Primary myxoid liposarcoma of the orbit.

Orbital liposarcoma is a rare and usually unsuspected neoplasm. Over a five-year period three female patients aged 22, 71, and 77 years presented with primary myxoid liposarcoma of the orbit. The management of one patient was complicated by a history of orbital decompression for suspected thyroid eye disease. The tumour infiltrates locally beyond a deceptive pseudocapsule, and surgery has to be radical to be effective.     

Outpatient liver biopsy: one man's experience

As an academically based gastroenterologist, I performed 94 outpatient liver biopsies over a 42-month period, using the standard suction technique. Differential blood count and vital signs were monitored, with no statistically significant postbiopsy changes noted in the group at large. One patient required admission to the hospital for bleeding, and six patients required intramuscular analgesics for pain at the biopsy site. Four patients had bradycardia, and one of them required atropine for bradycardia and hypotension. Outpatient liver biopsy is a safe procedure with low morbidity and complication rate. It would appear that prolonged monitoring is not necessary.     

Office-based laryngeal laser surgery: a review of 443 cases using three wavelengths.

BACKGROUND: Unsedated office-based laser surgery (UOLS) of the larynx and trachea has significantly improved the treatment options for patients with laryngotracheal pathology including recurrent respiratory papillomas, granulomas, leukoplakia, and polypoid degeneration. UOLS delivered by flexible endoscopes has dramatically impacted office-based surgery by reducing the time, costs, and morbidity of surgery. OBJECTIVES: To review our experience with 443 laryngotracheal cases treated by UOLS. METHODS: The laser logbooks at the Center for Voice and Swallowing Disorders were reviewed for UOLS, and the medical and laryngological histories were detailed, as were the treatment modalities, frequencies, and complications. RESULTS: Of the 443 cases, 406 were performed with the pulsed-dye laser, 10 with the carbon-dioxide laser, and 27 with the thulium: yttrium-aluminum-garnet laser. There were no significant complications in this series. A review of indications and wavelength selection criteria is presented. CONCLUSION: Unsedated, office-based, upper aerodigestive tract laser surgery appears to be a safe and effective treatment option for many patients with laryngotracheal pathology.     

Guidelines for dispensing medications

Federal and state codes exist regarding administering and dispensing medications and there is variation between the two. Recognition of the differences is imperative for the athletic trainer, who has traditionally dispensed these agents in compliance with established legal and professional guidelines. Statutes that apply to classifying, documenting, prescribing, dispensing, labeling, and housing medications by athletic trainers are presented as a baseline for this article. State and local regulations should be consulted to clarify differences existing at various governmental levels. These guidelines are provided to assist athletic trainers in properly dispensing medications.     

Manpower shortage: multiple competency and cross-training.

The terms "cross training" and "multi-competency" have been much confused--Ms. Wright clearly defines the terms and gives some observations on the manpower shortage. Since cost containment will be a fact of life for the '90s, she presents thoughtful strategies to increase productivity and to combat the shortage. Her perspective on changes occurring in our profession over the past two decades provides readers with a thoughtful article.     

Mental health patients in primary health care services in Nepal

Patients attending two primary care settings in Nepal (a village health post and a district hospital outpatient department) were screened for psychiatric morbidity using the Self Reporting Questionnaire. Approximately one-quarter of all patients screened were found to have psychiatric morbidity. Women presenting were found to have higher frequency of "psychiatric caseness" than men. All these psychiatric patients presented with physical complaints, none with psychological, and the most common physical symptoms presented were abdominal pain, headache and cough. Health worker recognition of these cases was 29% in the health post and 0% in the hospital. Conclusions are drawn regarding the need for sufficient and relevant psychiatric teaching in health worker curriculae.