In a previous study, emergency nurses gave a high priority to the educational topics of geriatric depression, physical assessment of the elderly, and mental status testing. Our objective was to measure the impact of a 1-day workshop for emergency nurses that addressed these educational needs.
The workshop consisted of case-based didactic sessions addressing (1) physical assessment of the elderly, (2) delirium, depression, and dementia, and (3) a practical approach to mental status testing in the elderly. The educational program was evaluated using 2 methods: (1) before, and 1 month after, the workshop, participants rated their own practice patterns; and (2) during the course of 2 years, changes in the number of referrals for geriatric assessment and home care from a large emergency department in the study area were monitored.
Of 101 ED nurses who attended the 1-day workshop, 51 completed both preworkshop and postworkshop questionnaires (response rate, 50.5%). the most significant self-reported changes in practice 1 month after the workshop were improved screening for depression and altered mental status in older adults (P
Level VI central neck dissections are commonly completed with thyroidectomy. This procedure involves risk of damage to, or incidental excision of, one or more of the parathyroid glands.
This study examined the pathology reports of patients undergoing thyroid surgery to determine the incidence of parathyroid tissue associated with level VI neck dissections and the risk factors associated with incidental parathyroidectomy.
Ninety pathology specimens were analyzed. The incidence of parathyroid tissue associated with level VI neck dissections was 41.4%. We discovered that a higher frequency of incidental parathyroid tissue was located in level VI neck dissections among patients discovered to have malignant thyroid disease. There was no significant association between incidental parathyroidectomy and the sex of the patient, the age of the patient, the type of thyroid surgery, or transient or permanent hypoparathyroidism.
A large percentage of level VI neck dissections in thyroid surgery were associated with incidental parathyroid tissue. A more detailed examination of surgical specimens may decrease this possibly preventable surgical complication.
This study was completed to evaluate the middle ear microbiology of a pediatric population with chronic otitis media with effusion and to determine if there has been a change in the spectrum of microorganisms or their antibiotic susceptibility in the modern age of antibiotic therapy.
Retrospective chart review.
A Canadian academic pediatric otolaryngology practice.
This study includes all consecutive patients under the care of one pediatric otolaryngologist undergoing myringotomy and tube placement between the dates of September 2008 and August 2010. Tympanocentesis was performed on each middle ear immediately following the myringotomy, and the specimen was sent for microbiologic analysis.
Culture results and sensitivities were compared to previous similar studies.
A total of 246 children (average age of 4 ± 3 years) and 506 ears had culture results as follows: normal flora, 47%; no growth, 35%; Haemophilus influenzae, 9%; Streptococcus pneumoniae, 4%; Moraxella catarrhalis, 3%; and Staphylococcus aureus, 2%. Ten of the 11 S. aureus cultures were methicillin resistant. The rate of pathogenicity decreased from 36.5% in children aged