ABSTRACT
AIMS: The purpose of the present study is to determine the overall and disease-related accuracy of clinical and radiological diagnosis when compared to the histology result of the surgical orbital biopsy. METHODS: A retrospective case notes analysis of patients who underwent surgical orbital biopsy during a 12-year period involving more than 100 orbital lesions. The accuracy of clinical and radiological diagnosis was compared with histological diagnosis. RESULTS: A total of 112 orbital biopsies were carried out in 104 eyes of 101 patients between 2003 and 2015. Correct diagnosis was reached in <50% of cases by both ophthalmologists and radiologists alike. Vascular lesions exhibit characteristic clinical and imaging features that allow for accurate diagnosis and can often be managed conservatively. The greatest challenge, both clinically and on imaging was in differentiating between inflammatory and haematological orbital lesions which represented half of our cases. There was no operative mortality and there were no post-operative complications recorded. CONCLUSION: Surgical orbital biopsy is a safe and accurate diagnostic tool for orbital lesions of unknown aetiology and, in our opinion, remains the gold standard.
Subject(s)
Biopsy/methods , Magnetic Resonance Imaging/methods , Ophthalmologic Surgical Procedures/methods , Orbit/diagnostic imaging , Orbital Diseases/diagnosis , Tomography, X-Ray Computed/methods , Adolescent , Adult , Aged , Aged, 80 and over , Child , Child, Preschool , Diagnosis, Differential , Female , Humans , Infant , Infant, Newborn , Male , Middle Aged , Orbit/surgery , Orbital Diseases/surgery , Reproducibility of Results , Retrospective Studies , Young AdultABSTRACT
The use of intravenous sedation and analgesia in patients undergoing interventional diagnostic and therapeutic procedures is increasing. Sedation by non-anaesthetists is considered to be safe, provided that they have received adequate training and have the necessary equipment, facilities, and personnel. This article aims to increase awareness of the safe use of sedative drugs in radiology and provide a practical guideline for minimal and moderate sedation.
Subject(s)
Analgesia/methods , Conscious Sedation/methods , Radiography, Interventional , Analgesia/standards , Analgesics/administration & dosage , Anesthetics, Local/administration & dosage , Conscious Sedation/standards , Humans , Hypnotics and Sedatives/administration & dosage , Injections, Intravenous , Practice Guidelines as Topic , Radiology Department, Hospital , Risk AssessmentABSTRACT
A growing scientific consensus states that the global climate is changing and that human activity is responsible for these changes. It folLows that each of us has a responsibility to look at how our own lives impact on the environment. This study aimed to investigate water use during surgical scrubbing. Two water delivery systems were assessed to see whether technological innovation can promote more 'environmentally friendly' scrubbing behaviour. At least 10 different individuals, comprising surgeons, assistants and scrub nurses, were observed at two sites. Twenty-five separate surgical scrubs were observed in each location and the length of time for which the tap was on recorded. The tap was on during surgical scrubbing for a mean of 2 min 23 s at Gartnavel General Hospital (maximum: 4 min 37 s; minimum: 49 s; SD: 55 s) and for a mean of 1 min 7 s at Stobhill Hospital (maximum: 2 min 25 s; minimum: 19 s; SD: 33 s). The mean 'tap on' time (in seconds) at Gartnavel was significantly greater than that at Stobhill [t(39.5)=P<0.001]. A different tap design resulted in a net saving of 5.7 L of hot water, approximately 600 kJ of energy and 80 g of carbon dioxide emitted per surgical scrub. Surgical scrubbing is a ubiquitous procedure performed daily in healthcare settings. A simple technological solution can reduce water and energy use by modifying hand-washing behaviour and thereby reduce the carbon footprint of surgical scrubbing.
