A variety of catheters, stylets, and obturators have been used to assist with problems in airway management. Obturators specifically designed for airway use are now available in different sizes. The pediatric-size obturators (2.2 mm diameter) can be placed into the airways of most patients without apparent respiratory impairment. Use of ...

A 10-year retrospective study of the management of airway obstruction in 26 infants with Pierre Robin sequence was made. It was not possible when the infant was first seen to assess the future severity of the airway obstruction but later 3 distinct groups could be identified according to the airway ...

The World Hypertension League (WHL) is an association of antihypertensive leagues, hypertension societies, committees and other national bodies whose aim is to control hypertension in populations. The present paper is the fourth in a series of 'In the Focus Statements' on topics selected for their practical importance to the management ...

Technetium-99m labelled diethylenetriamine penta-acetate (99mTc-DTPA) was used to compare small solute absorption (clearance) from nasal, tracheobronchial, and bronchoalveolar airways in anaesthetised guinea pigs. 99mTc DTPA dissolved in saline was superfused through nasal and orolaryngeal catheters on to nasal and tracheobronchial airways; a small particle aerosol of nebulised 99mTc DTPA was ...

A kit for difficult intubation can be assembled quickly from vascular catheters and sheaths commonly available in surgical facilities. The kit provides for continuous oxygen administration throughout all phases of its application in difficult upper airway management. Such applications include stylet-guided endotracheal intubation, cricothyroid puncture, transtracheal ventilation, and translaryngeal catheter-guided ...

The Canadian Consensus Conference on Non-Pharmacological Approaches to the Management of High Blood Pressure reviewed in March, 1989 on its meeting in Halifax, Nova Scotia, data concerning the efficacy of eight interventional strategies used for controlling hypertension. These strategies were as follows: alcohol restriction, weight reduction, physical exercise, reduction of ...

Transillumination of the cervical airway with the light wand for blind intubation is a valuable adjunct to anesthesiologists and emergency room physicians, particularly for management of the complicated airway in which direct visualization of the larynx is not possible. However, as an alternative to traditional methods, this technique should be ...

On his retirement, George Entwisle MD, who served for eight years as Commissioner on the Maryland Commission on High Blood Pressure and Related Cardiovascular Risk Factors, was honored by the establishment of an annual lectureship at the University of Maryland School of Medicine, Department of Epidemiology and Preventive Medicine. We ...

PTV is an adjunct to airway management that can prove helpful in selected cases. Its speed and ease of performance are offset by the need for specialized equipment to accomplish it. This difficulty, combined with infrequent indications, makes PTV a rarely performed procedure. Nevertheless, it remains a viable airway management ...

The airway is the most important priority in the management of the severely injured patient. It is essential to open and clear the airway to allow free access of air to the distal endobronchial tree. Manual methods of opening the airway are described. Numerous methods for establishing definitive control of ...

Airway obstruction during the induction of general anesthesia remains a persistent problem in modern anesthesia practice, particularly in obstetric patients. Generally, a careful preoperative airway evaluation uncovers most abnormalities that might make intubation difficult. The planning and preparation for additional intubation equipment facilitate an anticipated difficult intubation. However, situations may ...

A statement of philosophy of management is a powerful declaration and one that must be continually reviewed. If it is to be accepted and recognized, the statement must reflect the true beliefs of management. The actions taken by management must also mirror those beliefs. We say "we believe"; the staff ...

Post-marketing surveillance in general practice represents an important part of the monitoring of adverse events associated with newly introduced drugs. Such a study of the angiotensin-converting enzyme inhibitor enalapril maleate has been undertaken in 11 710 patients with essential hypertension. Serious adverse events occurred in 1.7% of patients, though most ...

The response of known hypertensives to advice on sodium restriction was examined as part of a 5-year study on hypertension screening in family practice. The study comprised 34 family practices, pair-matched for location, activity level, and length of time in present practice. One practice in each matched pair was randomly ...

The general practice records of 2371 hypertensive patients on drug therapy in 12 practices were reviewed retrospectively. It was found that the mean systolic blood pressure of the patients had fallen by 29 mmHg and the mean diastolic pressure by 16 mmHg after one year of treatment and that there ...

A group of previously untreated obese hypertensive patients were started on a weight reduction programme supervised by two dietitians working in a general practice surgery. It was stressed from the beginning of the programme that reducing blood pressure was the purpose of the diet. The results of follow-up after six ...

A management-by-objective approach was used by the health care administration of the Kupat Holim Sick Fund to improve the detection and quality of treatment of hypertension in 20 family practices in Ashdod, Israel. The number of hypertensive patients in each practice was estimated from the age-sex register and this was ...

Based mainly on the practice and experience in China, the radiology of aortoarteritis, including plain film and angiographic manifestations and its correlation to clinical syndromes, is reviewed in this article. The preliminary results of percutaneous transluminal angioplasty in the management of renovascular hypertension due to aortoarteritis are described briefly and ...

A diagnosis of malignant hypertension was recorded for 165 patients in the national morbidity study between 1970 and 1973. Three patients with benign hypertension were selected as age- and sex-matched controls for each case. The general practitioners in the study were asked to complete a further questionnaire about the patients ...

A case of acute epiglottitis in a 79-year-old man is presented describing the airway and anaesthetic management. Early reports of adult epiglottitis advocated observation or tracheostomy for airway management. Recent reports stress early endotracheal intubation. Unlike the paediatric age group adults may present with differing degrees of airway obstruction, epiglottic ...

An audit of a practice which has a policy of opportunistic screening for raised blood pressure showed that 80 per cent of patients born between 1930-44 had been screened in the last five years. Patients who had not been screened were identified and contacted; this increased the percentage screened to ...

The case records of an urban teaching practice in Britain were studied to assess the performance of the practice in the detection and management of hypertension. The prevalence of hypertension among adults was 9%. The original diagnosis of hypertension was made by the patients' own general practitioner in two-thirds of ...

The management of failure to intubate the trachea during emergency Caesarean section in a 116.7-kg woman is described. General anaesthesia was continued with the aid of a Gordon and Don Michael Esophageal Gastric Tube Airway. The forward displacement of the larynx caused by the tube in the oesophagus improved the ...

HT-ATTENDING is a computer system being developed to critique a physician's approach to the pharmacologic management of essential hypertension. The concept of having a computer critique a physician's plan of management (Medical Plan-Analysis) has already been implemented in ATTENDING, a system whose domain is anesthesia management. HT-ATTENDING extends this approach ...

An accurate age-sex register was used to identify patients in a practice who might be suffering from hypertension and to record the criteria on which the diagnosis was based. Information about blood pressure readings, diagnostic labels and treatment at the time of diagnosis were noted. The definition of hypertension sufficient ...

In 1974 eight general practitioners decided to co-operate in a hypertension screening exercise in their practices. The reasons for the survey and the methodology are described and the results of screening over 28,000 patients are given. The cut-off point for normal diastolic blood pressure was 89 mmHg and 23,979 (85 ...

In this third report on the management of hypertension by general practitioners and hospital physicians we review hospital outpatient practice in a representative sample of 90 new patients and 436 returning patients attending the clinics of three Edinburgh hospitals. Seventyeight per cent of the new patients were seen by a ...

Low patient cooperation erodes many of the proven benefits of antihypertensive therapy. Over the last few years, there have been important advances in our understanding of the nature and management of patient compliance in hypertension and other chronic illness. In this article we review the theoretical foundation of compliance behavior; ...

Hypertension is a major health problem for industrialized as well as developing countries, especially those with sizeable black populations. The author analyzes various aspects of hypertension in black and other populations with emphasis on contributing factors and therapeutic approaches.

Hemifacial microsomia is a rare congenitally acquired dentofacial deformity characterized by unilateral hypoplasia of the hard and soft tissues of the face and cranium. Associated anomalies of the vertebrae and hypopharynx cause perioperative airway management to be difficult. The case of a patient with severe heimfacial microsomia, cervical spine fusion, ...

We investigated the management of a group of 322 hypertensive patients by 71 general practitioners in the Lothian Health Board Area by a survey of the general practitioners' records. Eighty-five per cent of patients were diagnosed by the general practitioner and 57 per cent were cared for entirely by him. ...

The comprehensive diagnostic evaluation once recommended for hypertension is no longer practical or necessary. In the majority of cases, a thorough history, physical examination, and basic laboratory workup are sufficient to determine the severity of the hypertension and to detect target organ damage. Secondary hypertension is truly rare in clinical ...

The operative repair of craniofacial defects presents the surgeon with critical problems regarding airway management. Thirty-seven per cent of our series of 100 children operated upon for a variety of cranofacial deformities had some difficulty in airway management. Those patients with mandibular dysostoses and those requiring midface advancement (Le Fort ...

Progressive uremia is the hallmark of many renal diseases, some reversible. The signs and symptoms tend to parallel the declining glomerular filtration rate. With an understanding of the usual progression, the physician is equipped to plan therapy. Hypertension must be treated. Phosphorus binding, protein limitation and fluid and electrolyte control ...

Most street hallucinogens contain either LSD or phenycyclidine HCl (PCP). Because the acute phase of LSD and PCP mimic several other drugs and conditions, it is important to exclude these other possibilities. When faced with LSD or PCP, "talking down" usually suffices for the mild case; management becomes more complex ...

Endometrial carcinoma developed in a teenager with obesity, hypertension, hyperestrinism and lack of diurnal variation of plasma cortisol concentration. She underwent total abdominal hysterectomy and bilateral salpingo-oophorectomy and is receiving estrogen therapy. Her six obese sisters and her mother, who are at risk for endometrial carcinoma, are being managed conservatively.

Hypertension is a very common and important finding. The family physician is ideally suited to manage this problem on a long term basis. To do so, he must have an adequate practical plan of diagnosis and management. This article describes one approach to the problem.

A series of 24 patients with cirrhosis have undergone mesentericocaval shunt operations for the relief of portal hypertension. Overall the results have been satisfactory. Four of the five patients treated as an emergency and 17 of the 19 who had the operation two to six weeks after haemorrhage had been ...

Toe oedema is more commonly associated with lymphoedema but is frequently seen in patients with venous hypertension. In the long-term it leads to toe deformity and it is essential that the problem is managed. Brenda King outlines how to apply toe bandages and the long-term management once the problem is ...

Graduated compression hosiery has an important role in the management of venous leg ulcers by counteracting chronic venous hypertension. The historically high rates of venous ulcer recurrence can be significantly reduced by optimizing compliance with the wearing of support hosiery. This is facilitated by providing information, practical support and opportunities ...

Varicose veins occur in approximately 15-20 per cent of the UK population (Callam, 1994). Although there is no universally accepted definition of a varicose vein, Callam (1999) has described it as 'a superficial vein of the lower limb, which has permanently lost its valvular efficiency and, because of the resultant ...