ABSTRACT
The field of medical applications is currently one of the most dynamic in medicine due to the great potential for improving clinical practice they hold. However, clinicians' opinion around their usability in daily clinical care has not been thoroughly addressed. This study aimed to analyze the otolaryngologists response to a rhinoplasty application. It was designed as a survey of 21 otolaryngologists with regards to a rhinoplasty planning application for the iPhone with the capacity to project potential surgery outcomes through tactile morphing software compared to a photo tracing method used as the gold standard. The participants were asked to rate the usefulness of the two technologies on a visual analog scale from 0-10. Questions addressed included four topics: physician-patient communication; imaging process time; perceived usefulness for preoperative planning; and perceived usefulness for surgery. A one sample t-test was applied to compare the scores of both methods for each question. The test subjects (mean age 43.21 years) rated the utility of the iPhone application as superior to that of the photo tracing method (p < 0.05) concluding that the iPhone application could facilitate an immediate preliminary analysis of the options for nasal improvement.
Subject(s)
Cell Phone , Otolaryngology/methods , Rhinoplasty/methods , Software , Data Collection , Feasibility Studies , Humans , Otolaryngology/trends , Prospective StudiesABSTRACT
Introducción y objetivos: El vértigo y la inestabilidad tienen una importante implicación médico-legal en el paciente laboral. La posturografía dinámica computarizada (PDC) aporta información adicional a las pruebas vestibulares estándar, pero además se han descrito patrones de control postural compatibles con escasa colaboración o falta de sinceridad al esfuerzo, denominados afisiológicos. El objetivo de este trabajo es determinar la prevalencia de testafisiológicos en estudios de PDC sobre pacientes laborales con vértigo y/o inestabilidad. Material y métodos: Estudio retrospectivo de pacientes remitidos por mutuas laborales para estudio de vértigo y/o inestabilidad. Se realizó un estudio vestibular estándar y PDC. Los resultados de la prueba de organización sensorial (sensory organization test [SOT]) se valoraron como normales, vestibulares o afisiológicos usando el método de cálculo publicado por Cevette et al. en 1995. Resultados: El patrón afisiológico en el SOT, definido por los índices de Cevette, se observó en el 31% de los casos estudiados. Se ha encontrado una relación estadísticamente significativa (p = 0,01) entre los valores bajos de la puntuación compuesta (composite score) y el resultado afisiológico. La videonistagmografía (VNG) presentaba alteraciones en 14 de los 31 casos con SOT afisiológico. Conclusiones: La prevalencia de casi un tercio de los resultados de PDC afisiológicos entre pacientes laborales con vértigo y/o inestabilidad en nuestro medio, es relativamente elevada en comparación con el 25% publicado por Longridge y Mallinson en 2005. El patrón afisiológico no necesariamente significa simulación o exageración, siendo frecuente la presencia concomitante de signos videonistagmográficos de vestibulopatía en estos casos(AU)
Introduction and objectives: Medical-legal implications of dizziness and imbalance in work-related patients are important. In these cases, computerized dynamic posturography (CDP)adds information to standard vestibular tests and aphysiologic patterns have been described. The objective is to assess the prevalence of aphysiologic performance on CDP in work-related patients complaining of dizziness/imbalance. Material and Methods: Retrospective review of patients referred by the workers compensation board for assessment of dizziness, imbalance or both. Standard vestibular assessment including CDP was carried out in all patients. The sensory organization test (SOT) summaries were scored as normal, aphysiologic or vestibular using the scoring method published by Cevette et al. in1995.Results: Aphysiologic performance in SOT, evaluated with the Cevette formula, was found in 31out of 100 cases. Low composite score results and aphysiologic SOT results had a statistically significant association (P=.01). Videonystagmography (VNG) was altered in 14 out of 31 cases with aphysiologic SOT. Conclusion: The 31% prevalence of aphysiologic results on CDP among work-related patients complaining of dizziness/imbalance is relatively high in comparison with the 25% published by Longridge and Mallinson in 2005. However, aphysiologic performance should not necessarily be related to malingering or exaggeration and altered vestibular tests are found in some of these cases(AU)
Subject(s)
Humans , Occupational Diseases/etiology , Postural Balance , Sensation Disorders/epidemiology , Vertigo/diagnosis , Retrospective Studies , Dizziness/epidemiology , AudiometryABSTRACT
INTRODUCTION AND OBJECTIVES: Medical-legal implications of dizziness and imbalance in work-related patients are important. In these cases, computerized dynamic posturography (CDP) adds information to standard vestibular tests and aphysiologic patterns have been described. The objective is to assess the prevalence of aphysiologic performance on CDP in work-related patients complaining of dizziness/imbalance. MATERIAL AND METHODS: Retrospective review of patients referred by the workers' compensation board for assessment of dizziness, imbalance or both. Standard vestibular assessment including CDP was carried out in all patients. The sensory organization test (SOT) summaries were scored as normal, aphysiologic or vestibular using the scoring method published by Cevette et al. in 1995. RESULTS: Aphysiologic performance in SOT, evaluated with the Cevette formula, was found in 31 out of 100 cases. Low composite score results and aphysiologic SOT results had a statistically-significant association (P=.01). Videonystagmography (VNG) was altered in 14 out of 31 cases with aphysiologic SOT. CONCLUSION: The 31% prevalence of aphysiologic results on CDP among work-related patients complaining of dizziness/imbalance is relatively high in comparison with the 25% published by Longridge and Mallinson in 2005. However, aphysiologic performance should not necessarily be related to malingering or exaggeration and altered vestibular tests are found in some of these cases.
Subject(s)
Diagnosis, Computer-Assisted , Dizziness/diagnosis , Occupational Diseases/diagnosis , Postural Balance , Sensation Disorders/diagnosis , Vertigo/diagnosis , Vestibular Function Tests , Adult , Audiometry , Dizziness/physiopathology , Female , Humans , Male , Malingering/diagnosis , Middle Aged , Nystagmus, Pathologic/diagnosis , Nystagmus, Pathologic/physiopathology , Nystagmus, Physiologic , Occupational Diseases/physiopathology , Sensation Disorders/physiopathology , Severity of Illness Index , Vertigo/physiopathology , Video Recording , Workers' Compensation , Young AdultABSTRACT
INTRODUCTION AND OBJECTIVE: The number of patients attended in emergency rooms has gone up considerably in recent years. Immigration and an increase in life-expectancy have probably influenced this increase. A lot of patients come looking for immediate attention in order to avoid long waiting lists for specialist care at primary health-care facilities. The main objective is to know what pathologies in ear, nose and throat require urgent medical assistance. MATERIAL AND METHODS: This is a retrospective descriptive study of 8,872 patients seen in a year. The variables analyzed were age, gender, day of the week, time of arrival, final result). In addition, a category distribution was made, depending on the pathology suffered: otological, rhinological, pharyngeal, laryngeal, cervical and others. RESULTS: The daily mean was about 25 patients per day. There were no differences in distribution by gender. Monday was the day of the week when more patients were seen. Otological pathologies represented the most frequent reason for attending (32 %), followed by pharyngeal emergencies. However, epistaxis (9.2 %) was the most common entity. The final outcome for about 85 % of the patients was discharge to home on the same day. CONCLUSIONS: The rising demand for emergency attention in hospitals must be meticulously analyzed because it might become even worse, taking epidemiological trends into account. Different foci and new policies regarding emergency centres should be proposed.
Subject(s)
Emergency Service, Hospital/statistics & numerical data , Otorhinolaryngologic Diseases/epidemiology , Otorhinolaryngologic Diseases/therapy , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Female , Humans , Male , Middle Aged , Retrospective Studies , Young AdultABSTRACT
Introducción y objetivo. La actividad asistencial en urgencias ha crecido de forma considerable en los últimos años. Probablemente, la inmigración y un incremento de la esperanza de vida han influido en este crecimiento. Muchos pacientes acuden buscando atención inmediata con tal de evitar listas de espera de especialidad en los centros de salud básicos. El principal objetivo es saber qué enfermedades en otorrinolaringología requieren asistencia médica urgente. Material y métodos. Es un estudio retrospectivo y descriptivo de 8.872 pacientes visitados en un año. Se analizaron algunas variables: edad, sexo, día de la semana, hora de llegada, destino final. Además, se hizo una distribución por categorías, dependiendo de la enfermedad presentada: otológica, rinológica, de faringe, laringe, cervical y otros. Resultados. La media diaria fue de alrededor de 25 pacientes por día. No hubo diferencias en cuanto al sexo. El lunes fue el día de la semana en el que se visitó a más pacientes. La enfermedad de oído fue la más atendida (32 %), seguida por la de faringe. De todas formas, la epistaxis (9,2 %) fue la entidad más común. El destino final en alrededor del 85 % fue el alta domiciliaria el mismo día. Conclusiones. El aumento de demanda de la atención urgente en los hospitales debe analizarse de forma concienzuda porque puede ser aún peor, teniendo en cuenta las tendencias epidemiológicas. Deben proponerse diferentes focos y nuevas políticas en cuanto a las urgencias
Introduction and objective. The number of patients attended in emergency rooms has gone up considerably in recent years. Immigration and an increase in life-expectancy have probably influenced this increase. A lot of patients come looking for immediate attention in order to avoid long waiting lists for specialist care at primary health-care facilities. The main objective is to know what pathologies in ear, nose and throat require urgent medical assistance. Material and methods. This is a retrospective descriptive study of 8,872 patients seen in a year. The variables analyzed were age, gender, day of the week, time of arrival, final result). In addition, a category distribution was made, depending on the pathology suffered: otological, rhinological, pharyngeal, laryngeal, cervical and others. Results. The daily mean was about 25 patients per day. There were no differences in distribution by gender. Monday was the day of the week when more patients were seen. Otological pathologies represented the most frequent reason for attending (32 %), followed by pharyngeal emergencies. However, epistaxis (9.2 %) was the most common entity. The final outcome for about 85 % of the patients was discharge to home on the same day. Conclusions. The rising demand for emergency attention in hospitals must be meticulously analyzed because it might become even worse, taking epidemiological trends into account. Different foci and new policies regarding emergency centres should be proposed
