Base de dados : MEDLINE
Pesquisa : M01.526.485.810.734 [Categoria DeCS]
Referências encontradas : 32 [refinar]
Mostrando: 1 .. 10   no formato [Detalhado]

página 1 de 4 ir para página            

  1 / 32 MEDLINE  
              next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:29287872
[Au] Autor:Bezdjian A; Jiang J; Maby A; Daniel SJ
[Ad] Endereço:Department of Experimental Surgery, McGill University, Montreal, Quebec, Canada; McGill Auditory Sciences Laboratory, McGill University Health Centre, Montreal, Quebec, Canada.
[Ti] Título:What to do with medialized tympanostomy tubes? A survey of pediatric otolaryngologists.
[So] Source:Int J Pediatr Otorhinolaryngol;104:220-223, 2018 Jan.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: Tympanostomy tube placement is the most common surgical procedure performed in children. Medial migration of a tympanostomy tube is a rare occurrence where the tube migrates into the middle ear cavity as opposed to its normal extrusion into the external auditory canal. Whether medialized tympanostomy tubes should be surgically removed in asymptomatic patients is controversial. The objective of this study was to determine experience and management approach of medialized tympanostomy tubes among pediatric otolaryngologists. METHODS: A 12-question cross-section survey was designed and distributed to the American Society of Pediatric Otolaryngology (ASPO) members. The survey study was granted McGill University institutional review board and ASPO research committee approval. The survey data were filtered and cross-tabulated. Descriptive statistics were generated. RESULTS: 128 pediatric otolaryngologists completed the 12-question survey. The majority of respondents had experienced at least one case of medialized tympanostomy tube (90.6%). The majority of patients (82.0%) were asymptomatic. 74 out of 128 respondents (57.8%) indicated that they would not remove a medialized tube in an asymptomatic patient. However, 7.0% of those respondents clarified that they would proceed to surgical removal if the patient were undergoing general anesthesia for another surgery. 30.5% of respondents indicated that they would surgically remove the tube even if the patient were asymptomatic. 6.3% of respondents indicated that opted management in children would be based on a shared decision with parents. Most respondents (80.5%) did not experience complications with surgical removal nor with elected observation. CONCLUSION: There is no consensus among pediatric otolaryngologists regarding the necessity of surgically removing a medialized tympanostomy tube in asymptomatic patients. The survey suggests that both options are acceptable. If observation is chosen, it is important that parents are well informed of the potential long-term sequelae of a medialized tube and advised to consult if symptoms occur.
[Mh] Termos MeSH primário: Orelha Média/cirurgia
Ventilação da Orelha Média/efeitos adversos
Próteses e Implantes/efeitos adversos
[Mh] Termos MeSH secundário: Criança
Estudos Transversais
Feminino
Seres Humanos
Masculino
Ventilação da Orelha Média/métodos
Otorrinolaringologistas
Encaminhamento e Consulta
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1801
[Cu] Atualização por classe:180116
[Lr] Data última revisão:
180116
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171231
[St] Status:MEDLINE


  2 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28964302
[Au] Autor:Swords C; Tan NC; Jonas N
[Ad] Endereço:Department of Paediatric Otolaryngology, Addenbrooke's Hospital, Cambridge, CB2 0QQ, UK.
[Ti] Título:The implications of pneumomediastinum and subcutaneous emphysema for the paediatric otolaryngologist.
[So] Source:Int J Pediatr Otorhinolaryngol;101:241-245, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:Three patients presented within a 6-month period with pneumomediastinum. The underlying cause in each was distinct. One case occurred due to blunt laryngeal trauma and required urgent surgical intervention due to a decompensating airway. The second case was related to tracheal perforation secondary to a myofibroblastic tracheal tumour and the final case was related to adenovirus upper respiratory tract infection. Pneumomediastinum may be spontaneous or secondary to an underlying cause. Children should be managed using a multidisciplinary approach. Investigation and management should be influenced by clinical stability and invasive procedures should only be considered in patients who exhibit respiratory distress.
[Mh] Termos MeSH primário: Enfisema Mediastínico/etiologia
Enfisema Subcutâneo/etiologia
[Mh] Termos MeSH secundário: Criança
Pré-Escolar
Feminino
Seres Humanos
Laringe/lesões
Masculino
Lesões do Pescoço/complicações
Otorrinolaringologistas
Tomografia Computadorizada por Raios X
Traqueia/lesões
Ferimentos não Penetrantes/complicações
[Pt] Tipo de publicação:CASE REPORTS; JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171016
[Lr] Data última revisão:
171016
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


  3 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28964285
[Au] Autor:Kay-Rivest E; Khendek L; Bernard G; Daniel SJ
[Ad] Endereço:Department of Pediatric Otolaryngology - Head and Neck Surgery, Montreal Children's Hospital, McGill University Health Center, Montreal, Quebec, Canada.
[Ti] Título:Pediatric leukodystrophies: The role of the otolaryngologist.
[So] Source:Int J Pediatr Otorhinolaryngol;101:141-144, 2017 Oct.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:BACKGROUND: Leukodystrophies consist of degenerative neurogenetic diseases often associated with comorbidities that extend beyond the neurological system. Despite their impacts on patients' quality of life and risks of complications, head and neck symptomology is poorly reported in the literature. The objective of this study was to identify and quantify the main head and neck complaints among a cohort of patients diagnosed with leukodystrophies and define the role of the otolaryngologist as part of a multidisciplinary team for treating these patients. METHODS: During the First Canadian National Conference on Leukodystrophies held at the Montreal's Children Hospital, a cohort of 12 patients diagnosed with leukodystrophies were recruited and evaluated by a multidisciplinary team. An otolaryngology-focused assessment was done through history and physical examination, and included a screening questionnaire for 23 common otolaryngology issues. If families reported a history of sialorrhea, a validated questionnaire (Drool Quality of Life Assessment Questionnaire (DroolQoL)) was subsequently distributed. Results from the questionnaires were then compiled and analyzed. RESULTS: Of the 12 recruited patients, 83% (10/12) were known to an otolaryngologist. Drooling affected 67% (8/12) of patients although only 37.5% (3/8) of patients had undergone medical or surgical therapies for this issue. Four patients experienced at least one aspiration pneumonia. 58% (7/12) of the patients had dysphagia, of whom 43% (3/12) were fed exclusively via gastrostomy tube and 28% (2/7) required thickening of feeds. Two patients, despite suspicion of dysphagia and aspiration, had never undergone evaluation. As for otologic issues, it was noted that 25% (3/12) of patients had a history of pressure equalizing tubes (PETs) and one patient had a history of hearing loss. CONCLUSION: Head and neck comorbidities affect children with leukodystrophies. Therefore, the otolaryngologist should be part of the multidisciplinary team, specifically for the management of dysphagia and sialorrhea.
[Mh] Termos MeSH primário: Transtornos de Deglutição/etiologia
Doenças Neurodegenerativas/complicações
Doenças Neurodegenerativas/terapia
Sialorreia/etiologia
[Mh] Termos MeSH secundário: Adolescente
Canadá
Criança
Pré-Escolar
Feminino
Gastrostomia
Hospitais Pediátricos
Seres Humanos
Lactente
Masculino
Otorrinolaringologistas
Qualidade de Vida
Estudos Retrospectivos
Sialorreia/complicações
Inquéritos e Questionários
Adulto Jovem
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171023
[Lr] Data última revisão:
171023
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:171002
[St] Status:MEDLINE


  4 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28895455
[Au] Autor:Fujiwara RJT; Shih AF; Mehra S
[Ad] Endereço:1 Yale University School of Medicine, New Haven, Connecticut, USA.
[Ti] Título:Cross-sectional Analysis of the Relationship between Paranasal Sinus Balloon Catheter Dilations and Industry Payments among Otolaryngologists.
[So] Source:Otolaryngol Head Neck Surg;157(5):880-886, 2017 Nov.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objective To characterize the relationship between industry payments and use of paranasal sinus balloon catheter dilations (BCDs) for chronic rhinosinusitis. Study Design Cross-sectional analysis of Medicare B Public Use Files and Open Payments data. Setting Two national databases, 2013 to 2014. Subjects and Methods Physicians with Medicare claims with Current Procedural Terminology codes 31295 to 31297 were identified and cross-referenced with industry payments. Multivariate linear regression controlling for age, race, sex, and comorbidity in a physician's Medicare population was performed to identify associations between use of BCDs and industry payments. The final analysis included 334 physicians performing 31,506 procedures, each of whom performed at least 11 balloon dilation procedures. Results Of 334 physicians, 280 (83.8%) received 4392 industry payments in total. Wide variation in payments to physicians was noted (range, $43.29-$111,685.10). The median payment for food and beverage was $19.26 and that for speaker or consulting fees was $409.45. One payment was associated with an additional 3.05 BCDs (confidence interval [95% CI],1.65-4.45; P < .001). One payment for food and beverages was associated with 3.81 additional BCDs (95% CI, 2.13-5.49; P < .001), and 1 payment for speaker or consulting fees was associated with 5.49 additional BCDs (95% CI, 0.32-10.63; P = .04). Conclusion Payments by manufacturers of BCD devices were associated with increased use of BCD for chronic rhinosinusitis. On separate analyses, the number of payments for food and beverages as well as that for speaker and consulting fees was associated with increased BCD use. This study was cross-sectional and cannot prove causality, and several factors likely exist for the uptrend in BCD use.
[Mh] Termos MeSH primário: Dilatação/instrumentação
Indústrias/economia
Otorrinolaringologistas/economia
Padrões de Prática Médica/economia
Rinite/cirurgia
Sinusite/cirurgia
[Mh] Termos MeSH secundário: Centers for Medicare and Medicaid Services (U.S.)
Doença Crônica
Estudos Transversais
Seres Humanos
Estados Unidos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1711
[Cu] Atualização por classe:171106
[Lr] Data última revisão:
171106
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170913
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817728897


  5 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28766959
[Au] Autor:Beswick DM; Messner AH; Hwang PH
[Ad] Endereço:1 Stanford University School of Medicine, Department of Otolaryngology-Head and Neck Surgery, Stanford, California, USA.
[Ti] Título:Pediatric Chronic Rhinosinusitis Management in Rhinologists and Pediatric Otolaryngologists.
[So] Source:Ann Otol Rhinol Laryngol;126(9):634-639, 2017 Sep.
[Is] ISSN:1943-572X
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: To compare the management of pediatric chronic rhinosinusitis (PCRS) between members of the American Rhinologic Society (ARS) and the American Society of Pediatric Otolaryngology (ASPO). STUDY DESIGN: Comparison of surveys. METHODS: A web-based survey was distributed to ASPO membership twice in September-October 2016. Data were compared to previously published data from ARS membership in March-April 2016. RESULTS: ASPO survey completion rate was 22%. ARS members were more likely to employ oral steroids in initial ( P = .025) and maximal medical management ( P = .001). ASPO members more commonly performed adenoidectomy before computed tomography (CT) ( P < .001). Both groups commonly included adenoidectomy as part of initial surgical management (90% vs 94%, P = .316), while ASPO members more frequently performed adenoidectomy alone (70% vs 43%, P = .001). If initial surgical treatment failed, both groups commonly performed endoscopic sinus surgery (ESS; 81% vs 88%, P = .56) with a similar extent including frontal ( P ≥ .207) and sphenoid ( P ≥ .304) surgery. CONCLUSIONS: Pediatric chronic rhinosinusitis management is similar between groups, yet there are differences including oral steroid use, relative order of CT versus adenoidectomy, and performing concomitant procedures with adenoidectomy. Both groups commonly perform ESS with similar surgical extent if prior surgical treatment fails. Management by both groups is largely in agreement with published consensus statements.
[Mh] Termos MeSH primário: Antibacterianos/uso terapêutico
Glucocorticoides/uso terapêutico
Antagonistas dos Receptores Histamínicos/uso terapêutico
Otorrinolaringologistas
Procedimentos Cirúrgicos Otorrinolaringológicos/métodos
Pediatras
Rinite/terapia
Sinusite/terapia
[Mh] Termos MeSH secundário: Adenoidectomia/métodos
Adenoidectomia/utilização
Administração Oral
Criança
Doença Crônica
Gerenciamento Clínico
Endoscopia
Seres Humanos
Sprays Nasais
Otolaringologia
Procedimentos Cirúrgicos Otorrinolaringológicos/utilização
Pediatria
Guias de Prática Clínica como Assunto
Padrões de Prática Médica
Rinite/diagnóstico por imagem
Sinusite/diagnóstico por imagem
Sociedades Médicas
Inquéritos e Questionários
Tomografia Computadorizada por Raios X
[Pt] Tipo de publicação:COMPARATIVE STUDY; JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents); 0 (Glucocorticoids); 0 (Histamine Antagonists); 0 (Nasal Sprays)
[Em] Mês de entrada:1708
[Cu] Atualização por classe:170821
[Lr] Data última revisão:
170821
[Sb] Subgrupo de revista:AIM; IM
[Da] Data de entrada para processamento:170803
[St] Status:MEDLINE
[do] DOI:10.1177/0003489417719717


  6 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28719758
[Au] Autor:Jamal N
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Lewis Katz School of Medicine, Temple University, Philadelphia, Pennsylvania, USA.
[Ti] Título:Reflections on Patient-Centered Care: From the Perspective of a Young Otolaryngologist.
[So] Source:Otolaryngol Head Neck Surg;157(4):543-544, 2017 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:It is now well recognized that patient engagement in health care is a key factor in improving satisfaction; however, it is also critical if we are to improve the health outcomes of our patients, as well as the economic and quality outcomes of our health system. Medicine, though, has traditionally resisted a culture of patient-centered or patient-controlled care. What follow are the reflections of one otolaryngologist on the importance and challenges of making the transition to patient-centered care.
[Mh] Termos MeSH primário: Otorrinolaringologistas/normas
Satisfação do Paciente
Assistência Centrada no Paciente/organização & administração
Relações Médico-Paciente
[Mh] Termos MeSH secundário: Seres Humanos
[Pt] Tipo de publicação:JOURNAL ARTICLE; REVIEW
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170719
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817721455


  7 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28688565
[Au] Autor:Lundberg T; Biagio de Jager L; Swanepoel W; Laurent C
[Ad] Endereço:Department of Public Health and Clinical Medicine, Family Medicine, Umea University, S-901 87 Umea, Sweden. Electronic address: thorbjorn.Lundberg@umu.se.
[Ti] Título:Diagnostic accuracy of a general practitioner with video-otoscopy collected by a health care facilitator compared to traditional otoscopy.
[So] Source:Int J Pediatr Otorhinolaryngol;99:49-53, 2017 Aug.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:OBJECTIVE: Video-otoscopy is rapidly developing as a new method to diagnose common ear disease and can be performed by trained health care facilitators as well as by clinicians. This study aimed to compare remote asynchronous assessments of video-otoscopy with otoscopy performed by a general practitioner. METHOD: Children, aged 2-16 years, attending a health center in Johannesburg, South Africa, were examined. An otologist performed otomicroscopy and a general practitioner performed otoscopy. Video-otoscopy was performed by a health care facilitator and video sequences were stored on a server for assessment by the same general practitioner 4 and 8 weeks later. At all examinations, a diagnosis was set and the tympanic membrane appearance was graded using the OMgrade-scale. The otologist's otomicroscopic diagnosis was set as reference standard to compare the accuracy of the two otoscopic methods. RESULTS: Diagnostic agreement between otologist's otomicroscopic examination and the general practitioner's otoscopic examination was substantial (kappa 0.66). Agreement between onsite otomicroscopy and the general practitioners asynchronous video assessments were also substantial (kappa 0.70 and 0.80). CONCLUSION: Video-otoscopy performed by a health care facilitator and assessed asynchronously by a general practitioner had similar or better accuracy compared to face-to-face otoscopy performed by a general practitioner.
[Mh] Termos MeSH primário: Otopatias/diagnóstico
Clínicos Gerais/normas
Otoscopia/métodos
Telemedicina/métodos
[Mh] Termos MeSH secundário: Adolescente
Criança
Pré-Escolar
Feminino
Seres Humanos
Masculino
Otorrinolaringologistas
África do Sul
Membrana Timpânica
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170926
[Lr] Data última revisão:
170926
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170710
[St] Status:MEDLINE


  8 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28675119
[Au] Autor:Naunheim MR; Rathi VK; Naunheim ML; Alkire BC; Lam AC; Song PC; Shrime MG
[Ad] Endereço:1 Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear Infirmary, Boston, Massachusetts, USA.
[Ti] Título:What Do Patients Want from Otolaryngologists? A Discrete Choice Experiment.
[So] Source:Otolaryngol Head Neck Surg;157(4):618-624, 2017 Oct.
[Is] ISSN:1097-6817
[Cp] País de publicação:England
[La] Idioma:eng
[Ab] Resumo:Objectives Patient preferences are crucial for the delivery of patient-centered care. Discrete choice experiments (DCEs) are an emerging quantitative methodology used for understanding these preferences. In this study, we employed DCE techniques to understand the preferences of patients presenting for an ear, nose, and throat clinic visit. Study Design DCE. Setting Decision science laboratory. Methods A DCE survey of 5 attributes-wait time, physician experience, physician personality, utilization of visit time, and cost/copayment-was constructed with structured qualitative interviews with patients. The DCE was administered to participants from the general population, who chose among hypothetical scenarios that varied across these attributes. A conditional logit model was used to determine relative attribute importance, with a separate logit model for determining subject effects. Results A total of 161 participants were included. Cost/copayment had the greatest impact on decision making (importance, 32.2%), followed by wait time and physician experience (26.5% and 24.7%, respectively). Physician personality mattered least (4.7%), although all attributes were significantly correlated to decision making. Participants preferred doctors who spent more time performing physical examination than listening or explaining. Participants were willing to pay $52 extra to avoid a 4-week delay in appointment time; $87 extra for a physician with 10 years of experience (vs 0 years); and $9 extra for a caring, friendly, and compassionate doctor (vs formal, efficient, and business-like). Conclusion DCEs allow for powerful economic analyses that may help physicians understand patient preferences. Our model showed that cost is an important factor to patients and that patients are willing to pay extra for timely appointments, experience, and thorough physical examination.
[Mh] Termos MeSH primário: Comportamento de Escolha
Competência Clínica
Tomada de Decisões
Otorrinolaringologistas/normas
Preferência do Paciente/psicologia
Assistência Centrada no Paciente/normas
[Mh] Termos MeSH secundário: Adulto
Feminino
Seres Humanos
Modelos Logísticos
Masculino
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1710
[Cu] Atualização por classe:171012
[Lr] Data última revisão:
171012
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170705
[St] Status:MEDLINE
[do] DOI:10.1177/0194599817717662


  9 / 32 MEDLINE  
              first record previous record next record last record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28609261
[Au] Autor:Wang KH; Austin SA; Chen SH; Sonne DC; Gurushanthaiah D
[Ad] Endereço:Head and Neck Surgeon at the Oakland Medical Center in CA. kevin.h.wang@kp.org.
[Ti] Título:Nasopharyngeal Carcinoma Diagnostic Challenge in a Nonendemic Setting: Our Experience with 101 Patients.
[So] Source:Perm J;21, 2017.
[Is] ISSN:1552-5775
[Cp] País de publicação:United States
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: We studied the presenting symptoms, time intervals, and workup involved in the diagnosis of nasopharyngeal carcinoma in an integrated health care system. METHODS: A retrospective chart review of all patients with a nasopharyngeal carcinoma diagnosis between 2007 and 2010 at Kaiser Permanente Northern California. Main outcome measures included diagnostic time intervals, presenting symptoms, diagnostic accuracy of nasal endoscopy, imaging, and diagnosis at first otolaryngologist (Oto-HNS) visit. RESULTS: This study included 101 patients: 70 (70%) were of Chinese or of Southeast Asian descent. The median time intervals along the diagnostic pathway were symptom onset to primary care physician visit, 6.0 weeks; primary care physician to Oto-HNS, 2.4 weeks; Oto-HNS to pathologic diagnosis, 1.1 weeks; and diagnosis to treatment onset, 5.5 weeks. The most common presenting symptoms were otologic issues (41, 41%), neck mass (39, 39%), nasal issues (32, 32%), and headache/cranial neuropathy (16, 16%). A nasopharyngeal lesion was detected in 54 (53%) patients after the first Oto-HNS visit. Among the initial nasal endoscopy reports, 32 (32%) did not reveal a nasopharyngeal lesion; 32 (32%) initial imaging studies also did not reveal a nasopharyngeal lesion. There was no correlation between diagnostic delay and disease stage. CONCLUSION: Nasopharyngeal carcinoma presenting symptoms are extremely variable, and initial misdiagnosis is common. Median time from symptom onset to treatment was almost six months among patients studied. Nearly one-third of nasopharyngeal cancers were missed with nasal endoscopy and imaging. An understanding of the risk factors, presenting symptoms, and limitations associated with these diagnostic tests is necessary to support earlier detection of this insidious cancer.
[Mh] Termos MeSH primário: Carcinoma/diagnóstico
Erros de Diagnóstico
Neoplasias Nasofaríngeas/diagnóstico
[Mh] Termos MeSH secundário: Adulto
California
Carcinoma/complicações
Carcinoma/diagnóstico por imagem
Diagnóstico Tardio
Progressão da Doença
Endoscopia
Feminino
Cabeça/diagnóstico por imagem
Cabeça/patologia
Cefaleia/diagnóstico
Cefaleia/etiologia
Seres Humanos
Masculino
Meia-Idade
Neoplasias Nasofaríngeas/complicações
Neoplasias Nasofaríngeas/diagnóstico por imagem
Pescoço/diagnóstico por imagem
Pescoço/patologia
Otorrinolaringologistas
Estudos Retrospectivos
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170913
[Lr] Data última revisão:
170913
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170614
[St] Status:MEDLINE
[do] DOI:10.7812/TPP/16-180


  10 / 32 MEDLINE  
              first record previous record
seleciona
para imprimir
Fotocópia
Texto completo
[PMID]:28576535
[Au] Autor:Marom T; Bobrow M; Eviatar E; Oron Y; Ovnat Tamir S
[Ad] Endereço:Department of Otolaryngology-Head and Neck Surgery, Assaf Harofeh Medical Center, Tel Aviv University Sackler Faculty of Medicine, 70300 Zerifin, Israel. Electronic address: talmarom73@gmail.com.
[Ti] Título:Adherence to acute otitis media diagnosis and treatment guidelines among Israeli otolaryngologists.
[So] Source:Int J Pediatr Otorhinolaryngol;95:63-68, 2017 Apr.
[Is] ISSN:1872-8464
[Cp] País de publicação:Ireland
[La] Idioma:eng
[Ab] Resumo:INTRODUCTION: The recent Israeli acute otitis media (AOM) guidelines, drafted mainly by pediatricians and family physicians in 2013, addressed diagnostic and therapeutic issues, in order to reduce over-diagnosis and treatment. These guidelines are considered as the 'standard of care' for AOM management. While the adherence rate of pediatricians to previous Israeli AOM guidelines (2004) was reported to be high (>85%), the compliance of otolaryngologists has not been studied. METHODS: An anonymous 19-item questionnaire was circulated among practicing Israeli otolaryngologists (residents [n = 93], specialists [n = 283]). All the items were scored according to the number of correct answers in line with the guidelines, and summed on a 0-100 scale. RESULTS: Response rate was 34% (n = 127). Overall, scores of correct answers of residents (n = 48, 52% of all residents) and specialists (n = 79, 28% of all specialists) were similar, and showed comparable moderate adherence to both guidelines: 55.7 vs 58.3 (p = 0.26). Residents were more likely to adhere to the U.S. guidelines, when compared to specialists (score difference 6.1 vs 2.8, p = 0.008). Responders preferred the microscope for diagnosis (48%), over the recommended (pneumatic) otoscope (62%) (p = 0.05), and were more likely to start antibiotic therapy (62%), rather than the 'watchful waiting' (38%) (p = 0.03). Concerning antibiotic treatment, 50% of otolaryngologists prescribed amoxicillin as recommended, at 60-80 mg/kg/d. CONCLUSION: The moderate adherence rate suggests that the guidelines were partially adopted by otolaryngologists, who use different instrumentation than recommended, and treat more severe/complicated cases. Over-treatment with antibiotics and inaccurate dosing regimens are still common. Better implementation of the AOM guidelines among otolaryngologists should be performed in designated training platforms.
[Mh] Termos MeSH primário: Fidelidade a Diretrizes/estatística & dados numéricos
Otite Média/diagnóstico
Otorrinolaringologistas/estatística & dados numéricos
Padrões de Prática Médica/estatística & dados numéricos
[Mh] Termos MeSH secundário: Doença Aguda
Antibacterianos/uso terapêutico
Feminino
Seres Humanos
Israel
Otite Média/tratamento farmacológico
Médicos
Inquéritos e Questionários
[Pt] Tipo de publicação:JOURNAL ARTICLE
[Nm] Nome de substância:
0 (Anti-Bacterial Agents)
[Em] Mês de entrada:1709
[Cu] Atualização por classe:170911
[Lr] Data última revisão:
170911
[Sb] Subgrupo de revista:IM
[Da] Data de entrada para processamento:170604
[St] Status:MEDLINE



página 1 de 4 ir para página            
   


Refinar a pesquisa
  Base de dados : MEDLINE Formulário avançado   

    Pesquisar no campo  
1  
2
3
 
           



Search engine: iAH v2.6 powered by WWWISIS

BIREME/OPAS/OMS - Centro Latino-Americano e do Caribe de Informação em Ciências da Saúde