ABSTRACT
OBJECTIVES: The aim of this study was to assess the impact on implant survival, abutment skin reaction and patient satisfaction in patients implanted with a bone-anchored hearing aid (BAHA), following the introduction of a multidisciplinary team (MDT) in 1997. DESIGN AND METHODS: Part prospective and retrospective analysis. Implant survival and cause of failures were recorded along with abutment skin reaction (graded as none, mild, moderate and severe, according to the amount of wound care required). Patient satisfaction and quality of life were assessed using a questionnaire enquiring about several aspects of the use and benefits of their BAHA. SETTING AND PARTICIPANTS: Eighty patients treated at the Bradford Royal Infirmary between 1991 and 2005. The unit is a recognized tertiary referral centre. RESULTS AND CONCLUSIONS: Twelve out of 80 implants failed, giving an overall failure rate of 15 per cent. Kaplan-Meier survival curves show a steady decrease in implant survival. The MDT had a positive effect on implant survival and adverse skin reactions, with a higher proportion of patients experiencing no reaction after its introduction. There was a 92.5 per cent response rate to the questionnaire. Overall patient satisfaction was high, both before and after the introduction of the MDT.
Subject(s)
Cochlear Implants , Patient Care Team , Adolescent , Adult , Aged , Child , Cochlear Implantation/adverse effects , Cochlear Implantation/methods , Cochlear Implants/adverse effects , Female , Hearing Loss, Conductive/surgery , Humans , Male , Middle Aged , Patient Compliance , Patient Satisfaction , Prospective Studies , Prosthesis Design , Prosthesis Failure , Quality of Life , Retrospective Studies , Skin Diseases/etiology , Treatment OutcomeABSTRACT
The religious beliefs of Jehovah's Witnesses forbid them to receive blood or blood products. We report a case of life-threatening epistaxis in a Jehovah's Witness, causing severe anaemia (Hb 2.7 g/dl). The successful management of this case and literature relating to this are discussed.
Subject(s)
Epistaxis/therapy , Jehovah's Witnesses , Anemia/etiology , Critical Illness , Epistaxis/psychology , Female , Humans , Hyperbaric Oxygenation/methods , Middle Aged , Treatment Refusal/psychologyABSTRACT
Although safe and rapid, air travel may present problems for people with certain medical conditions. Most medical emergencies that occur during a flight are preventable by judicious screening and preparation. We provide guidelines for physicians who are consulted about the wisdom of undertaking a journey by air. Potential stresses before, during and after the flight are outlined, including decreased atmospheric pressure, low humidity, turbulence, inactivity and time changes. We recommend precautionary measures for passengers with certain medical conditions, such as recent myocardial infarction, pulmonary disorders, pneumothorax, cerebrovascular accidents and diabetes and for those who have recently had surgery. The policy regarding air travel for pregnant women varies with each airline, but for certain conditions associated with pregnancy supplemental oxygen should be ordered before the trip. The special equipment and care that most airlines offer to ill or disabled people are described.
Subject(s)
Patient Care Planning , Travel , Aircraft , Altitude , Atmospheric Pressure , Humans , HumiditySubject(s)
Ear Neoplasms/diagnostic imaging , Ear, Middle/diagnostic imaging , Glomus Tumor/diagnostic imaging , Granuloma/diagnostic imaging , Adolescent , Adult , Aged , Cholesterol , Diagnosis, Differential , Ear Diseases/diagnostic imaging , Female , Humans , Jugular Veins/abnormalities , Jugular Veins/diagnostic imaging , Male , Tomography, X-Ray ComputedSubject(s)
Attitude of Health Personnel , Otolaryngology , Tonsillectomy , Humans , Surveys and QuestionnairesABSTRACT
A cell line that normally supports the replication of herpes simplex virus types 1 and 2 became resistant to these viruses after transformation by simian adenovirus 7. Kinetic studies of the mechanism of resistance demonstrated that both herpesviruses were able to attach to the transformed cells and express some early genomic functions, as demonstrated by the presence of low levels of viral thymidine kinase. However, isopycnic centrifugation studies of the abortive system failed to detect viral deoxyribonucleic acid synthesis, whereas indirect immunofluorescent studies of viral proteins revealed that less than 10 per cent of the cells contained these viral macromolecules at any given time. Collectively the data suggest that after transformation by simian adenovirus 7 these cells are altered so as to render them resistant or incapable of supporting the growth of herpes simplex virus types 1 and 2. The results further suggest that the block occurs after viral absorption and prior to viral deoxyribonucleic acid synthesis.
