Prospective Clinical Study of Bleeding Sites in Idiopathic Adult Posterior Epistaxis

2007 ◽  
Vol 137 (3) ◽  
pp. 390-393 ◽  
Author(s):  
Tor W. Chiu ◽  
Gerry W. McGarry
Keyword(s):  
Clinical Study ◽  
Prospective Study ◽  
General Anesthesia ◽  
Nasal Cavity ◽  
Study Design ◽  
Teaching Hospital ◽  
Prospective Clinical Study ◽  
Bleeding Site ◽  
Bleeding Point ◽  
Efficient Management

OBJECTIVES: The precise identification of the bleeding point is important to the efficient management of epistaxis. Our hypothesis was that the septum was the commonest bleeding site. STUDY DESIGN AND SETTING: This was a prospective clinical study of 50 consecutive adult idiopathic posterior epistaxis patients carried out in a busy teaching hospital. METHODS: The nasal cavity was inspected with endoscopy to identify the site of bleeding before any intervention. The location of bleeding sites was recorded on a proforma. RESULTS: Of bleeding sites posterior to the piriform fossa, 94 percent were identifiable, with 70 percent arising from the septum. CONCLUSIONS AND SIGNIFICANCE: This is the largest prospective study of the bleeding site in adult patients with posterior epistaxis and the only one with a well-defined population. The vast majority of posterior bleeding sites can be identified by endoscopy without general anesthesia. The septum should be examined closely in cases of idiopathic bleeding.

scholarly journals Design of a field trial to develop a tabletop platform for rapid detection of XDR-TB in clinical samples (Preprint)

2020 ◽  
Author(s):  
Naomi Hillery ◽  
Marva Seifert ◽  
Donald G Catanzaro ◽  
Symone McKinnon ◽  
Rebecca E Colman ◽  
...  
Keyword(s):  
Clinical Study ◽  
Data Collection ◽  
Study Design ◽  
Human Subjects ◽  
Bacterial Load ◽  
Objective Evaluation ◽  
Clinical Samples ◽  
Prospective Clinical Study ◽  
Global Public Health ◽  
Drug Concentrations

BACKGROUND Extensively drug-resistant tuberculosis (XDR-TB) continues to be a serious threat to global public health, due in part to the lack of accurate and efficient diagnostic devices for XDR-TB. A prospective clinical study in an intended-use cohort was designed to evaluate the Akonni Biosystems XDR-TB TruArray® and Lateral Flow Cell (XDR-LFC), which has the potential to address this gap in TB diagnostics. OBJECTIVE The objective of this publication is to share documentation of the study conceptualization and design that is replicable and of use to the scientific community. METHODS This clinical study was conducted in three phases, the first to observe changes in bacterial load and culture positivity in patient sputa over time and better understand the diversity of prospective clinical samples, the second to prospectively collect clinical samples for sensitivity and specificity testing of the Akonni Biosystems XDR-LFC device, and the third to explore anti-TB drug concentrations in serum over the course of DR-TB treatment. RESULTS The methodology described includes the study design, laboratory sample handling, data collection, and human subjects protection elements of the clinical study to evaluate a potential new XDR-TB diagnostic device. The complex systems implemented facilitated thorough clinical data collection for objective evaluation of the device. This trial is closed to recruitment. Follow-up data collection and analysis are in progress. CONCLUSIONS This publication outlined the methods used in a prospective cohort study to evaluate a device to rapidly detect XDR-TB. The documentation of this clinical study design may be of use to other researchers with similar goals.

scholarly journals Complications associated with splenectomy in thalassemia

2016 ◽  
Vol 11 (4) ◽  
Author(s):  
Farogh Zahra ◽  
Muhammad Ashraf ◽  
Muhammad Aslam ◽  
Qaim Deen ◽  
Javeria Mannan
Keyword(s):  
Clinical Study ◽  
Study Design ◽  
Perioperative Management ◽  
Late Complications ◽  
Prospective Clinical Study ◽  
Massive Splenomegaly ◽  
Study Materials ◽  
Operative Complications ◽  
Post Operative Complications

Aims and Objectives: The study aims at investigating the complications associated with splenectomy in thalassemic patients Study Design: It was a prospective clinical study. Materials and Method: Sixty Splenectomies were preformed electively after pre-operative preparation in Sir Ganga Ram Hospital, Lahore during the year Jan 2003 to Sep 2005. Results: Complications were categorized into per-operative, early post-operative and late complications. The frequency of per-operative complications was 3%, early post-operative complications were 10% and late complications were 1.6%. Interpretation and Conclusion: The rate of complications has decreased markedly as the patients are well prepared and improved post operative carp has also reduced the post-operative complications. With good perioperative management, splenectomy in children with massive splenomegaly is both safe and effective.

A Prospective Clinical Study of the A1 Pulley in Trigger Thumbs

2008 ◽  
Vol 33 (3) ◽  
pp. 260-265 ◽  
Author(s):  
J. BORETTO ◽  
V. ALFIE ◽  
A. DONNDORFF ◽  
G. GALLUCCI ◽  
P. DE CARLI
Keyword(s):  
Clinical Study ◽  
Prospective Study ◽  
Clinical Data ◽  
Pinch Strength ◽  
Prospective Clinical Study ◽  
Metacarpophalangeal Joints ◽  
Biomechanical Parameters ◽  
A Prospective Study ◽  
A1 Pulley

A prospective study was performed in 19 patients with trigger thumbs to define the anatomy of the A1 pulley of the thumb in this condition and to evaluate biomechanical parameters of the thumb after complete division of the A1 pulley. Pre- and postoperatively, flexion of the interphalangeal and metacarpophalangeal joints, key pinch strength and tip pinch strength were measured and compared with these measurements on the contralateral thumb. We identified three types of A1 pulley. The clinical data showed that there is no deficit with respect to motion and strength of the thumb after completely sectioning any of the three types of A1 pulley.

Dermatophytosis of the Ear

2005 ◽  
Vol 133 (1) ◽  
pp. 113-115
Author(s):  
Setsuko Morinaka
Keyword(s):  
Seasonal Variation ◽  
Clinical Study ◽  
Dimethyl Sulfoxide ◽  
Study Design ◽  
Potassium Hydroxide ◽  
Clinical Characteristics ◽  
Prospective Clinical Study

OBJECTIVES: The prevalence and characteristics of patients with and without dermatophytosis of the ear were investigated. STUDY DESIGN AND SETTING: Prospective clinical study. In 54 patients who complained of slight itching or accumulation of cerumen, and/or who had erythema and scales in the ears, the presence of dermatophytosis was examined by potassium hydroxide and dimethyl sulfoxide (KOH-DMSO test). RESULTS: Nineteen patients had dermatophytosis of the ear. Dermatophytosis was more frequent in May and June. Other clinical characteristics did not differ markedly from those without dermatophytosis. CONCLUSION: About one third of patients had dermatophytosis and their characteristics were similar to those of patients without dermatophytosis except for seasonal variation. SIGNIFICANCE: Dermatophytosis of the ear may be increased. Its diagnosis is difficult without the KOH-DMSO test.

Does epistaxis with an unknown bleeding site originate from the posterior part of the nasal cavity?

2019 ◽  
Vol 133 (09) ◽  
pp. 818-821
Author(s):  
Z-C Lou
Keyword(s):  
Nasal Cavity ◽  
Nasal Mucosa ◽  
Posterior Part ◽  
Case Series ◽  
Lateral Wall ◽  
Bleeding Site ◽  
Consecutive Case ◽  
Bleeding Point ◽  
Inferior Meatus

AbstractObjectiveTo review the origins of epistaxis in patients with unknown bleeding sites.MethodsThis consecutive case series included 26 patients with unknown bleeding sites previously considered to have posterior epistaxis. All patients had previously been examined endoscopically at least once, and were again examined with 30°, 45° and 70° endoscopes.ResultsThe bleeding site was at the: anterior end of the lateral wall of the inferior meatus in one patient (3.8 per cent); anterosuperior lateral wall of the nasal cavity in five patients (19.2 per cent); anterior nasal cavity roof in seven patients (26.9 per cent); anterosuperior part of the cartilaginous septum in nine patients (34.6 per cent); ostium pharyngeum tubae in two patients (7.7 per cent); and anterior nasal base in two patients (7.7 per cent). The morphology of the bleeding point showed: nasal mucosa ulceration in 1 patient, isolated primary telangiectasia in 3 patients, prominent vessels in 5 patients and capillary angioma in 17 patients.ConclusionEpistaxis originating from the anterosuperior nasal cavity and nasopharynx can be easily misdiagnosed as posterior epistaxis or unknown bleeding sites. Areas that should be considered as possible origins of epistaxis in cases with unknown bleeding sites were identified.

Vicryl Rapide® Versus Vicryl® Suture in Skin Closure of the Hand in Children: A Randomized Prospective Study

2005 ◽  
Vol 30 (1) ◽  
pp. 90-91 ◽  
Author(s):  
M. M. AL-QATTAN
Keyword(s):  
Clinical Study ◽  
Treatment Group ◽  
Prospective Study ◽  
Suture Material ◽  
Hand Surgery ◽  
Wound Complications ◽  
Prospective Clinical Study ◽  
Skin Closure ◽  
Absorbable Sutures

This randomized prospective clinical study compared the use of two absorbable sutures, Vicryl Rapide® versus Vicryl®, in elective paediatric hand surgery. Sixty children were randomly allocated into two groups (30 in each group) and all were seen and assessed at 3 and 6 weeks for wound complications and suture reactions. Five problems occurred in the Vicryl® treatment group and none in the Vicryl Rapide® group ( P = 0.03). All the problems were related to the delayed absorption of the Vicryl® suture material and hence the prolonged presence of the suture in the hands of these children. It is concluded that Vicryl Rapide® sutures are more suitable than Vicryl® ones in paediatric hand surgery.

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