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Background: Multiple sclerosis (MS) is a neurological disease which is highly prevalent in Canada. To date limited data exists on the characteristics of this population in Ontario. Methods: A retrospective chart review was conducted of initial patient presentations to a MS clinic in 2011. Initial and follow-up consult notes were reviewed. Patients with a previous MS diagnosis were excluded. Results: 81 patients presented to the clinic for the first time in 2011. 41 were given alternative diagnoses (non-MS). Of the remaining 40 patients (MS group), 9 had clinically or radiologically isolated syndrome and 8 were in a progressive phase of MS. The mean age of presentation was 22 (MS group) and 47 (non-MS group). The most common initial symptom in both groups was a sensory disturbance. The mean initial EDSS in the MS group was 1.75 (0-6.5). In the MS group only 35% were put on disease modifying treatments. The most common reasons for exclusion of treatment were progressive disease phase, clinically or radiologically isolated syndrome, and unclear diagnosis. In the non-MS group, the most common diagnoses were non-specific MRI findings, transverse myelitis and peripheral nerve or muscular diagnoses. Conclusions: This retrospective review has outlined the characteristics of a MS population in Ontario.
To investigate the frequency and management of epistaxis in schools.
A postal survey of schools.
One hundred and fifty-seven questionnaires were posted out to 41 secondary schools (students aged 11–18 years) and to 116 primary schools (students aged four to 11 years). One hundred and twelve completed questionnaires were returned, 32 from secondary schools and 80 from primary schools. Most schools stated that they encountered a nose bleed once per month. The commonest method of treating a nose bleed was to pinch the top of the nose (an ineffective method), although pinching the bottom of the nose was almost as common. Only a minority of primary and secondary schools (37.5 and 25 per cent, respectively) had a policy for dealing with nose bleeds. Despite many respondents reportedly using an ineffective method, only two stated that they did not feel confident in dealing with nose bleeds.
Nose bleeds in school students are common, and management frequently deviates from recommended guidelines.
To determine the effect of tonsillectomy on morbidity in patients listed for tonsillectomy.
Questionnaire survey of 257 children and 159 adults who had been listed for tonsillectomy. The cohort studied had experienced delays of greater than 12 months between being listed for tonsillectomy and undergoing surgery. They had responded to an earlier questionnaire in 2003 regarding morbidity experienced while waiting for surgery. The same questionnaire was presented to them again in 2005. Morbidity experienced in 2003 was compared to that experienced in 2005 in subjects who had and had not proceeded to surgery in the interval.
Forty-seven per cent of the cohort had undergone tonsillectomy. The questionnaire response rate was 48 per cent. Respondents reported less morbidity in 2005 than in 2003, whether or not they had had surgery. Respondents who had undergone tonsillectomy reported significantly greater reductions in morbidity than those who had not. Five per cent of children who had undergone tonsillectomy experienced at least three short episodes of tonsillitis in the six months before the questionnaire, compared with 35 per cent of those who had not undergone tonsillectomy (p < 0.001).
The morbidity reported by patients suffering from chronic, untreated tonsillitis decreases with time. Tonsillectomy produces significantly greater reductions in morbidity than time alone.
We evaluated the relative usefulness of data on head and neck cancer available on the websites of cancer registries in the United Kingdom. Data were analysed to determine the accuracy and completeness of essential information related to the incidence of head and neck cancer.
We found that 16 per cent (2/11) of the registries had some cancer data but none relating to head and neck cancer patients. Seventy-five per cent (9/12) of the registries had selected data on head and neck cancer, but 33 per cent (3/9) of these pooled the various head and neck cancers into a single group. The remainder of registries offering data [66 per cent (6/9)] had a variety of ways of grouping and presenting the various types of head and neck cancer. The overall value and usefulness of head and neck cancer information on these websites were limited, especially when all the sites were considered together.
The cancer registries collectively possess an extremely important asset of immense value to both the medical profession and, possibly, patients with cancer. The accessibility of this data and the overall experience of those seeking information on this subject could be improved. However, this would require significant thought, collaboration and agreement between each registry, which would involve significant extra investment.
Objective: Our aim was to determine the morbidity of patients awaiting tonsillectomy.
Design: The study comprised a questionnaire survey of 379 children and 278 adults waiting over 12 months for tonsillectomy.
Outcome measures: These comprised frequency of infection, sickness absence and continuing desire for surgery.
Results: Response rates were 70 per cent (children) and 60 per cent (adults). Morbidity was similar in adults and children, and in those waiting more or less than two years. In the six months prior to the study, 86 per cent of children and 83 per cent of adults had had tonsillitis. Sixty per cent of children and 50 per cent of adults had had three or more episodes. Sixty-two per cent of children and 59 per cent of adults had had at least one long episode of tonsillitis, and 29 per cent of children and 24 per cent of adults had had more than three long episodes. Eighty-nine per cent of children had missed school at least once, compared with 71 per cent of adults missing work at least once (p = 0.01). The frequency of infection was significantly associated with patients' desire for surgery (p < 0.001).
Conclusions: Patients awaiting tonsillectomy experience considerable morbidity. This study does not support the hypothesis that untreated patients will ‘outgrow’ their condition.
We present a unique case of a mucin-secreting papillary adenocarcinoma of intestinal type which has invaded and completely destroyed the hyoid bone and metastasized to the cervical lymph nodes bilaterally. The tumour is believed to have originated from a malignant thyroglossal duct remnant, and was managed with surgery and radiotherapy. We describe the case and discuss the literature regarding hyoid bone tumours.
splitting theorems due to Zaicev and Duan proving the following result. Let
G be a locally soluble FC-hypercentral group and let
A be a periodic artinian ℤG-module. If
A has no finite ℤG-submodules then any
extension E of A by G
splits conjugately over A.
Meningo-encephalocoeles of the skull base may present as spontaneous cerebrospinal fluid rhinorrhoea or acute meningitis. Previous approaches to midline skull base lesions have been either intracranial, via a craniotomy, or by transfacial or endoscopic extracranial approaches. This paper presents an alternative approach to lateral sphenoid sinus encephalocoeles through a Le Fort I osteotomy approach.
The pathophysiology of otitic hydrocephalus remains controversial. It has been argued that involvement of the superior sagittal sinus, by, at least, a mural thrombus is a necessary component of this disease.
We present a case of otitic hydrocephalus where on magnetic resonance imaging (MRI) normal luminal and mural flow within the superior sagittal sinus is demonstrated. The presence of thrombus in the lateral venous sinus alone appears sufficient in this case to impede venous drainage of the intracranial contents into the neck and produce a rise in the cerebral venous pressure and a subsequent increase in the CSF pressure. The presence of a superior sagittal sinus mural thrombus is not required.
Fitting classes and their associated injectors have been considered
in a number of
classes of locally finite groups [9, 8, 4,
5]. In particular, Dixon has considered the class
[Lfr ] of countable locally finite groups with min −p for
all primes p. He has shown that
if the [Lfr ]-group G is radical (that is, it has an ascending
locally nilpotent series) then
G has locally nilpotent injectors, any two of which are
isomorphic. Question 7.4.7 in
 asks whether the restriction of being radical
can be removed in this result.
Auricular haematoma is a problem frequently complicated by recurrence due to failure to apply adequate pressure over the pinna following simple drainage. We describe a simple method of splinting the pinna using silicone putty which overcomes this problem.
Infra-red tympanic thermometry is a relatively new technique for measuring body temperature which requires the minimum of co-operation and is quick and easy to use. It is therefore ideal for use in children. Its use is becoming more widespread and as it is theoretically possible that minor ear surgery may interfere with function its reliability in these patients may be in question.
Twenty-two children (mean age 5.3 years) who underwent myringotomy ± grommet insertion had the tympanic temperature of each ear measured immediately before, and 15 minutes after, surgery on the recovery ward. No difference was found between the pre- and post-operative temperatures (mean difference – 0.1°C, p>0.1, paired t-test, hypothesized difference of 0).
This thermometer appears to be a reliable way of monitoring body temperature on a paediatric ENT recovery ward in patients who have undergone minor ear surgery.
We introduce a definition of a Schunck class of periodic abelian-by-finite soluble groups using major subgroups in place of the maximal subgroups used in Finite groups. This allows us to develop the theory as in the finite case proving the existence and conjugacy of projectors. Saturated formations are examples of Schunck classes and we are also able to obtain an infinite version of Gaschütz Ω-subgroups.
Palatal myoclonus is defined as a continuous, rhythmic contraction of the palatal musculature. Reverberant neuronal activity in a region of the brain stem known as the Guillain-Mollaret triangle is believed to underlie this condition.
We present a case of palatal myoclonus which could be abolished, by anterior neck flexion. The pathology and management of this condition is briefly discussed.
Atomically ordered PdAgH and PdCuH hydrides synthesized in an atmosphere of gaseous hydrogen at P = 3 GPa were studied by inelastic neutron scattering. The results showed a large difference between the Pd-H, Ag-H and Cu-H interactions. Values of 93 and 116 meV were predicted for the local H vibrations in dilute Ag-H and Cu-H solid solutions.
The authors together with M. J. Karbe [Ill. J. Math. 33 (1989) 333–359] have considered Fitting classes of -groups and, under some rather strong restrictions, obtained an existence and conjugacy theorem for -injectors. Results of Menegazzo and Newell show that these restrictions are, in fact, necessary.
The Fitting class is normal if, for each is the unique -injector of G. is abelian normal if, for each. For finite soluble groups these two concepts coincide but the class of Černikov-by-nilpotent -groups is an example of a nonabelian normal Fitting class of -groups. In all known examples in which -injectors exist is closely associated with some normal Fitting class (the Černikov-by-nilpotent groups arise from studying the locally nilpotent injectors).
Here we investigate normal Fitting classes further, paying particular attention to the distinctions between abelian and nonabelian normal Fitting classes. Products and intersections with (abelian) normal Fitting classes lead to further examples of Fitting classes satisfying the conditions of the existence and conjugacy theorem.
The phonon spectra of pristine fullerene, superconducting K3C60 and saturation-doped Rb6C60 measured by inelastic neutron scatteringin the energy range 2.5 - 200 meV at low temperatures reveal substantial broadening of five-fold degenerate Hg intramolecular vibrational modes both in the low-energy radial and the high-energy tangential part of the spectrum. This provides strong evidence for a traditional phonon-mediated mechanism of superconductivity in the fullerides but with an electron-phonon coupling strength distributed over a wide range of energies (33-195 meV) as a result of the finite curvature of the fullerene spherical cage.