Management of retrosternal goitres: results of early surgical intervention to prevent airway morbidity, and a review of the English literature.

We present our experience and also review the world literature on the management of retrosternal goitres (RSGs). There is now irrefutable evidence that almost all RSGs will continue to grow and eventually cause airway compression. We describe the diagnosis, investigation and surgical approach to the management of this condition.

Hernia through an iliac crest bone graft site: report of a case and review of the literature.

The iliac crest is a common donor site for autogenous bone graft as it offers the advantage of easy access and a relatively large and safe supply of bone. One of the less frequently reported complications of harvesting bone grafts from the iliac crest is a graft-site hernia. In the last decade less than 15 cases have been reported, however the true incidence of this complication is unknown.

Comparison of subjective perception with objective measurement of olfaction.

Objective: To see if nasal peak inspiratory flow rate and subjective sense of smell had any correlation with olfactory thresholds.

Study Design And Setting: A cohort study of 186 normal volunteers was recruited from among staff and visitors at a university hospital. Olfactory thresholds were detected for each subject (103 with eucalyptol and 83 with phenethyl alcohol), along with nasal peak inspiratory flow (PIFR).

Dall-Miles cable and plate fixation system in the treatment of periprosthetic femoral fractures: a review of 20 cases.

Purpose: To assess the effectiveness of Dall-Miles cables and plates in the treatment of periprosthetic femoral fractures around hip arthroplasties.

Methods: We retrospectively reviewed 20 cases of periprosthetic femoral fracture treated with the Dall-Miles cable and plate system between November 1999 and December 2002 in James Paget Hospital in the United Kingdom. Demographic data, fracture type, and surgical outcome of the patients were reviewed and assessed.

The performance of Pipelle endometrial sampling in a dedicated postmenopausal bleeding clinic.

Endometrial sampling using the Pipelle device is widely used in the UK especially in the investigation of postmenopausal bleeding. This study was aimed at evaluating the clinical benefit and diagnostic accuracy of the procedure in the setting of a dedicated one-stop clinic for women with postmenopausal bleeding. The study also examined the factors that would affect the adequacy of endometrial samples in terms of their suitability for histopathalogical examination.

Microwave endometrial ablation for menorrhagia: outcome at 2 years--experience of a district general hospital.

One hundred and twenty-three women underwent microwave endometrial ablation (MEA) for the treatment of dysfunctional uterine bleeding (DUB). The mean age at treatment was 40.2 years and the average treatment time was 2 minutes 50 seconds.

Is there a role for more day-case septal surgery?

A significant number of patients requiring septal surgery are still undergoing in-patient procedures at a time when pressures on in-patient beds are increasing. A retrospective audit of 109 patient case notes was performed to assess the potential for day-case surgery amongst patients undergoing septal surgery in the ENT department at Leicester Royal Infirmary. The other aims of the audit were to assess the overall complication rates, because these have implications for day-case surgical patients, and to see which patients should be selected.

Patients' preference for gender of urologist.

The NHS Plan is for a health service designed around the patient. Several studies have investigated patients' preference for the gender of their doctor. However, within these studies, the patients have predominantly been females.

A primigravida allegedly allergic to local anaesthetics.

Pregnant patients may give a history of allergy to local anaesthetics, but many of these supposed allergies have not been investigated. There is cross-reactivity between the amide local anaesthetics, which are the only group available in the UK for regional analgesia. We report the management of a primigravida who gave a history of allergy to two local anaesthetics, lidocaine and prilocaine.

Swallowed nasal pack: a rare but serious complication of the management of epistaxis.

Packing of the nose with a suitable material remains a popular method of treating epistaxis. The authors report a serious complication of a new design of nasal pack; Rapid Rhino, which was swallowed during the treatment of a patient with epistaxis, resulting in bowel perforation.

Initial experiences with medicinal extracts of cannabis for chronic pain: results from 34 'N of 1' studies.

Three Cannabis Based Medicinal Extracts (CBMEs) for sublingual use became available in 2000. A total of 34 'N of 1' studies were undertaken using this novel therapy for patients with chronic, mainly neuropathic, pain and associated symptoms to explore efficacy, tolerability, safety and dosages. Three CBMEs (Delta9 Tetrahydrocannabinol (THC), Cannabidiol (CBD) and a 1:1 mixture of them both) were given over a 12-week period.

Reidel's thyroiditis and Tolosa-Hunt syndrome, a rare association.

A previously undescribed association of Reidel's thyroiditis with Tolosa-Hunt syndrome is reported. A 33 year-old Caucasian female presented with a two-year history of painful progressive goitre, histologically a Reidel's thyroiditis. She underwent left partial thyroidectomy.

Sclerotherapy with bleomycin for recurrent massive inguinal lymphoceles following partial vulvectomy and bilateral lymphadenectomy-Case report and literature review.

Background: Formation of lymphoceles following radical vulvectomy presents a formidable problem that is associated with high degree of morbidity. A variety of approaches have been described in the literature to treat this condition.

Case: An 82-year-old woman developed massive inguinal lymphoceles following partial vulvectomy and inguinal lymphadenectomy for cancer vulva.

Swallowed partial dentures.

Swallowed or inhaled partial dentures can present a diagnostic challenge. Three new cases are described, one of them near-fatal because of vascular erosion and haemorrhage. The published work points to the importance of good design and proper maintenance.