ABSTRACT
This report describes an ethnographic study of document use by anaesthetists. In doing so, it focuses on the role of the preoperative risk assessment form as used in anaesthetic practice at a cardiothoracic hospital, and considers what would be the advantages and disadvantages of shifting the paper into the electronic form. Evidence from this case study is used to comment on how the practical use of documents by medical professionals can be fundamentally at odds with how the organization at large would like to use them. We argue that hospital trusts need to take into account this practical perspective in order to build effective, on-line document systems.
Subject(s)
Anesthesiology/organization & administration , Cardiology Service, Hospital/organization & administration , Medical Records Systems, Computerized , Task Performance and Analysis , Anthropology, Cultural , England , Humans , Online Systems , Risk AssessmentABSTRACT
Diethylstilbestrol (DES) exposure in utero in twin gestations has been reported on infrequently. In this case, both twins had colposcopically proven and biopsy-proven evidence of cervical adenosis. Infertility was discordant.
Subject(s)
Diethylstilbestrol/adverse effects , Prenatal Exposure Delayed Effects , Twins, Monozygotic , Twins , Vagina/drug effects , Adult , Female , Humans , Infertility, Female/chemically induced , Metaplasia , Pregnancy , Vagina/pathologyABSTRACT
From 1 July 1974 to 31 December 1982, 127 patients with primary carcinoma of the cervix were assessed to determine the prognosis of patients with adenosquamous cell carcinoma. Of all patients, 34 are dead of disease for an overall corrected survival rate of 73.2%. The survival of 20 patients with adenosquamous cell carcinoma is 20%. Seventy-five percent of the adenosquamous cell patients had stage IB lesions. When patients with adenosquamous cell carcinoma were compared with patients with squamous cell carcinoma or adenocarcinoma, there was a statistically significant decrease in survival. Patients with adenosquamous cell carcinoma were relatively young with a mean age of 41.1 years. A normal appearing cervix was noted in 30% of all patients with adenosquamous cell carcinoma. The majority of adenosquamous cell patients (87.5%) dead from cancer had distant metastases. This report emphasizes that, independent of stage, adenosquamous cell cervical carcinoma is an extremely aggressive neoplasm and carries a poor prognosis.
Subject(s)
Adenocarcinoma/pathology , Carcinoma, Squamous Cell/pathology , Uterine Cervical Neoplasms/pathology , Adenocarcinoma/drug therapy , Adenocarcinoma/mortality , Adult , Carcinoma, Squamous Cell/drug therapy , Carcinoma, Squamous Cell/mortality , Female , Humans , Middle Aged , Neoplasm Invasiveness , Neoplasm Metastasis , Neoplasm Recurrence, Local , Neoplasm Staging , Prognosis , Uterine Cervical Neoplasms/drug therapy , Uterine Cervical Neoplasms/mortalityABSTRACT
Temperature diffusion was monitored through in vivo restorations with and without bases 0.5 and 1 mm thick. Temperature diffusion was highest through amalgam restorations and slowest through unfilled resin restorations. The rate of diffusion through composite resins and silicate cement fell between the extremes. Bases of both zinc phosphate cement and zinc oxide-eugenol cement reduced the rate of temperature change on the floor of the cavity beneath amalgam restorations. The temperature change was generally less under the 1 mm base than the 0.5 mm base. Bases used beneath the nonmetallic restorations did not reduce the magnitude of temperature change on the cavity floor.
