The aim of this study was to find out whether patients attending ENT clinics obtain health information about their medical condition and to assess satisfaction with the sources of health information, including the internet. Three hundred and thirty patients attending ENT outpatient clinics at District General Hospitals in Wigan and Warrington during June 2001 were asked to complete detailed questionnaires. Fifty-seven per cent of patients attempted to obtain health information before their visit to the specialist clinic. Forty-five per cent of patients had access to the internet, but only 13% used it to obtain health information. General practitioners were the source of health information for 64%, but the NHS-Direct help line was only used by 16%. Patients also trusted the health information provided by their GPs the most. In the twenty-first century, patients turn to their GP as the main source of health information.
Rehabilitation of voice and speech after laryngectomy with valve prosthesis has become a well-established practice in recent years. The formation of tracheo-oesophageal fistula (TOF) and the subsequent management of the patient with a voice prosthesis can be associated with a number of problems and complications. We report a new technique of the use of injectable Bioplastique in the treatment of persistent leakage around Provox 2 voice prosthesis. Our experience in two cases has shown that it is a relatively simple and effective procedure in stopping the leak around the valve immediately and is without any short-term complications.
This study aimed to evaluate the safety of this birth setting for low-risk deliveries based on our hospital protocol. The study was carried out at Heatherwood Hospital, Ascot (a low-risk unit) and Wexham Park Hospital, Slough, Berkshire (a consultant-led unit). This was a retrospective analysis of the computerised records and statistics of low-risk women delivered at Heatherwood Hospital, Ascot, UK following the unit protocol between July 1995 and December 2001. Women were assessed to be at low risk in accord with the unit protocol. Those who had antenatal and intrapartum care at Heatherwood Hospital and those who were transferred to the consultant unit for delivery were included in this study. We analysed the appropriateness of the structure of the unit with its medical staff input, reviewed the inclusion and exclusion criteria, analysed the perinatal and maternal mortality rates and evaluated the safety of this birth setting. We have had a total of 5468 women delivered at this low-risk maternity unit since the unit was opened. Approximately 1950 women were transferred to consultant care during this period. The intrapartum transfer in the first 18 months was 7.9%. However, since 1997 it has been static at 2.7% as confidence has grown in this model of care. The antenatal transfer rate has been static around 23%. Our emergency caesarean section rate was around 6% and the normal delivery rate was around 85%. For the first time we noted a rise in the emergency caesarean rate in 2001 at 9.5%. There were no maternal deaths. We had no serious postpartum complications accounting for long-term maternal morbidity. The antepartum stillbirths accounted for the majority of the perinatal mortality for 19/23 babies. Intrauterine growth retardation accounted for 4/23 babies in this group. The perinatal mortality rate in this low-risk population was 4.2 per 1000 total births and the stillbirth rate was 3.6 per 1000 total births. We conclude that this birth setting is safe to deliver low-risk women with less intrapartum intervention and a low transfer rate and should be setting an example for any future similar birth centre in this country.
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