Identifying the sick: can biochemical measurements be used to aid decision making on presentation to the accident and emergency department.

Background: Early and accurate identification of patients who may benefit from aggressive optimal medical intervention is essential if improved outcomes in terms of survival are to be achieved. We studied the usefulness of routine clinical measurements and/or markers of metabolic abnormality in the early identification of those patients at greatest risk of deterioration on presentation to the accident and emergency department.

Methods: We conducted a prospective observational study in the accident and emergency department of a 602-bed district general hospital.

Improving senior house officer training in accident and emergency medicine: the benefits of a diploma.

Accident and emergency is a fascinating specialty providing exposure to a wide range of acute and chronic conditions from all branches of medicine. To ensure a minimal standard of training nationally we propose the introduction of a diploma for junior doctors.

Women and migration: a public health issue.

The need to migrate is usually a function of the complex interaction of economic, social, familial and political factors. Among the most important, however, are the denial of access to education, employment, goods and services and the lack of respect for basic human rights. Because in many societies women are marginalized from these rights, migration to more economically and educationally open societies can often help improve their personal situation and their professional opportunities.

Distribution of ear drops using a non-aerosol spray delivery system.

The distribution of ear drops in normal ears is variable. A new product Otomize (Stafford-Miller) containing dexamethasone and neomycin has a non-aerosol spray mist delivery system. This has been applied to normal ears and found to be superior in its distribution to generally available ear drops previously assessed.

Distribution of ear drops in normal ears.

Ear drops are prescribed widely with little thought for the distribution inside the ear canal. This study compares the distribution of water and oil based drops. The results indicate that, under the test conditions, the penetration of ear drops is extremely variable.

Mucosal thickening on sinus X-rays and its significance.

Mucosal thickening is commonly seen on X-rays of the paranasal sinuses taken in the ENT department. This sometimes leads to a sinus washout, which is clear, even though the X-rays were strongly suggestive of disease. This paper examines the prevalence of sinus X-ray anomalies in a general population, having facial X-rays for conditions other than possible sinus disease.

Recurrent multiple epidermoid inclusion cysts following rhinoplasty--an unusual complication.

Epidermoid inclusion cysts are a relatively common finding following superficial trauma. Inclusion cysts have previously been reported following rhinoplasty, but these have been mucosal cysts and one case of a paraffinoma. A case of multiple recurrent epidermoid inclusion cysts, developing in relation to rhinoplasty, is presented.