Investigation of acute flank pain: how do practices of U.K.and Irish urologists compare with those of transatlantic and continental European colleagues?

Background And Purpose: Noncontrast-enhanced spiral CT (NESCT) is more accurate and reliable than intravenous urography (IVU) in diagnosing the cause of acute flank pain. This study aimed to determine the impact of current literature on the choice of imaging modality used to investigate acute flank pain within the UK and the Republic of Ireland.

Materials And Methods: A questionnaire regarding the preferred investigation for acute flank pain was sent to all consultant urologists registered as British Association of Urological Surgeons members.

Awareness of correct use of a seatbelt among pregnant women and health professionals: a multicentric survey.

A questionnaire survey was conducted to determine if pregnant women and healthcare professionals were aware of the correct use of a seatbelt and if advice was given. A total of 154 pregnant women and 56 health professionals were included in the study. A total of 115 (74.

Renal ultrasonography not required in babies with isolated minor ear anomalies.

Aim: To determine whether infants with isolated minor anomalies of the external ear are at increased risk of renal malformations.

Methods: Consecutive infants with isolated minor anomalies of the external ear (preauricular skin tags, preauricular sinuses, ear pits, and misshapen pinnae) were offered renal ultrasonography by experienced sonographers over a 41 month period. The prevalence of renal anomalies in such infants was compared with that detected on routine fetal scanning during the same period.

The persistent foramen ovale and migraine.

There is association between migraine, particularly migraine with aura, and large persistent foramen ovale (PFO) and other right-to-left shunts. Migraine is often improved by closure of a PFO in patients who have a large shunt. Inheritance of migraine is linked to the inheritance of large atrial shunts in some families.

Parents' information needs about the treatment of their chronically ill child: a qualitative study.

Unlabelled: Effective information provision is a prerequisite for partnership between child patients, their parents and health professionals.

Objectives: To explore the complexity of parents' information needs and how current information provision is evaluated.

Methods: Qualitative methodology using semi-structured interviews with 27 parents of 20 families with a chronically ill child, recruited at the paediatric department of a British district general hospital.

Clopidogrel reduces migraine with aura after transcatheter closure of persistent foramen ovale and atrial septal defects.

Objective: To report the clinical events leading to alteration of an anticoagulation regimen for patients undergoing transcatheter closure of an atrial shunt and how this affected migraine symptoms after the closure procedure.

Method: Audit of a change of anticoagulant regimen.

Results: In the first few weeks after a closure procedure migraine frequency and severity increased despite treatment with aspirin for six months in 71 patients.

An evaluation of taster days to recruit untrained health care staff to pre-registration mental health nurse education within one UK university.

With a decrease in the amount of college leavers available to recruit to nurse training and a simultaneous increase in demand for nurses, achieving recruitment targets is becoming more difficult. The widening participation agenda has encouraged us to look wider and one very rich area for recruitment is untrained health and social care staff. Some of this group do eventually opt for professional education, but many could take up places sooner, but lack the confidence or the information they need to make informed decisions.

The investigation and management of neonatal hypoglycaemia.

Assessment of neonatal glycaemic status requires accurate and reliable measurement of blood glucose concentrations. Most point-of-care technologies are, however, unsuitable for use in neonates. Although the definition of hypoglycaemia remains elusive, current knowledge allows adoption of pragmatic threshold blood glucose concentrations when clinical intervention should be considered.

An algorithm to standardise the investigation of the undiagnosed traumatic painful adult hip: results at one year.

Introduction: A significant number of adults present to accident and emergency departments with a painful hip following a fall. When plain radiography is non-diagnostic, it has been traditionally difficult to decide on further investigations as rapid access MRI is still unavailable in many NHS hospitals and, therefore, alternative methods of reliable investigation are required.

Patients & Methods: An algorithm was designed for the management of these patients without the availability of MRI investigation.

Percutaneous gastrostomy in patients with complete obstruction of the upper digestive tract.

Gastrostomy for nutritional support can be performed radiologically when endoscopic technique is not possible. In patients with complete obstruction of the upper digestive tract, the radiological technique in its conventional method may not be possible, as insertion of naso-gastric tube for gastric insufflation is not always successful. We reviewed our experience of gastrostomy insertion in nine such patients after failure of the conventional method.

Arthroscopic observation of capsulolabral reduction after shoulder dislocation.

The standard treatment for most first-time anterior shoulder dislocations is reduction and immobilization. This places the arm in a position of adduction and internal rotation. We question whether this position assists or hinders reduction of a displaced capsulolabral injury (Bankart lesion).

Individualised unsupervised exercise training in adults with cystic fibrosis: a 1 year randomised controlled trial.

Background: Short term studies of exercise training have shown benefits in cystic fibrosis. Transferring exercise programmes to the community and sustaining them long term is a challenge for the patient. The effectiveness of an individualised unsupervised home based exercise programme was examined in adults with cystic fibrosis over a 1 year period.

Inheritance of persistent foramen ovale and atrial septal defects and the relation to familial migraine with aura.

Objective: To determine whether smaller atrial shunts (large persistent foramen ovale (PFO) and small atrial septal defect (ASD)) are inherited and whether this has a role in the inheritance of migraine with aura.

Methods: Contrast echocardiography was used to detect atrial shunts in 71 relatives of 20 probands with a significantly sized atrial shunt (large PFO or ASD). Four families with three generations, 14 families with two generations, and two sibships were studied.

The use of essential oils to treat snoring.

Snoring is a very common social inconvenience. This double-blind study suggests a significant reduction in snoring reported by bed partners in a group of snoring volunteers using either an essential oil spray or gargle formulation. Possible modes of action of the essential oils are discussed.

Intramural molar pregnancy: a case report.

Background: Intramural pregnancy is a rare but potentially life-threatening condition. The condition remains unknown to many clinicians and sonographers. With the ever-increasing use of high-resolution ultrasound scanning, early diagnosis of the condition is now possible, provided that the condition is thought of.

Current trends in bladder cancer in England and Wales.

Purpose: We examined trends in bladder cancer (BC) incidence, mortality and survival in England and Wales during a 30-year period.

Materials And Methods: Age standardized incidence and mortality rates for BC, cohort incidence ratios, and 1 and 5-year relative survival from BC were calculated, and current trends were assessed.

Results: Between 1971 and 1998 the total number of cases of BC increased by 57% from around 7,200 to almost 11,400.

A survey on the management of reactionary haemorrhage following adenoidectomy in the UK and our practice.

We present the results of a nation-wide survey in the management of reactionary haemorrhage following adenoidectomy, in the absence of specific national guidelines for this complication in the UK. We have reported the practice of the consultant members of the BAO-HNS through a confidential postal questionnaire with regard to their preferred method of management and experience. Valid replies were received from 285 ENT surgeons, of which 87.

The combined orthodontic and surgical treatment of traumatic Class II division 2 in the adult.

A mild Class II division 2 incisal relationship is often associated with a pleasing facial profile and aesthetically acceptable arrangement of the teeth. Severe cases, however, have the potential to cause trauma and a number of older patients present with extensive soft and hard tissue damage. Management options may range from simple preventive advice to complicated surgical orthodontics.

The assessment of ocular injury by ultrasound.

Ocular trauma is readily investigated by ultrasound, which is of particular value when the light conducting media are opacified by haemorrhage or other injury. In this situation, direct visualization of the ocular contents by ophthalmoscopy is difficult or impossible. Severe complications are treated by microsurgical techniques, and ultrasound evaluation represents the only practicable method of examination for surgical planning.

Inhaler technique in older people in the community.

Background: Good inhaler technique and medication concordance is important for symptom and disease control in chronic airways disease.

Objectives: Establish the prevalence of inhaler use; the main inhaler devices used by older people at home; their ability to use the inhalers they have been prescribed; and the relationship between perceived ease of use and actual performance.

Design: Cross-sectional population based study.

Ethnic differences in the rates of BCG vaccination.

An audit of the selective neonatal BCG immunisation programme showed that only 51% of eligible infants received the vaccination. Infants of Indian subcontinental origin (ISC) were significantly more likely to have been vaccinated than non-ISC infants (ISC 70% v non-ISC 29%). Greater awareness of the eligibility of non-ISC infants for BCG as well as simplification of the eligibility criteria are needed to help increase BCG vaccination rates.