International journal of clinical practice
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Int. J. Clin. Pract. · Mar 2002
Randomized Controlled Trial Multicenter Study Clinical TrialMultidose flurbiprofen 8.75 mg lozenges in the treatment of sore throat: a randomised, double-blind, placebo-controlled study in UK general practice centres.
The flurbiprofen 8.75 mg lozenge is a novel formulation that combines a demulcent effect with the analgesic activity of a non-steroidal anti-inflammatory drug. Previous controlled clinical studies have demonstrated the single- and multi-dose efficacy of these lozenges over placebo. ⋯ Additionally, significant benefit over placebo was demonstrated where concomitant antibiotic use was introduced, indicating that flurbiprofen 8.75 mg lozenges can be co-administered when antibiotic therapy is appropriate. No significant safety issues were identified.
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Int. J. Clin. Pract. · Mar 2002
Randomized Controlled Trial Comparative Study Clinical TrialComparison of non-invasive ventilation and standard medical therapy in acute hypercapnic respiratory failure: a randomised controlled study at a tertiary health centre in SE Turkey.
This study was designed in a tertiary health centre in south-eastern Turkey to compare the effectiveness of non-invasive ventilation (NIV) plus standard medical therapy (ST) to ST alone, in acute hypercapnic respiratory failure (AHRF) due to chronic obstructive pulmonary disease (COPD) exacerbation. Thirty-four consecutive patients were randomly assigned to receive either NIV plus ST or ST alone. NIV was applied with a simple non-invasive ventilator through a full face mask in the general ward. ⋯ PaO2 (p<0.05) showed significant improvement only in the first hour of ST. The intubation rate and duration of hospitalisation in the NIV group were significantly shorter than those in the ST group (p<0.05). We conclude that NIV provides adjunctive therapeutic benefits compared with ST alone, and should be the choice of first step treatment in the AHRF due to COPD exacerbation in the appropriate setting and in selected patients.
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Int. J. Clin. Pract. · Jan 2002
Use of a customised endotracheal tube for tracheostomy in the large neck.
Patients with huge necks who require a tracheostomy pose particular problems. This paper describes a technique to customise a standard endotracheal tube to make a long tracheostomy tube. This can be used as a short-term emergency airway. It is recommended because it is cheap, simple, safe and potentially life saving.
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Int. J. Clin. Pract. · Jan 2002
Comparative StudyReferral patterns to a district general hospital gastroenterology outpatient clinic: implications for the 'two-week target'.
We defined the pattern and appropriateness of GPs' new-patient referrals to a large district general hospital gastroenterology department, and assessed the implications for workload in the context of the recently introduced 'two-week target'. Prospective data were collected on all new referrals over a two-month period and 426 new appointments were included, from which data were available on 390. ⋯ Nineteen per cent of all GP referrals were classified as urgent and 6% of these had a malignancy. Fifty per cent of patients with malignancy were not perceived as meriting an urgent referral by the GP Gastroenterology outpatient facilities are already overstretched and the implementation of the two-week target will add considerable strain to the current resources, with little gain in identifying malignancy.
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A foreign body causing obstruction of the larynx is usually removed by coughing, blows to the back, chest thrusts, abdominal compression or finger sweep manoeuvres on the unconscious victim. In extremis, crichothyroidotomy or emergency tracheostomy may be the only life-saving option. ⋯ A case of supraglottic impaction of the larynx by a piece of sausage occurred in our hospital; the patient was semiconscious. It was managed successfully by a carefully timed laryngoscope blade being inserted into the mouth without the aid of sedative drugs.