Quality circles as problem-solving tools in perioperative settings.
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Biomedical subjects
Publications and source records attributed to D Tuttle.
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Hairy polyp of the oronasopharynx is an uncommon developmental malformation that is most frequently seen as a pedunculated tumor in the neonate. Derived from the ectoderm and mesoderm, this benign tumor generally has been classified as dermoid. The clinical presentation is dependent on the polyp's size and location. A full-term girl was evaluated for an oral mass that was first noted at the time of birth. Evaluation showed a 5- x 2.5-cm soft, nontender, skin-covered mass that protruded from the oral cavity. During surgery, it was noted that the stalk was attached to the superior pole of the left tonsil. The histology of the mass was consistent with a hairy polyp. Knowledge of this type of malformation facilitates early intervention and avoids significant morbidity.
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Seventy-seven patients with ectopic pregnancy underwent culdocentesis; the tap was positive in 70%, negative in 10% and inadequate in 20%. A positive tap was significantly associated with a low hematocrit but was often obtained in patients without hypotension, tachycardia, peritoneal irritation or tubal rupture. While patients with peritoneal irritation were significantly more likely to have a large hemoperitoneum, many with 500 ml or more of hemoperitoneum did not have peritoneal irritation, hypotension, tachycardia, low hematocrit or tubal rupture. Culdocentesis is valuable for evaluating the patient suspected of having an ectopic pregnancy, and the absence of tachycardia, hypotension, low hematocrit or peritoneal irritation should not dissuade one from performing the test. A positive tap does not indicate tubal rupture, and a large hemoperitoneum may accumulate in its absence.
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Explore the source record for details and available documents.
Explore the source record for details and available documents.