OBJECTIVETo evaluate whether the use of power Doppler to confirm the presence or absence of blood flow within retained products of conception (RPC) in women with an incomplete miscarriage can predict subsequent successful expectant management.METHODSProspective observational study in the Acute Gynaecology and Early Pregnancy Unit (AGEPU) at Nepean Hospital from ...

There are many recent and ongoing changes in the practice of medicine from a business standpoint as well as in overall practice management. Economic and lifestyle desires have pushed many physicians to a decision point of whether or not to join a large multispecialty group or to sell their practice ...

Objective:To provide an update on the ever-increasing role that embolisation plays in the practice of otolaryngology.Method:A literature search was performed during November 2008. The Medline, Embase, PubMed and Cochrane databases were searched. This resulted in 285 papers relevant for review.Conclusion:The role of embolisation has expanded greatly to include the management ...

Personalized medicine refers to the application of an individual's biological fingerprint - the comprehensive dataset of unique biological information - to optimize medical care. While the principle itself is straightforward, its implementation remains challenging. Advances in pharmacogenomics as well as functional assays of vascular biology now permit improved characterization of ...

Background Prevention of vascular disease is an important and challenging role for general practice. Various professional bodies in Australia have published best practice guidelines that address the major behavioural and physiological risk factors for vascular disease. Although these guidelines provide consistent advice and have been widely disseminated, they have not ...

High-flow priapism is uncommon particularly in children. While it is a non-emergent condition, delayed management may result in secondary vascular deformities. Embolisation is not commonly offered as first-line management because of the risk of potentially severe ramifications regarding sexual function, particularly with cases of bilateral penile arteriolacunar fistulae. We demonstrate ...

Diabetic foot ulcers can cause considerable disability and morbidity. The complex pathology requires expert and in-depth assessment and management to achieve the best outcomes. Assessment is underpinned by attention to four key points: vascular sufficiency, neurological/sensory status, appropriateness of footwear, and presence of foot deformity. The 'shopping list' for management ...

This article assesses the current mandates on conflict of interest issues as they affect the practice of community-based vascular surgery and the pharmaceutical and medical technology industries and expresses the views of a private practice vascular surgeon. Scenarios where conflict of interest may occur are presented with assessments on how ...

Perioperative risk in vascular medicine is particularly high due to the increased prevalence of cardiovascular comorbidity. Therefore, it is of the utmost importance that during periprocedural management the patient remains in good general condition and that the patient is mobilized as soon as possible. Along with implementation of minimally-invasive techniques ...

It has been 50 years since fluorescein angiography was developed as a clinical procedure by 2 medical students at Indiana University. The story of its discovery and the recognition of its value to ophthalmology involve a combination of insight and serendipity. Fluorescein had been in use clinically for more than ...

For the last 40 years, most of the research and publications on hemodialysis access, has focused on the management of its complications e.g. thrombosis, infection, aneurysms. In other words, a damage control strategy. While this is undoubtedly an important part of access management, it is a deficient reactive strategy that ...

Report on the meeting: Frontiers in Cell Biology and Medicine, University of York, UK, 26-29 September 2010.

Induced pluripotent stem (iPS) cells are derived from adult somatic cells via reprogramming with ectopic expression of four transcription factors (Oct3/4, Sox2, c-Myc and Klf4; or, Oct3/4, Sox2, Nanog and Lin28), by which the resultant cells regain pluripotency, namely, the capability exclusively possessed by some embryonic cells to differentiate into ...

Portal hypertensive gastropathy and gastric antral vascular ectasia are gastric mucosal lesions that can cause chronic gastrointestinal haemorrhage and, consequently, chronic anaemia, in patients with cirrhosis. Although chronic anaemia is the most common clinical manifestation, these entities may also lead to acute gastrointestinal bleeding. Despite similar clinical manifestations, their pathophysiology ...

Securing the airway in emergency is among the key requirements of appropriate prehospital therapy. The Easytube (Ezt) is a relatively new device, which combines the advantages of both an infraglottic and supraglottic airway. Our goal was to evaluate the effectiveness and the safety of use of Ezt by emergency physicians ...

Any patient can have a difficult airway, but obese patients have anatomic and physiologic features that can make airway management particularly challenging. Obesity does not seem to be an independent risk factor for difficult intubation but is one of the several factors that need to be considered as part of ...

Objective To describe the profile and success rates of emergency endotracheal intubation conducted by the Queensland Royal Flying Doctor Service aeromedical retrieval team comprising a doctor and flight nurse. Method Each intubator completed a study questionnaire at the time of each intubation for indications, complications, overall success, drugs utilised and ...

Hypertension is prevalent in the population at large and among hospitalized patients. Little has been reported regarding the attitudes and patterns of care of physicians managing nonemergent elevated blood pressure (BP) among inpatients. Resident physicians in internal medicine (IM), family medicine (FM), and surgery were surveyed regarding inpatient BP management. ...

The aim of the present paper is to review the literature regarding video-laryngoscopes (Storz V-Mac and C-Mac, Glidescope, McGrath, Pentax-Airway Scope, Airtraq and Bullard) and discuss their clinical role in airway management. Video-laryngoscopes are new intubation devices, which provide an indirect view of the upper airway. In difficult airway management, ...

Airway management is germane to safe patient care. Keys to management of difficult airways (DAs) are the "Right People, Right Parts, and Right Place" (R3P3). Successful management of DA requires clinicians who have adequate training, experience, and equipment. Policies were implemented to optimize the management of DAs. One identified inpatients ...

The aim of this study was to determine if use of a standardized airway data collection sheet can survey airway management practices in an emergency department. Success rates and trends from the authors' facility have been benchmarked against the National Emergency Airway Registry (NEAR). This study included all patients requiring ...

PURPOSE: Although guidelines for difficult airway management have been published, the extent to which consultant anesthesiologists follow these guidelines has not been determined. The purpose of this study is to observe how consultant anesthesiologists manage a "cannot intubate, cannot ventilate" (CICV) scenario in a high-fidelity simulator and to evaluate whether ...

Hypertension is emerging in many developing nations as a leading cause of cardiovascular mortality, morbidity and disability in adults. In sub-Saharan African (SSA) countries it has specificities such as occurring in young and active adults, resulting in severe complications dominated by heart failure and taking place in limited-resource settings in ...

Regenerative medicine offers new tools with which to tackle disorders for which there is currently no good therapeutic option. The trachea is an ideal organ in which to explore the clinical potential of tissue engineering because severe large airway disease is poorly managed by conventional treatments, and the success of ...

Traditionally, anaesthetists have provided airway management skills on resuscitation teams. Because advanced life support (ALS) courses teach practical airway management, some UK hospitals have dropped anaesthetists from cardiac arrest teams. Does the ALS course give non-anaesthetists adequate skills to manage an airway during a cardiac arrest? We recruited adult surgical ...

Dentists need to play a bigger role in managing airway development and craniofacial formation even though the relationship between the airway, breathing and malocclusion remains quite controversial. Certainly the airway, the mode of breathing and craniofacial formation are so interrelated during growth and development that form can follow function and ...

This review article discusses the pathophysiology and management of pulmonary hypertension (PH) in the newborn unit. The discussion revolves around 2 aspects: persistent pulmonary hypertension in the newborn, which is seen in the first few weeks of life, and PH associated with chronic lung disease in the post neonatal period ...

The oral and maxillofacial surgeon frequently encounters and manages difficult airways. Knowledge of and calm progression by practitioner and staff through different means to ventilate and manage a difficult airway are crucial. Practitioners should become comfortable with different types of alternative or rescue airways in order to intervene quickly in ...

There are few conditions in emergency medicine as potentially challenging and high-risk as the difficult or failed airway. The emergency physician must be able to anticipate the difficult or failed airway, recognize associated physiologic deficits, and plan accordingly. Preparation, pretreatment strategies, and selection of alternative airway devices may mitigate the ...

Endometriosis is a common condition that affects as many as 10% to 20% of women of reproductive age. Because of the subtle clinical signs and symptoms and limitations of imaging methods, the diagnosis is frequently delayed or missed, with serious consequences including hypertension, hydronephrosis, and loss of kidney function. We ...

Management of airway in trauma victim with penetrating cervical/thoracic spine injury has always been a challenge to the anaesthesiologist. Stabilisation of spine during airway manipulation, to prevent any further neural damage, is of obvious concern to the anaesthesiologist. Most anaesthesiologists are not exposed to direct laryngoscopy and intubation in lateral ...

A postal survey was conducted to investigate difficult airway management, training and equipment availability among Fellows of the Australian and New Zealand College of Anaesthetists in Queensland. The survey aimed to determine practise patterns for predicted difficult airways and investigate equipment availability. Participants were asked to nominate an induction method, ...

Since its first introduction in the 1980s, transjugular intrahepatic portosystemic shunt has played an increasingly important role in the management and treatment of the complications of portal hypertension. In 2005, the American Association for the Study of Liver Diseases published the Practice Guidelines for the use of transjugular intrahepatic portosystemic ...

The 'can't intubate, can't ventilate' scenario is a nightmare for all clinicians who manage airways. Cricothyroidotomy is one of several emergency airway management techniques. Cricothyroidotomy is a short-term solution which provides oxygenation, not ventilation, and is not a definitive airway. Although there are tests which can help predict whether an ...

BACKGROUND: The burden of chronic noncommunicable diseases continues to rise in South Africa, leading to high rates of morbidity and mortality. The control of hypertension is far from optimal because of factors such as inadequate patient understanding of the condition and its therapy, as well as poor adherence to prescribed ...

AIM: Retrospective analysis of the prescribing practice and cost of ambulatory treatment of hypertension and its common complications--heart failure, sequelae of cerebrovascular disease, and angina pectoris. METHODS: Analysis of 3,240 reimbursable ambulatory prescriptions for hypertension, heart failure, sequelae of cerebrovascular disease and angina pectoris according to the complexity of the ...

1. Although congenital ureteral obstruction is a common disorder in infants, its pathophysiology remains poorly understood and its clinical management continues to be debated. During the past decade, the surgical management of non-symptomatic hydronephrosis in children has become more conservative, but the long-term physiological consequences of this new policy are ...

SUMMARY: Supraglottic devices have changed the face of the airway management. These devices have contributed in a big way in airway management especially, in the difficult airway scenario significantly decreasing the pharyngolaryngeal morbidity. There is a plethora of these devices, which has been well matched by their wider acceptance in ...

PURPOSE: The purpose of this Continuing Professional Development module (CPD) is to update clinicians regarding a systematic approach for anticipated difficult airway management. PRINCIPAL FINDINGS: The focus of the approach should be directed towards providing adequate oxygenation and ventilation and not necessarily intubating the trachea. The purpose of preoperative airway ...

BACKGROUND: Most patient chronic disease self-management interventions target single-disease outcomes. We evaluated the effect of a tailored hypertension self-management intervention on the unintended targets of glycosylated hemoglobin (HbA1c) and low-density lipoprotein cholesterol (LDL-C). METHODS: We evaluated patients from the Veterans Study to Improve the Control of Hypertension, a 2-year randomized ...

Both the American Society of Anesthesiologists and the Difficult Airway Society of the United Kingdom have published guidelines for the management of unanticipated difficult intubation. Both algorithms end with the 'can't intubate, can't ventilate' scenario. This eventuality is rare within elective anaesthetic practice with an estimated incidence of 0.01-2 in ...

Adequate equipment is one prerequisite for advanced, out of hospital, airway management. There are no data on current availability of airway equipment on UK rescue helicopters. An internet search revealed all UK rescue helicopters, and a questionnaire was sent to the bases asking for available airway management items. We identified ...

Stridor is caused by turbulent flow through a narrow airway. Common causes of stridor are deep neck infection, malignancy, angioneurotic oedema, trauma and congenital anomalies like laryngomalacia. The majority of these conditions can progress rapidly to complete airway obstruction. These conditions are traditionally managed with one of the following techniques: ...

INTRODUCTION: Australian emergency nurses have a primary role in advanced airway management. Consequently, they need to be competent in, and have a systematic approach to, airway preparation, management and rescue. AIM: The aims of the study were to (i) identify all patients undergoing endotracheal intubations in the emergency department; (ii) ...

Central airway obstruction is a complex problem that requires a careful multidisciplinary evaluation. The central airways can be obstructed by intrinsic exophytic tumor, by extrinsic mass compression or by dynamic collapse. Both benign and malignant processes can obstruct the airway lumen. This article reviews the core principles and techniques available ...

Difficult airway management is a dilemma for any anesthesiologist. Although practice guidelines and algorithms may help in such situations, the anesthesiologist's judgment and vigilance remain the primary means to save lives. In the following case, we encountered an acutely enlarging thyroid mass that was compromising the airway. This huge neck ...

Airway management is an essential component of the emergency medicine skill set. Management of the difficult airway may include airway adjuncts, including variants of laryngoscopic blades, supraglottic devices, stylets, and video laryngoscopy. These various airway adjuncts have certain advantages and disadvantages, and factors to be considered include ease of use, ...

Management of the airway is the first priority in any patient. Dealing with a difficult airway can be a challenge, whether or not it involves facemask ventilation, an intermediate airway device, laryngoscopy and intubation, or a surgical airway. Various scales predict which patient is likely to have a difficult airway. ...

Difficult airway management and maintenance of oxygenation remain the two most challenging tasks for anesthetists, while also being controversial items in terms of clinically based-evidence to support relevant guidelines in the literature. Nevertheless, different expert groups and scientific societies from several countries have published guidelines dedicated to the management of ...

Congenital upper airway obstruction can pose difficult problems immediately after birth. Newer strategies to maintain the airway in such situations include pharyngeal ventilation, the laryngeal mask airway and flexible fibreoptic intubation. These methods have decreased the potential for malformations such as Pierre Robin sequence to cause perinatal hypoxia. The most ...