Antiplatelet drugs in elective ENT surgery

2012 ◽  
Vol 126 (9) ◽  
pp. 886-892 ◽  
Author(s):  
J R Savage ◽  
A Parmar ◽  
P J Robinson
Keyword(s):  
Head And Neck ◽  
Online Survey ◽  
Response Rate ◽  
Expert Panel ◽  
Operative Management ◽  
Low Risk ◽  
British Association ◽  
Antiplatelet Drugs ◽  
Main Text ◽  
Ent Surgery

AbstractIntroduction:Oral antiplatelet drugs are increasingly being encountered in patients scheduled for elective ENT surgery. Their pre-operative cessation can have potentially serious complications in some patients, particularly those with intracoronary stents.Methods:In order to gain an impression of current peri-operative management of patients taking antiplatelet drugs, an online survey was distributed to the Expert Panel of ENT UK, the British Association of Otolaryngologists Head and Neck Surgeons, between 13 January and 15 February 2011.Results:Three hundred and three members were contacted. The response rate was 55 per cent (167 replies); 78 per cent of respondents were consultants. Results are presented in the main text.Conclusion and recommendations:Patients can be categorised as high or low risk, depending on their indication for taking antiplatelet drugs. Recommendations taken from the literature are given on how best to manage these two groups.

How do hand therapists conservatively manage acute, closed mallet finger? A survey of members of the British Association of Hand Therapists

Hand Therapy ◽  
2016 ◽  
Vol 22 (1) ◽  
pp. 13-25 ◽  
Author(s):  
Samantha Cook ◽  
Nikki Daniels ◽  
Sarah Woodbridge
Keyword(s):  
Best Practice ◽  
Online Survey ◽  
Response Rate ◽  
Clinical Skills ◽  
Current Treatment ◽  
Therapeutic Management ◽  
British Association ◽  
Mallet Finger ◽  
Clinical Practices ◽  
Diverse Range

Introduction Previous research concerning the conservative management of mallet finger has focused on splint application, with limited representation of supplementary rehabilitation and best practice. This research sought to investigate the practice and opinions of members of the British Association of Hand Therapists regarding their current treatment and to determine whether any specific exercise prescription or rehabilitation protocols are followed. Methods British Association of Hand Therapists members were contacted via e-mail and requested to complete an online survey. Thirty-five responses (5.7% response rate), 30 (4.8% response rate) of which were fully completed were obtained over the eight-week data collection period. The questionnaire consisted of 30 questions (20 quantitative and 10 qualitative) concerning therapists’ roles and condition management. Responses were analysed in terms of response frequencies, percentages and thematic text analysis. Results The results demonstrated current clinical practices in line with available best-evidenced practice. Conservative therapeutic management is diverse and varied. Therapists believe their role to be significant in optimising outcome success. Discussion Exercises and other interventions supplementary to splinting are commonly utilised in the therapeutic management of acute, closed mallet finger. This research found hand therapists implement a diverse range of clinical skills in order to optimise outcome success. Recommendations for best practice and further research are presented.

Knowledge, Perceptions and Practices on Modified Release Tablets among Prescribers: A Preliminary Study

2020 ◽  
Vol 01 (01) ◽  
pp. 05-14
Author(s):  
M.G.K.M. Fernando ◽  
K.I.J. Priyadarshi ◽  
L.G.T. Shanika ◽  
N.R. Samaranayake
Keyword(s):  
Online Survey ◽  
Product Information ◽  
Response Rate ◽  
Immediate Release ◽  
State Universities ◽  
Modified Release ◽  
Validated Questionnaire ◽  
Therapeutic Outcomes ◽  
Medical Faculties ◽  
Enteric Coated

Introduction: Modified release tablets (MRTs) are developed to achieve different therapeutic outcomes and are frequently prescribed. This study aims to evaluate the knowledge, perceptions and practices on using MRTs among a selected cohort of prescribers. Methods: A self administered online survey was conducted using a pre-validated questionnaire, prepared in-house to assess knowledge, perceptions and practices on using MRTs, among academics with an MBBS degree in medical faculties of State universities in Sri Lanka. Results: The response rate was 15.5% among 375 prescribers. Most were females (53.4%) and were 46-55 years (29.3%). Over 50% correctly expanded abbreviations related to MRTs. Most defined enteric coated (87.9%) and targeted release (77.6%) forms accurately. However, 87.0% mixed-up definitions of sustained release with controlled release. Most believed that inability to split tablets (70.7%) and high cost (70.7%), as disadvantages of MRTs. Nearly half did not identify the risk of dose dumping (53.5%) and inflexible dosing schedule (44.8%) as disadvantages. For frequency of administering MRTs, 86.2% referred the product information leaflet (PIL) while 29.0% depended on the frequency of the corresponding immediate release tablet. Most (79.3%) prescribed MRTs to increase patient compliance while 12.1% prescribed them to reduce cost. When problems regarding MRTs were encountered, most referred PILs (81.0%) and clarified with experts (75.9%). Conclusions: Although the response rate was low, a clear gap in knowledge, perceptions and practices on using MRTs were identified among prescribers who responded. Interventions are needed to improve the knowledge, perceptions, and practices on using MRTs among prescribers.

scholarly journals Assessing the utility and attitudes toward molecular testing in neuro-oncology: a survey of the Society for Neuro-Oncology members

2021 ◽  
Author(s):  
Shannon Fortin Ensign ◽  
Maya Hrachova ◽  
Susan Chang ◽  
Maciej M Mrugala
Keyword(s):  
Online Survey ◽  
Clinical Decision Making ◽  
Unmet Needs ◽  
Practice Patterns ◽  
Response Rate ◽  
Clinical Decision ◽  
Molecular Testing ◽  
Newly Diagnosed ◽  
Tumor Boards ◽  
Oncology Practice

Abstract Background Molecular testing (MT) is utilized in neuro-oncology with increasing frequency. The aim of this study was to determine clinical practice patterns to acquire this information, interpret and utilize MT for patient care, and identify unmet needs in the practical clinical application of MT. Methods We conducted a voluntary online survey of providers within the Society for Neuro-Oncology (SNO) membership database between March and April 2019. Results We received 152 responses out of 2022 SNO members (7.5% of membership). 88.8% of respondents routinely order MT for newly diagnosed gliomas. Of those who do not, testing is preferentially performed in younger patients or those with midline tumors. 82.8% use MT in recurrent gliomas. Other common indications included: metastatic tumors, meningioma, and medulloblastoma. Many providers utilize more than one resource (36.0%), most frequently using in-house (41.8%) over commercially available panels. 78.1% used the results for clinical decision-making, with BRAF, EGFR, ALK, and H3K27 mutations most commonly directing treatment decisions. Approximately, half (48.5%) of respondents have molecular tumor boards at their institutions. Respondents would like to see SNO-endorsed guidelines on MT, organized lists of targeted agents available for specific mutations, a database of targetable mutations and clinical trials, and more educational programs on MT. Conclusion This survey was marked by several limitations including response rate and interpretation of MT. Among respondents, there is routine use of MT in Neuro-Oncology, however, there remains a need for increased guidance for providers to effectively incorporate the expanding genomic data resulting from MT into daily Neuro-Oncology practice.

scholarly journals Effectiveness of nivolumab affected by prior cetuximab use and neck dissection in Japanese patients with recurrent or metastatic head and neck cancer: results from a retrospective observational study in a real-world setting

2021 ◽  
Author(s):  
Shin Kariya ◽  
Yasushi Shimizu ◽  
Nobuhiro Hanai ◽  
Ryuji Yasumatsu ◽  
Tomoya Yokota ◽  
...  
Keyword(s):  
Head And Neck Cancer ◽  
Head And Neck ◽  
Neck Dissection ◽  
Neck Cancer ◽  
Median Overall Survival ◽  
Response Rate ◽  
Objective Response ◽  
Progression Free Survival ◽  
Japanese Patients ◽  
Free Survival

Abstract Background To examine the effect of prior use of cetuximab and neck dissection on the effectiveness of nivolumab, we conducted a large-scale subgroup analysis in Japanese patients with recurrent/metastatic head and neck cancer. Methods Data on the effectiveness of nivolumab were extracted from patient medical records. All patients were analyzed for effectiveness by prior cetuximab use. In the analyses for prior neck dissection, only patients with locally advanced disease were included. Results Of 256 patients analyzed, 155 had received prior cetuximab. Nineteen of 50 patients with local recurrence underwent neck dissection. The objective response rate was 14.7 vs 17.2% (p = 0.6116), median progression-free survival was 2.0 vs 3.1 months (p = 0.0261), and median overall survival was 8.4 vs 12 months (p = 0.0548) with vs without prior cetuximab use, respectively. The objective response rate was 23.1 vs 25.9% (p = 0.8455), median progression-free survival was 1.8 vs 3.0 months (p = 0.6650), and median overall survival was 9.1 vs 9.9 months (p = 0.5289) with vs without neck dissection, respectively. Conclusions These findings support the use of nivolumab for patients with recurrent/metastatic head and neck cancer regardless of prior cetuximab use or neck dissection history. Trial registration number UMIN-CTR (UMIN000032600), Clinicaltrials.gov (NCT03569436)

Perspectives of physicians on medical acupuncture in Lebanon: a preliminary study

2020 ◽  
pp. 096452842096883
Author(s):  
Fadila Bassem Naji ◽  
Kamal Wahab ◽  
Ghassan Hamadeh ◽  
Sani Hlais
Keyword(s):  
Integrative Medicine ◽  
Online Survey ◽  
Response Rate ◽  
Mechanisms Of Action ◽  
Medical Curricula ◽  
Chinese Acupuncture ◽  
The Future ◽  
Preliminary Study ◽  
Medical Acupuncture ◽  
The Difference

Objectives: There are no regulations governing the practice of acupuncture in Lebanon as it is not yet registered as a profession. To our knowledge, no studies have ever been conducted in Lebanon regarding the practice of acupuncture. The purpose of this preliminary study was to explore the knowledge of Lebanese physicians about acupuncture, with the intent of conducting larger scale studies and developing strategies aimed at refining this knowledge in the future, and the ultimate goal of setting guidelines for acupuncture practice in Lebanon. Methods: An online survey looking into physicians’ knowledge of acupuncture, its mechanisms of action, effectiveness, indications and safety, and physicians’ understanding of its concepts, was circulated to 4651 physicians registered in the Lebanese orders of physicians. Results: One hundred forty-nine physicians (3.2%) completed the survey. Most study respondents stated that they were unaware of the difference between traditional Chinese acupuncture (TCA) and Western medical acupuncture (WMA). Overall, 30% of respondents had personally used and/or referred patients for acupuncture. Physicians who had personally tried acupuncture were more likely to refer patients for acupuncture (p < 0.001). Those who know the difference between WMA and TCA were more likely to have tried or referred for acupuncture (p = 0.004). 72% believed that acupuncture and other integrative medicine modules should be introduced in medical curricula in Lebanon. Conclusion: Interest in acupuncture among physicians in Lebanon appears to be limited, based on the low response rate. Among respondents, physicians who had tried or referred patients for acupuncture appeared to be more well informed about different acupuncture styles.

scholarly journals Impact of the COVID-19 Pandemic on Physicians Working in the Head and Neck Field

2021 ◽  
Vol 25 (01) ◽  
pp. e150-e159
Author(s):  
Rui Imamura ◽  
Ricardo F. Bento ◽  
Leandro L. Matos ◽  
William N. William ◽  
Gustavo N. Marta ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Head And Neck ◽  
Personal Protective Equipment ◽  
Outpatient Care ◽  
Online Survey ◽  
Family Income ◽  
Protective Equipment ◽  
Psychological Burden ◽  
The Public ◽  
The Third

Abstract Background With the COVID-19 pandemic, the clinical practice of physicians who work in the head and neck field in Brazil dropped dramatically. The sustained impact of the pandemic is not known. Methods An anonymous online survey was distributed to Brazilian otolaryngologists, head and neck surgeons, medical and radiation oncologists, asking about their clinical practice in the third to fourth months of the pandemic. Results The survey was completed by 446 specialists. About 40% reported reduction of more than 75% in outpatient care. A reduction of 90% to 100% in airway endoscopies was reported by 50% of the responders, and the same rate of reduction regarding surgeries (pediatric or nasosinusal) was reported by 80% of them. Family income decreased by 50%, and the psychological burden on physicians was considerable. The availability of personal protective equipment and safety precautions were limited, especially in the public sector. Conclusion COVID-19 is still impacting the head and neck field, and safety concerns may hinder the prompt resumption of elective care.

scholarly journals The Impact of the COVID-19 Pandemic on Head and Neck Surgery Training: A Brazilian National Survey

2021 ◽  
Author(s):  
Ana Kober Leite ◽  
Leandro Luongo Matos ◽  
Claudio R. Cernea ◽  
Luiz Paulo Kowalski
Keyword(s):  
Head And Neck ◽  
Surgical Training ◽  
Online Survey ◽  
Negative Impact ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Educational Activities ◽  
Residency Programs ◽  
Surgery Training ◽  
The Impact

Abstract Introduction The COVID-19 pandemic has had a high impact on surgical training around the world due to required measures regarding the suspension of elective procedures and the dismissal of nonessential personnel. Objectives To understand the impact the pandemic had on head and neck surgery training in Brazil. Methods We conducted a 29-question online survey with head and neck surgery residents in Brazil, assessing the impact the pandemic had on their training. Results Forty-six residents responded to the survey, and 91.3% of them reported that their residency was affected by the pandemic, but most residents were not assigned to work directly with patients infected with the new coronavirus (71.4%). All residents reported decrease in clinic visits and in surgical procedures, mostly an important reduction of ∼ 75%. A total of 56.5% of the residents described that the pandemic has had a negative impact on their mental, health and only 4 (8.7%) do not have any symptoms of burnout. The majority (78.3%) of the residents reported that educational activities were successfully adapted to online platforms, and 37% were personally infected with the virus. Conclusion Most surgical residencies were greatly affected by the pandemic, and residents had an important decrease in surgical training. Educational activities were successfully adapted to online modalities, but the residency programs should search for ways of trying to compensate for the loss of practical activities.

scholarly journals Physical activity counselling in Ireland: a survey of doctors’ knowledge, attitudes and self-reported practice

2019 ◽  
Vol 5 (1) ◽  
pp. e000572 ◽  
Author(s):  
Sarah O'Brien ◽  
Lucia Prihodova ◽  
Mairéad Heffron ◽  
Peter Wright
Keyword(s):  
Physical Activity ◽  
General Practitioners ◽  
Royal College ◽  
Patient Preference ◽  
Online Survey ◽  
Response Rate ◽  
Further Education ◽  
Pharmaceutical Intervention ◽  
And Training ◽  
Do So

ObjectivePhysical activity (PA) counselling has been shown to raise awareness of the importance of PA and to increase the rate of PA engagement among patients. While much attention has been paid to examining the knowledge, attitudes and practice of general practitioners in relation to PA counselling, there is less literature examining such issues in hospital-based doctors in Ireland and further afield. This study aimed to explore doctors’ PA counselling practices and to analyse how this related to their level of PA knowledge, training and attitudes.MethodsAn invitation to participate in an online survey was sent to 4692 members of the Royal College of Physicians of Ireland who were listed as having an address in Ireland. Descriptive and explorative analyses of the data were performed using IBM SPSS V.22.0.ResultsA total of 595 valid responses were included (response rate 12.7%; 42.7% male, 42.6±12.1 years). The majority reported enquiring about PA levels (88.0%) and providing PA counselling (86.4%) in at least some of their patients. Doctors who saw it as their role and those who felt more effective/confident in providing PA counselling were significantly more likely to do so. A perceived lack of patient interest in PA and patient preference for pharmaceutical intervention were significant barriers to undertaking PA counselling.ConclusionThis study demonstrates the need for further education and training in PA counselling in Ireland with a particular focus on improving the attitudes and self-efficacy of doctors in this area at both undergraduate and postgraduate levels.

Shattering the Glass Podium: Successes and Setbacks of Women in Collegiate Choral Conducting

2021 ◽  
pp. 875512332110183
Author(s):  
Melissa Baughman
Keyword(s):  
Gender Discrimination ◽  
Online Survey ◽  
Response Rate ◽  
The United States ◽  
Choral Conducting ◽  
Demographic Information ◽  
Choral Conductors ◽  
The Status ◽  
Study Participants ◽  
Experiences Of Women

The purpose of this study was to explore the status and experiences of women in collegiate choral conducting positions. Out of all collegiate choral conductors ( N = 992) at institutions accredited by the National Association of Schools of Music in the United States, 68.65% ( n = 681) were men and 31.35% ( n = 311) were women at the time of this study; I invited the women collegiate choral conductors to serve as study participants. Ninety-six respondents completed an online survey, resulting in a response rate of 30.86%. I collected data through a researcher-designed survey. First, I asked respondents to provide demographic information and respond to Likert-type and open-ended prompts related to three domains: gaining entry into the profession, navigating the profession, and issues surrounding gender. I analyzed data through descriptive statistics and qualitative methods of assigning codes, combining codes into themes, and displaying the data. I addressed general discrepancies in the self-reported attitudes of respondents. Although women reported an overall attitude of satisfaction as choral conductors in their Likert-type responses, many respondents detailed several instances of gender discrimination and other challenges in their open-ended responses. Implications for the music profession, including specific strategies to help empower women in collegiate choral conducting settings, are discussed.

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