Tympanosclerosis: Clinical Implications of the Theory of Pathogenesis

1983 ◽  
Vol 92 (6) ◽  
pp. 635-639 ◽  
Author(s):  
Maurice Schiff
Keyword(s):  
General Practitioner ◽  
Connective Tissue ◽  
Clinical Significance ◽  
Family Physician ◽  
Disease Process ◽  
Clinical Implications ◽  
Developmental Patterns ◽  
Preventable Disease ◽  
Causative Factors

Tympanosclerosis is a preventable disease. Its elimination is more the responsibility of the pediatrician and general practitioner than the otolaryngologist's. The education of our colleagues is the most effective way of possibly eliminating this disease process. Cholesteatoma and tympanosclerosis may have similar causative factors, but certainly have different pathogenic developmental patterns; their occurrence together in otologic disease is coincidental. The mechanism of this disease process shows that the subepidermal and submucosal connective tissue layers of the eardrum are the ones involved. The cure for tympanosclerosis may be achieved more easily than its amelioration. This may seem like a strange paradox, but cure is intimately bound up with prevention which is the key for the clinical significance of this theory of pathogenesis. The pediatrician and the general practitioner, or family physician — the first to see the children with their ear problems — are urged to refer patients to an otologist when fluid is turbid. Development of tympanosclerosis must be prevented in the early but treatable stages. Prevention is less costly than repair.

scholarly journals Mortality of Elderly Patients in Ontario after Hospital Admission for Chronic Obstructive Pulmonary Disease

2007 ◽  
Vol 14 (8) ◽  
pp. 485-489 ◽  
Author(s):  
Jason X Nie ◽  
Li Wang ◽  
Ross EG Upshur
Keyword(s):  
Chronic Obstructive Pulmonary Disease ◽  
General Practitioner ◽  
Elderly Patients ◽  
Hospital Admission ◽  
Pulmonary Disease ◽  
Family Physician ◽  
Mortality Rates ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
Significant Mortality

BACKGROUND: Chronic obstructive pulmonary disease (COPD) is associated with significant mortality. It is currently the fourth leading cause of death in Canada and the world.OBJECTIVES: To describe the mortality of elderly patients in Ontario after hospital admission for COPD.METHODS: A retrospective cohort study was conducted using the Discharge Abstract Database from the Canadian Institute for Health Information. Patients aged 65 years and older who were admitted to hospital between 2001 and 2004 with primary discharge diagnoses labelled with International Classification of Diseases, Ninth Revision codes 491, 492 and 496 were included in the study.RESULTS: Mortality rates were 8.81, 12.10, 14.53 and 27.72 per 100 COPD hospital admissions at 30, 60, 90 and 365 days after hospital discharge, respectively. Mortality also increased with age, and men had higher rates than women. No significant differences in mortality rates were found between different socioeconomic groups (P>0.05). Patients with shared care of a family physician or general practitioner and a specialist had significantly lower mortality rates than the overall rate (P<0.05), and their rates were approximately one-half the rate of patients with only one physician.CONCLUSIONS: Hospitalization with COPD is associated with significant mortality. Patients who were cared for by both a family physician or general practitioner and a specialist had significantly lower mortality rates than those cared for by only one physician, suggesting that continuous and coordinated care results in better survival.

Flaws in Study of Management of Children with Febrile Illness

PEDIATRICS ◽  
1983 ◽  
Vol 71 (5) ◽  
pp. 866-867
Author(s):  
JOURNAL CLUB
Keyword(s):  
General Practitioner ◽  
General Hospital ◽  
General Practitioners ◽  
Family Physician ◽  
Journal Club ◽  
Febrile Illness ◽  
Emergency Rooms ◽  
Children's Hospital ◽  
Children’S Hospital

To the Editor.— Our residency's journal club recently reviewed your October issue and the article on management of febrile illness.1 We found it to be misleading and inconclusive for the following reasons. First, the study presented itself as a comparison of the management of fever in children by pediatricians and "general practitioners." Based on introductory statements the term "general practitioner" implies family physician, but this is not clearly stated. As the article progresses, we find the data collected are based on experience in emergency rooms at a children's hospital v a "general" hospital, each staffed by residents or interns.

Configuration of Circle of Willis and Its Clinical Significance

2018 ◽  
Vol 08 (04) ◽  
pp. 270-273
Author(s):  
Aisha Hassan Brohi ◽  
Kevin Joseph Jerome Borges ◽  
Gulraiz Hikmat Yar ◽  
Syed Nudrat Nawaid Shah ◽  
Nuzhat Hassan
Keyword(s):  
Clinical Significance ◽  
Anatomical Variations ◽  
Circle Of Willis ◽  
Brain Diseases ◽  
Clinical Implications ◽  
Clinical Effects ◽  
Radiological Procedures

In occlusive vascular brain diseases, the structure of the circle of Willis is of immense importance. A high percentage of variations have been reported in the arteries forming circle of Willis. These have profound clinical implications. With advances in interventional radiological procedures, the interventional radiologists and neurosurgeons need to have thorough knowledge of these variations. This article will help readers understand the significance of anatomical variations and their clinical effects.

scholarly journals The Role of Nitric Oxide, ADMA, and Homocysteine in The Etiopathogenesis of Preeclampsia—Review

2019 ◽  
Vol 20 (11) ◽  
pp. 2757 ◽  
Author(s):  
Weronika Dymara-Konopka ◽  
Marzena Laskowska
Keyword(s):  
Nitric Oxide ◽  
Asymmetric Dimethylarginine ◽  
Disease Process ◽  
Endothelial Activation ◽  
Morbidity And Mortality ◽  
Clinical Implications ◽  
Target Tissue ◽  
Vessel Involvement

Preeclampsia is a serious, pregnancy-specific, multi-organ disease process of compound aetiology. It affects 3–6% of expecting mothers worldwide and it persists as a leading cause of maternal and foetal morbidity and mortality. In fact, hallmark features of preeclampsia (PE) result from vessel involvement and demonstrate maternal endothelium as a target tissue. Growing evidence suggests that chronic placental hypoperfusion triggers the production and release of certain agents that are responsible for endothelial activation and injury. In this review, we will present the latest findings on the role of nitric oxide, asymmetric dimethylarginine (ADMA), and homocysteine in the etiopathogenesis of preeclampsia and their possible clinical implications.

Reactivity of amniotic fluid alpha-fetoprotein with concanavalin A in relation to gestational age: clinical implications.

1980 ◽  
Vol 26 (12) ◽  
pp. 1656-1659 ◽  
Author(s):  
K Toftager-Larsen ◽  
E Kjaersgaard ◽  
J C Jacobsen ◽  
B Nørgaard-Pedersen
Keyword(s):  
Amniotic Fluid ◽  
Clinical Significance ◽  
Concanavalin A ◽  
Gestational Age ◽  
Normal Values ◽  
Alpha Fetoprotein ◽  
Clinical Implications ◽  
Fetal Malformation ◽  
Average Decrease ◽  
Normal Outcome

Abstract We used concanavalin A crossed-line affinity immunoelectrophoresis to determine the percentage of concanavalin A nonreactive alpha-fetoprotein in amniotic fluid samples from pregnancies with normal and abnormal fetuses. In 167 samples from pregnancies with a normal outcome and normal values for total alpha-fetoprotein concentration in amniotic fluid the percentage decreased from a median value of 27.4% in the 13th week to 8.5% in the 21st week of gestation, and a statistically significant (p &lt; 0.001) average decrease of 1.7% per week was found from the 14th to the 19th week. A similar average decrease (2.2%) was found in 22 pregnancies from which two or more samples were obtained. The clinical significance of this decrease is discussed. Of 108 samples from patients with above-normal values for total alpha-fetoprotein and a normal outcome, seven had a total alpha-fetoprotein above recommended cut-off values, and only one of these had a low percentage of concanavalin A nonreactive alpha-fetoprotein. In contrast, for all 27 samples from pregnancies with a severe fetal malformation this percentage was low, even in one case where the total alpha-fetoprotein concentration was below the recommended cut-off value.

P1182Asymptomatic masses on the pacing leads - influence on long term survival

EP Europace ◽  
2020 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Polewczyk ◽  
D Nowosielecka ◽  
A Tomaszewski ◽  
W Brzozowski ◽  
D Szczesniak-Stanczyk ◽  
...  
Keyword(s):  
Connective Tissue ◽  
Clinical Significance ◽  
Electronic Devices ◽  
Single Center ◽  
Term Survival ◽  
Long Term Survival ◽  
Cardiac Implantable Electronic Devices ◽  
Pacing Leads

Abstract Background Asymptomatic Masses on Endocardiac Leads  (AMELs) are relatively often found in echocardiography in patients with cardiac implantable electronic devices (CIED) but their clinical significance is unknown. Purpose Aim of the study was to evaluate the incidence of AMELs and assesment of their influence on long term survival (mean follow up- 4,28 ± 3,13 years) of patients undergoing transvenous leads extraction (TLE). Methods We analyzed the clinical data of patients undergoing TLE in single center in years 2006-2019. Echocardiography before TLE was performed in 2558  patients (60,4% male). AMELs were detected in 426 (16,7%) cases. Classifications of AMELs included connective tissue surronding the leads, clots, alike vegetations masses.  Additionally, real vegetations, thickening of the leads and strong connective tissue scars were distinguished. Long term survival was compared between individual types of AMELs and patients without any additional masses on the leads. Results are presented in the table. Conclusion Poor long-term survival was observed in patients with AMELs on the pacing leads. Abstract Table

scholarly journals General practitioner referral of older patients to Improving Access to Psychological Therapies (IAPT): an exploratory qualitative study

2018 ◽  
Vol 42 (3) ◽  
pp. 115-118 ◽  
Author(s):  
Noel Collins ◽  
Laurie Corna
Keyword(s):  
Older Adults ◽  
General Practitioner ◽  
Thematic Analysis ◽  
Older Patients ◽  
Watchful Waiting ◽  
Behavioural Therapy ◽  
Clinical Implications ◽  
Psychological Therapies ◽  
Cognitive Behavioural ◽  
Willingness To Refer

Aims and methodTo understand general practitioner (GP) reticence to refer older patients to a local Improving Access to Psychological Therapies (IAPT) service providing mostly cognitive–behavioural therapy (CBT)-based interventions. Semi-structured, hour-long interviews were conducted with eight GPs and then analysed by modified grounded theory and thematic analysis.ResultsGP views regarding the treatability of older adults with CBT influenced their willingness to refer to a CBT-based IAPT service. Perceptions of local IAPT assessment processes being distressing and onerous to older patients also motivated referral inaction. GPs expressed a preference to treat depressed older patients themselves (with medication and psychological approaches such as watchful waiting).Clinical implicationsAny strategy to increase referral rates of older adults to CBT-based IAPT services should address local GP concerns regarding assessment processes and the effectiveness of offered treatments.Declaration of interestNone.

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