153 research outputs found
Is routine pathological examination required in South African children undergoing adenotonsillectomy?
Objective. We aimed to determine the incidence of abnormal pathological findings in the tonsils and/or adenoids of children undergoing tonsillectomy and/or adenoidectomy, and the incidence of tuberculosis of the tonsils and adenoids; suggest criteria to identify children at risk for adenotonsillar tuberculosis; and investigate the association between HIV and adenotonsillar abnormality, the cost-effectiveness of routine pathological examination of adenotonsillectomy specimens, and criteria to decide which specimens to send for histological examination. Methods. We undertook an 8-month prospective study on all children (≤12 years) undergoing consecutive tonsillectomy or adenotonsillectomy (T&A) at Red Cross War Memorial Children’s Hospital. Patients were assessed pre-operatively and tonsil sizes graded pre- and intra-operatively. Blood was taken for HIV testing, and all tonsils and adenoids were examined histologically. A cost-benefit analysis was done to determine the cost-effectiveness of adenotonsillectomy routine pathology. Results. A total of 344 tonsils were analysed from 172 children (102 boys, 70 girls); 1 patient had nasopharyngeal tuberculosis, and 1 lymphoma of the tonsils; 13 (7.6%) patients had clinically asymmetrically enlarged tonsils but no significant abnormal pathological finding. The average cost of detecting a clinically significant abnormality was R22 744 (R45 488 ÷ 2 abnormalities). Conclusions. The following criteria could improve cost-effectiveness of pathological examination of adenotonsillectomy specimens: positive tuberculosis contact at home, systemic symptoms of fever and weight loss, cervical lymphadenopathy >3 cm, suspicious nasopharyngeal appearance, HIV-positive patient, rapid tonsillar enlargement or significant tonsillar asymmetry. On our evidence, routine pathological investigation for South African children does not seem to be justified
Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsils?
Objectives. The aims of the study were: (i) to determine
the necessity for diagnostic tonsillectomy in children with
asymmetrically enlarged tonsils; (ii) to determine the accuracy
of clinical assessment of tonsillar asymmetry; and (iii) to
determine how to manage children with clinical tonsillar
asymmetry in a developing-world practice.
Methods. A prospective study was carried out at Red Cross
War Memorial Children's Hospital in Cape Town, over an
8-month period. All children undergoing tonsillectomy
or adenotonsillectomy had a clinical assessment of tonsil
symmetry done, and all tonsil and adenoid specimens were
examined histologically. The maximum diameter and volume of
the resected tonsils were measured. A comparison was done of
true tonsil asymmetry in patients with asymmetrical tonsils and
a subgroup of matched controls with symmetrical tonsils.
Results. A total of 344 tonsils were analysed (172 patients).
The 13 patients (7.6%) diagnosed as having clinically
asymmetrically enlarged tonsils had no significant pathological
diagnosis. In the patients with symmetrical tonsils there were
2 abnormal pathological findings (tuberculosis of the adenoids
and T-cell lymphoma of the tonsils and adenoids).
In the clinically asymmetrical tonsil group, true tonsillar
asymmetry was 3 mm (maximum diameter), and 2.2 cm3
(volume), compared with 1.9 mm and 1.5 cm3 in the
symmetrical tonsil group. When patients with clinical tonsillar
asymmetry and symmetry were compared, the difference in
maximum diameter (p = 0.62) and volume (p = 0.73) was not
significantly different.
Conclusions. Clinical tonsillar asymmetry is usually apparent
rather than real. The incidence of significant pathology
in children with asymptomatic, asymmetrical tonsils is
low. Diagnostic tonsillectomy is indicated in children with
asymmetrically enlarged tonsils associated with constitutional
symptoms, cervical lymphadenopathy, rapid tonsil enlargement
or significant tonsillar asymmetry
Is diagnostic tonsillectomy indicated in all children with asymmetrically enlarged tonsil?
Objectives. The aims of the study were: (i) to determine the necessity for diagnostic tonsillectomy in children with asymmetrically enlarged tonsils; (ii) to determine the accuracy of clinical assessment of tonsillar asymmetry; and (iii) to determine how to manage children with clinical tonsillar asymmetry in a developing-world practice.
Methods. A prospective study was carried out at Red Cross War Memorial Children’s Hospital in Cape Town, over an 8-month period. All children undergoing tonsillectomy or adenotonsillectomy had a clinical assessment of tonsil symmetry done, and all tonsil and adenoid specimens were examined histologically. The maximum diameter and volume of the resected tonsils were measured. A comparison was done of true tonsil asymmetry in patients with asymmetrical tonsils and a subgroup of matched controls with symmetrical tonsils.
Results. A total of 344 tonsils were analysed (172 patients). The 13 patients (7.6%) diagnosed as having clinically asymmetrically enlarged tonsils had no significant pathological diagnosis. In the patients with symmetrical tonsils there were abnormal pathological findings (tuberculosis of the adenoids and T-cell lymphoma of the tonsils and adenoids). In the clinically asymmetrical tonsil group, true tonsillar asymmetry was 3 mm (maximum diameter), and 2.2 cm3 (volume), compared with 1.9 mm and 1.5 cm3 in the symmetrical tonsil group. When patients with clinical tonsillar asymmetry and symmetry were compared, the difference in maximum diameter (p = 0.62) and volume (p = 0.73) was not significantly different.
Conclusions. Clinical tonsillar asymmetry is usually apparent rather than real. The incidence of significant pathology in children with asymptomatic, asymmetrical tonsils is low. Diagnostic tonsillectomy is indicated in children with asymmetrically enlarged tonsils associated with constitutional symptoms, cervical lymphadenopathy, rapid tonsil enlargement or significant tonsillar asymmetry
An action framework for the participatory assessment of nature-based solutions in cities
Impact assessment is a key step in mainstreaming urban nature-based solutions (NBS). Yet, it remains unclear if and how assessment frameworks influence urban planning, design and management. We contend that the potential of current NBS assessment frameworks is not fully exploited due to: (1) limited contextualisation of monitoring and assessment to place-specific contexts and (2) the depoliticisation of co-production. To address this, we present a practical five-step action framework to guide inclusive participation across different stages of monitoring and assessment of urban NBS, including indicator selection. Unlike previous approaches, applying selection criteria at the level of individual indicators, we also use criteria at the aggregate level of the indicator set. We conclude that participatory assessment contributes to mainstreaming urban NBS for sustainable and just cities, provided data is contextualised to local decision-making contexts and the process is designed to amplify marginalised voices
On subsequential spaces
AbstractSimple generators for the coreflective category of subsequential spaces, one of them countable, are constructed. Every such must have subsequential order ω1. Subsequentialness is a local property and a countable property, both in a strong sense. A T2-subsequential space may be pseudocompact without being sequential, in contrast to T2-subsequential compact (countably compact, sequentially compact) spaces all being sequential. A compact subsequential space need not be sequential
High-temperature ferromagnetism of electrons in narrow impurity bands: Application to CaB
Ferromagnetism with high Curie temperature , well above room
temperature, and very small saturation moment has been reported in various
carbon and boron systems. It is argued that the magnetization must be very
inhomogeneous with only a small fraction of the sample ferromagnetically
ordered. It is shown that a possible source of high within the
ferromagnetic regions is itinerant electrons occupying a narrow impurity band.
Correlation effects do not reduce the effective interaction which enters the
Stoner criterion in the same way as in a bulk band. It is also shown how, in
the impurity band case, spin wave excitations may not be effective in lowering
below its value given by Stoner theory. These ideas are applied to
CaB and a thorough review of the experimental situation in this material is
given. It is suggested that the intrinsic magnetism of the B and O
dimers might be exploited in suitable structures containing these elements.Comment: 26 pages, 2 figure
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