[Clinical management of epistaxis]. / Klinisches Management bei Epistaxis.

BACKGROUND: Epistaxis is a symptom with many causes, often multifactorial and a frequent cause of consultation in acute medicine. OBJECTIVES: The goal of this study is to analyse the diagnostics used for and therapy of epistaxis, complications and the predictive benefit of laboratory tests. MATERIALS AND METHODS: In this retrospective clinical analysis reports of 720 patients with epistaxis in the period from January 2005 to December 2015 were evaluated. The causes and the therapy of the epistaxis relapses were analysed. RESULTS: Male patients were predominant. Patients with relapses of epistaxis were significantly more likely to be older than 70 years, with higher multimorbidity and more often had used a combination of blood thinning medications. Posterior bleeding was the most found location and was associated with a longer hospitalization. In laboratory tests most patients with coumarins were shown to have inadequate INR (international normalized ratio) control. The prevalence of nicotine consumption was clearly increased compared to the total population. The most used therapy was nasal tamponade. The most complication was anemia with need of blood transfusion. CONCLUSIONS: High age and posterior bleeding source seem to raise the necessity of inpatient therapy. In most cases tamponade is sufficient for treatment. Initial laboratory tests are of limited use to estimate risk of recurrence, but is necessary for patients taking coumarins to determine INR control.

Procedures for preparation of otological and audiological data for computer analysis.

Extensive amounts of clinical data exist in the files of facilities providing otological and audiological services. Because of the considerable time involved in manual analysis, some departments are beginning to consider the use of computers for analyzing the data. It is often assumed that this data can simply be submitted to a computer center for analysis. This, however, is not the case. A careful series of planned procedures must be undertaken before information can be submitted and analyzed. This paper illustrates the procedural steps necessary to permit the utilization of a computer system for analysis of clinical data. The feasibility of the use of these procedures in the examination of otological and audiological data is considered.

Enzyme clearing of alcian blue stained whole small vertebrates for demonstration of cartilage.

Preparation of small vertebrates cleared after alcian blue staining of cartilage is facilitated by trypsin digestion. Specimens are fixed in formation, washed, skinned, and eviscerated. After staining in a solution of alcian blue in acetic acid-alcohol for 24-48 hours, they are transferred to water through graded alcohols. Excess alcian blue is removed over a period of up to three weeks by changes every 2-3 days of 1% trypsin in approximately one-third-saturated sodium borate. Bony tissues may be stained after this in a solution of alizarin red S in 0.5% KOH. Specimens are bleached if necessary and dehydrated through graded KOH-glycerine mixtures for storage in glycerine. Since alcohol treatment in addition to formalin fixation does not affect results with this method, it should be useful to researchers who want to study the cartilage or cartilaginous skeletons in museum specimens, which are routinely fixed in formalin and stored in alcohol.