Ring finger testing in carpal tunnel syndrome.
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Biomedical subjects
Publications and source records attributed to C A Simpson.
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Cost analysis and cost benefit analysis are useful tools in the objective comparison of drug therapy regimens. The authors report on their systematic evaluation of all available English language papers cited in the MEDLINE database from 1977 to February 1988 that were referenced under the medical subject headings, "costs and cost analysis" or "cost benefit analysis." The 94 papers that met the criteria for inclusion are described in a tabular summary of the approaches of calculating costs and methods of comparing relative costs of therapy for a variety of agents and disease entities. Additional references offering analyses of specific aspects of drug therapy which may provide practitioners with additional direction in analyzing costs of therapy, as well as a number of editorials and reviews offering useful insights and discussions regarding cost analysis, are also included.
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A study of 200 patients referred to a community neurologist showed that 87.5% of the patients were seen in the office and only 12.5% in hospital. Neurological signs were present in 52% and 28.5% had neurological signs which materially affected the diagnosis. A questionnaire sent to several teaching centers showed that only one center sent students and residents to community neurologists' offices at all and in most centers the resident spent just 10 to 20% of his time seeing out-patients. It was felt that the balance of in-patient/out-patient teaching for students and residents was wrong, and that more emphasis should be placed on the neurological history than on the examination. Proposals are made to involve the community neurologist as well as the academic neurologist in the training of students and residents which would benefit all four groups.
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A stereotaxic apparatus was designed which would enable a needle to be passed easily through the foramen ovale with accuracy and with a minimum of radiological aid by one relatively unskilled in injection of the trigeminal ganglion. Successful penetration of the foramen was achieved in 39 of 46 injections on cadavers and in six injections on five patients. The substance injected was 5% phenol in glycerin. In one patient alcohol was used. The anesthesia produced was satisfactory in all except one patient. We feel that this apparatus will enable the trigeminal ganglion to be injected relatively easily in all patients except those with unusually shaped skulls.
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