Management of the N0 neck--reference or preference.

For patients with squamous cell carcinoma of the upper aerodigestive tract, appropriate management of the regional lymph nodes is an important and often controversial issue that has significant influence on survival. Over the years radical treatment either by surgery or radiotherapy contributed to improvement in prognosis. Recently, a more conservative approach has achieved a similar level of cancer control with less morbidity.

Elective and therapeutic selective neck dissection.

Selective neck dissection is a modification of the more comprehensive modified radical or radical neck dissection that is designed to remove only those nodal levels considered to be at risk for harboring nodal metastases. The role of selective neck dissection continues to evolve: while initially designed as a staging and diagnostic procedure for patients without clinical evidence of nodal disease, a growing body of literature suggests that selective neck dissection has a therapeutic role in patients with clinical and histologic evidence of nodal metastases. The rationale behind selective neck dissection, its application in the clinically negative but histologically node-positive neck and the extended application of selective neck dissection in patients with clinical evidence of nodal disease are discussed.

Use of nonpharmacologic interventions for pain and anxiety after total hip and total knee arthroplasty.

Purpose: The purpose of this study was to compare pain and anxiety in orthopaedic patients scheduled for elective total hip or knee arthroplasty who have received a kit of nonpharmacologic strategies for pain and anxiety in addition to their regularly prescribed analgesics to those who receive the usual pharmacologic management alone.

Design: Descriptive comparative and correlational design using surveys and chart audits.

Sample: Sixty-five patients randomized to receive usual care or usual care plus a kit of nonpharmacologic strategies.

Symptom validity assessment: practice issues and medical necessity NAN policy & planning committee.

Symptom exaggeration or fabrication occurs in a sizeable minority of neuropsychological examinees, with greater prevalence in forensic contexts. Adequate assessment of response validity is essential in order to maximize confidence in the results of neurocognitive and personality measures and in the diagnoses and recommendations that are based on the results. Symptom validity assessment may include specific tests, indices, and observations.

Renkioi: a forgotten Crimean War hospital and its significance.

Renkioi Civil Hospital was built late in the Crimean War (1854-6) in Turkey on the Dardanelles. Designed by Isambard Kingdom Brunel, its prefabricated structure was a brilliant engineering innovation. As a civil hospital for military patients, it was staffed by experienced civilian doctors, thereby relieving the shortage of military doctors.

Stability of arithmetic disability subtypes.

Cross-sectional research has identified subtypes of children with learning disabilities who may have distinctive cognitive ability patterns. This study examined the stability over 19 months of academic subtyping classifications for 80 children ages 9 to 13 representing four subtypes of arithmetic disabilities (AD), using three criteria for learning disability identification. Approximately half of the sample retained AD regardless of identification method.

Techniques for radiofrequency ablation of head and neck tumors.

Objectives: To describe the various techniques that have been developed for application of radiofrequency ablation in the palliative treatment of recurrent and advanced head and neck malignant tumors.

Design: Case series with a follow-up of 3 to 18 months.

Setting: Faculty practice, research protocol, tertiary care academic medical center.

Radiofrequency ablation of head and neck tumors: dramatic results from application of a new technology.

Background: Radiofrequency ablation (RFA) is a new treatment modality used over the past decade predominantly in the treatment of unresectable liver tumors. We find no prior reported series on the use of RFA for malignant tumors of the head and neck.

Methods: Four patients with recurrent tongue tumors not amenable to standard surgical or radiation therapy were treated with RFA administered transorally, endoscopically, or percutaneously.