Considerable confusion exists with the diagnosis and management of vascular birthmarks. For this article we reviewed charts for the diagnosis and recommended management of 208 new patients with vascular birthmarks presenting to the Albany Medical Center Vascular Malformation Clinic, Albany, NY, over a 26-month period from October 1995 through December 1997. Based on our patient population, data available, and the current literature, we concluded that an early evaluation and an accurate diagnosis in infants with a vascular birthmark are important. Furthermore, intervention by way of systemic steroids, laser therapy, or surgical debulking is appropriate and safe in a select group of patients presenting with a proliferating hemangioma and in patients with an involuting but disfiguring hemangioma. Also in this article we present an algorithm to assist the clinician with the management of the pediatric patient with a diagnosis of a hemangioma.

Adrenal Cortex Hormones↗

PubMedDate not supplied

Nutritional concepts and considerations in head and neck surgery.

Assessment and correction of malnutrition is a major contribution to the improvements in the pre- and postoperative management of patients with head and neck cancer over the past 20 years. These patients are often in a poor nutritional status and thereby are at a higher operative risk secondary to the local and systemic effects of the tumor and its treatment. This article reviews current data emphasizing preoperative nutritional assessment, modalities available for nutritional therapy in head and neck cancer patients, and indications for perioperative use of these modalities.

Carcinoma, Squamous Cell↗

PubMedDate not supplied

Current transfusion therapy: indications for basic components.

OBJECTIVE: To review basic blood components and currently acceptable transfusion practices. DATA SOURCES: Professional journals, current texts, and the author's experience. STUDY SELECTION: Not applicable. DATA EXTRACTION: Not applicable. DATA SYNTHESIS: Red blood cells, platelets, cryoprecipitate, and fresh-frozen plasma are the basic blood components ordered daily in hospitals and transfusion services all over the world. To notify the laboratory medical director of inappropriate orders for components, the clinical laboratory scientist must be aware of currently acceptable transfusion practices. This article reviews these four components and indicates acceptable processing methods and appropriate use. CONCLUSION: Considering the known risk factors of blood and blood component transfusions, it is essential that components be used only when necessary. Criteria for appropriate transfusion have changed over the years; old transfusion triggers are no longer acceptable. To provide the best medical care to the patient, the clinical laboratory scientist must stay abreast of currently acceptable transfusion practices.

Blood Component Transfusion↗