Nonischemic central retinal vein occlusion in an adolescent patient with ulcerative colitis.

Inflammatory bowel disease (IBD) can present with extraintestinal manifestations occasionally involving the eye. Retinal vein occlusions are rarely seen and have never been reported in the pediatric population though vascular thrombosis can be associated with IBD. Here, we present a case of what we believe is the youngest reported patient with nonischemic central retinal vein occlusion (CRVO).

Surgical management of troublesome mastoid cavities.

Objective: To examine the reasons for discharging mastoid cavities, the operative findings during revision surgery, and the medium-term outcome.

Patients: One hundred and forty revision mastoidectomies in 131 patients were studied. Post-operatively, patients were followed up at three, six and 12 months and then yearly.

A problem in diagnostic imaging.

Many pathological processes can present as a swelling in the groin. We present a case of complex, ruptured pyonephrosis causing a psoas collection, which in turn presented clinically as an apparent right "incarcerated inguinal hernia." The patient was successfully treated with antibiotics and ultrasound-guided drainage of the abscess.

Topical vaginal estrogen therapy in managing postmenopausal urinary symptoms: a reality or a gimmick?

Postmenopausal estrogen deprivation has been suggested as a risk factor for lower urinary tract dysfunction including stress incontinence, overactive bladder and recurrent urinary tract infection. These symptoms could have enormous effects on individuals and health-care providers in terms of impact on quality of life and cost. Recent randomized, controlled trials suggested that systemic hormone replacement therapy does have a negative effect on female lower urinary tract function, probably because of the progestogen component.

Titanium versus nontitanium ossicular prostheses-a randomized controlled study of the medium-term outcome.

Objective: The study compares the medium-term outcome of ossiculoplasty using titanium and nontitanium prostheses.

Study Design: Randomized controlled, prospective clinical trial.

Setting: District general hospital.

Premenopausal bleeding: When should the endometrium be investigated?--A retrospective non-comparative study of 3006 women.

Objective: There is lack of consensus amongst professional organizations as regards the cut-off age for endometrial sampling of premenopausal women presenting with abnormal uterine bleeding (AUB) to exclude endometrial hyperplasia or carcinoma. Therefore we conducted this study to quantify the prevalence of hyperplasia and carcinoma in different age categories in premenopausal women with AUB to identify the appropriate cut-off age for endometrial sampling.

Study Design: A retrospective review of the histopathology reports of endometrial samples taken from 3006 women presenting with AUB and aged from > or =30 to < or =50 years at Ipswich Hospital, UK, from 1 January 1998 to 31 December 2007.

Irregular surface compensation for radiotherapy of the breast: correlating depth of the compensation surface with breast size and resultant dose distribution.

Irregular surface compensation uses dynamic multileaf collimators to modify the fluence to an irregular surface along the cranio-caudal axis. The depth of the compensation surface can be varied by specifying a user-defined parameter called the transmission penetration depth (TPD). In our institution, a review has been carried out of 60 breast patients treated using irregular surface compensation of the tangent fields.

Levonorgestrel-releasing intrauterine system--the discontinuing story.

Levonorgestrel-releasing Intrauterine System (LNG-IUS) is licensed for use as a contraceptive, for the treatment of heavy menstrual bleeding and during estrogen replacement therapy. It is publicized as a local source of progestogen with minimal systemic adverse effects. However, there is overwhelming evidence of elevated serum and tissue levels of levonorgestrel, and high discontinuation and dissatisfaction rates amongst users.

Towards evidence based emergency medicine: Best BETs from the Manchester Royal Infirmary. BET 1: Is ultrasound or chest x ray best for the diagnosis of pneumothorax in the emergency department?

ED transthoracic ultrasound is better than plain x ray in the diagnosis of pneumothorax in the supine patient. CT thorax is the gold standard for diagnosis.

Postcoital bleeding: a study of the current practice amongst consultants in the United Kingdom.

Objectives: To measure the variations amongst consultant gynaecologists all over the UK in managing women with postcoital bleeding (PCB).

Study Design: A questionnaire was sent to 1020 consultant gynaecologists in the UK, using the database of The Royal College of Obstetricians and Gynaecologists, enquiring about their opinions and the details of practice.

Results: Six hundred and fourteen (60%) replies were received.

Advances in deep vein thrombosis management with thrombolysis.

Lower extremity deep vein thrombosis (DVT) is a common disease associated with serious short term and long term complications. Its conventional treatment has been anticoagulation. Thrombolytic treatment has been used for DVT for over 40 years.

Evaluating bone health in women with oestrogen receptor positive breast cancer (ERBC) starting aromatase inhibitors.

Aims: There is an increase in fractures in women with oestrogen receptor positive breast cancer (ERBC) particularly those taking aromatase inhibitors (AIs). How to identify women at osteoporosis risk, assess bone health and who to treat, are questions not adequately answered by previous studies.

Methods: We present an audit of osteoporosis risk factors, bone mineral density (BMD) measurement and other data relevant to bone health (falls and laboratory tests) in 85 women with ERBC starting AIs.

International Common Otology Database: taste disturbance after stapes surgery.

Objective: To use a study on dysgeusia to assess the usefulness of an otology database.

Study Design: Data were extracted from the international Common Otology Database.

Intervention: Primary stapes operations.

Promoting healthy eating: the role of pre-operative assessment.

Aim: The recent significant rise in childhood obesity requires a commitment from all healthcare professionals to promote healthy eating and exercise when working with children. The aim of this project was to identify the number of children attending pre-operative assessment who were overweight or obese, and to offer support and advice to these children and their families. This was achieved by establishing a working group to develop a tool to identify the number of children presenting as overweight or obese at pre-operative assessment, and to produce a nutritional support package that follows locally agreed guidelines for children whose body mass index (BMI) falls outside the normal range for their age.

Cartilage tympanoplasty: literature review.

There has been renewed interest in the use of cartilage for middle-ear reconstructions. The aim of the present review is to examine the indications, techniques and surgical outcomes of cartilage tympanoplasties reported in the literature. There have been concerns regarding weakening of cartilage struts, from histological studies involving explants; as a result, cartilage struts for ossiculoplasty have not gained popularity.

Administration of oxygen therapy.

This article aims to increase nurses' knowledge of the safe administration of oxygen therapy in acute care. The administration and potential complications associated with delivery of oxygen to patients with chronic obstructive pulmonary disease (COPD) and type II respiratory failure are discussed.

Mid-temporal pericranial and inferiorly based periosteal flaps in mastoid obliteration.

Objective: To study the outcome of mastoid obliterations where mid-temporal pericranial flap and inferiorly based periosteal flap were used.

Study Design: A prospective longitudinal study with a minimum follow-up of 1 year.

Subjects And Methods: Between 2000 and 2005, 102 mastoid obliterations were performed on 96 patients, the majority having hydroxyapatite granules as fillers.

A 5-year observational study of the outcome in pediatric cholesteatoma surgery.

Objective: The present report is a 5-year observational study after pediatric cholesteatoma surgery.

Study Design: Retrospective analysis was made on pediatric cholesteatoma cases in a county hospital.

Intervention: Between 1988 and 2001, 52 primary cholesteatoma operations were performed on 50 children.

A longitudinal study on pediatric myringoplasty.

Objectives: Observational study on pediatric myringoplasty to examine the success rate in young and older children.

Patients And Intervention: Fifty-one first-time primary myringoplasties were analyzed on children aged 4 to 13 years.

Main Outcome Measures: Using life-table analysis, the survival course of the graft in young children (aged 4-8 yr) was compared with those in older children (aged 9-13 yr).

Change in health status after rhinoplasty.

Objective: To assess the change in health status of patients undergoing rhinoplasty.

Design: Retrospective mail-based questionnaire study using a validated post-intervention questionnaire specifically designed for otolaryngology surgery.

Setting: District general hospital otolaryngology department.