Balloon sinuplasty has been licensed for the treatment of chronic rhinosinusitis since 2006. Balloon dilation enlarges the sinus ostium by effecting tiny fractures of the surrounding bone and compressing soft tissue such that no mucosa is removed. We believe this to be the ideal technique for achieving drainage of an acutely infected frontal sinus when surgical intervention is required. We report the application of this new technique in a 32-year-old female with acute frontal sinusitis. The frontal sinus was successfully cannulated and drained. Post-operative irrigation was achieved using a modified Vortex catheter.
Objectives:To determine the accuracy of the OnTrak rapid urine latex agglutination immunoassay (AIA) for testing pregnant ED patients for the cocaine metabolite benzoylecgonine (BE), and to determine the frequency of urine BE in pregnant E D patients and the association of test results with patient demographics.Methods: A test performance evaluation was conducted using an inception cohort of pregnant patients at an urban teaching hospital ED. Patients with positive urine chorionic gonadotropin tests who had adequate remaining urine samples were studied. Patient demographics, E D diagnoses, and assay results were recorded without patient identifiers. Urine was tested using the rapid AIA. The first 150 samples were confirmed using a second immunoassay and gas chromatography with a nitrogen phosphorus detector. All positive samples also were confirmed with thin-layer chromatography, and quantification by gas chromatography-mass spectrometry.Results: Twenty of 342 (5.9%, 95% CI 3.4-8.4%) pregnant patients had urine samples positive by AIA testing for BE. Confirmation testing demonstrated no false-positive or -negative AIA result. Positive test results were not associated with specific patient diagnoses or demographics.Conclusions: E D screening for cocaine use among pregnant patients can be accurately performed using the OnTrak AIA for BE. In the E D population screened, 5.9% of the pregnant women had urine samples positive for BE.Acad. Emerg. Med. 1995; 2:795-798.
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