PubMed Health⌕ Search

Biomedical subjects

Ioannis Kyprianou

Publications and source records attributed to Ioannis Kyprianou.

5 recordsLinked to original sources
PubMed2005

A comparative study of referral patterns and management of patients with malignant brain tumours in Birmingham, UK, and Toronto, Canada.

The management of malignant brain tumours comprises a huge financial burden to any health care system. The referral pattern and initial management of this condition has not been widely investigated. Our main aim was to investigate and compare the referral patterns between two tertiary referral centres in Birmingham, UK, and Toronto, Canada, which have similar health care provision structures, but different financial resources, in order to examine whether there are any significant delays in the pathway of either system. The investigation consisted of a retrospective analysis of case records of patients identified as having malignant brain tumours who had been operated on at the two centres during the period 1997-1998. Data were collected on patient demographics, symptomatology at presentation, referral pattern, and time intervals between presentation, investigations, neurosurgical consultation and operation. Mann-Whitney U-tests of statistical significance were used to compare the two centres. Sixty-eight and 100 patients in Birmingham and Toronto, respectively, were identified from the registers following exclusion of patients with benign or low-grade tumours. Both centres were found to be similar with respect to sociodemographic factors of patients with malignant brain tumours. Referral patterns were analysed for presenting symptoms of neurological deficit and seizure, and found to be similar for both centres. Time intervals from presentation to investigation and from investigation to neurosurgical consultation were not significantly different between the two centres. Significant differences were found from neurosurgical consultation to operation (Birmingham, 3 days, and Toronto, 6 days, p = 0.006), and the duration of stay in hospital (Birmingham, 11 days, and Toronto, 2 days, p < 0.001). Although there are differences in the financial resources of the two tertiary centres our study reveals no significant differences in the referral pathway to operation.

Adult↗
PubMed2005

Referral patterns in paediatric orbital cellulitis.

OBJECTIVES: Orbital cellulitis in children may result in severe visual morbidity and even mortality if not managed appropriately. The definitive management of orbital cellulitis is in the realms of the otolaryngologist, as the underlying pathology is associated with sinus disease in more than 90% of cases. Our observations suggest that there is a tendency for patients with suspected orbital cellulitis not to be referred promptly for otolaryngological opinion and management, which may result in adverse outcomes. The aim of this study was to determine the initial management by establishing general practitioners' attitudes to the referral and management of suspected orbital cellulitis. METHODS: Anonymous questionnaires were sent to general practitioners to ascertain details on their initial treatment modalities and preferred specialist referral. General practitioners in Worcestershire and North Staffordshire, two major regions in the West Midlands, UK, were targeted. RESULTS: The majority of general practitioners initially commenced patients on oral antibiotics, and referred patients primarily to ophthalmologists for further assessment, although significant variations in referral patterns were found. CONCLUSION: Better education for primary care physicians is needed regarding the initial management and referral of paediatric patients with suspected orbital cellulitis. They should be referred promptly for hospital admission. A good multidisciplinary approach with quick involvement of the three specialities (ear, nose and throat, ophthalmology and paediatrics) would avoid delays in the definitive management and ensure optimal outcomes.

Anti-Bacterial Agents↗