patient population. 相似文献
35.
Cellan V. Thomas Kevin G. McMillan Pete Jeynes Tim Martin Sat Parmar 《The British journal of oral & maxillofacial surgery》2013
Reconstructing maxillary defects can be challenging. In particular, Class 3 and 4 defects require careful planning.3 Bone for reconstruction must be placed in the correct three dimensional (3D) position in order to achieve a good cosmetic and functional result. Correct size and positioning of the harvested bone also enables placement of dental implants and allows rehabilitation. 相似文献
36.
DH Mallon M Kostalas FJ MacPherson A Parmar A Drysdale E Chisholm 《Annals of the Royal College of Surgeons of England》2013,95(4):258-262
Introduction
Fine needle aspiration (FNA) is a safe and quick method of diagnosing superficial lumps, which aids preoperative planning. However, FNA of the parotid gland has not gained the widespread acceptance noted in other head and neck lumps. The aim of this study was to determine the ability of FNA of the parotid gland to differentiate benign and malignant disease, and to determine the impact on surgical outcome.Methods
A retrospective analysis of 201 consecutive parotid operations with preoperative FNA in a large district hospital in the UK was performed. The diagnostic characteristics were calculated for benign and malignant disease, and the impact on surgical procedure was determined.Results
In identifying benign disease, FNA has a sensitivity of 85% and a specificity of 76%. In detecting malignant disease, FNA has a sensitivity and specificity of 52% and 92% respectively. A false positive on FNA was associated with a higher incidence of neck dissection.Conclusions
FNA is a useful diagnostic test. However, owing to low sensitivity, it is necessary to interpret it in the context of all other clinical information. 相似文献37.
Emery-Dreifuss muscular dystrophy (EDMD) is an inherited disorder affecting skeletal and cardiac muscles and characterized by muscular atrophy, contractures, and cardiomyopathy with conduction defects. It can be X-linked or autosomal. Not all patients with EDMD develop heart involvement, but heart disease associated with EDMD can be unpredictable and may be life threatening. In rare cases heart problems may be the first symptom of EDMD. Early recognition of heart involvement is of utmost importance as placement of a pacemaker and/or defibrillator may be lifesaving. 相似文献
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40.
Vital pulpotomy in the primary dentition: attitudes and practices of community dental staff in Wales
Hingston EJ Parmar S Hunter ML 《International journal of paediatric dentistry / the British Paedodontic Society [and] the International Association of Dentistry for Children》2007,17(3):186-191
OBJECTIVE: The International Agency for Research on Cancer (IARC) has classified formaldehyde as carcinogenic to humans, leaving the dental profession to look for viable substitutes to formocresol in the vital pulpotomy technique. This study was designed to examine the attitudes and practices of Community Dental Service (CDS) staff in Wales in relation to vital pulpotomy for primary molars 18 months following the IARC's press release. METHODS: The study employed a postal questionnaire. RESULTS: Questionnaires were returned by 79 (78.2%) of the CDS staff surveyed, yielding a sample of 65 dentists practising the technique. The most commonly used pulpotomy agents were formocresol, paraformaldehyde and ferric sulphate. Twenty-seven (41.5%) dentists expressed concern regarding their preferred pulpotomy agent and 17 (26.2%) were considering changing their technique. Only one respondent (1.5% of the sample) routinely took preoperative radiographs; follow-up radiographs were routinely taken by only three dentists (4.6%). Only 44 respondents (67.7%) always used local anaesthesia for this form of treatment. Amalgam was the most commonly used restorative material. Twenty-two respondents (33.8%) stated that they would pulp treat a primary molar on more than one occasion. CONCLUSIONS: The results of this study suggest that there is need for relevant continuing professional development courses for CDS staff in Wales. 相似文献