Progressive sensorineural hearing loss in children.
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Bone Diseases↗
Biomedical subjects
S Cass
Publications and source records attributed to S Cass.
Vein graft replacement of the distal vertebral artery.
Vein graft reconstruction of the cervical portion of the vertebral artery has been commonly used for the treatment of atherosclerotic arterial disease. In this article, we describe two instances of vein graft replacement of the distal portion of the vertebral artery. In the first case, the vein graft was placed from C2 transverse foramen to the intradural portion of the vertebral artery to replace an artery abnormally encased and involved by meningioma. The grafting was done in this case to preserve the cerebrovascular reserve in a young patient. In the second case, a vein graft was placed from the extradural C1 portion to the intradural artery beyond the posterior inferior cerebellar artery. This was done to replace a segment of the artery involved by a giant aneurysm, which could not be clipped without occluding the parent artery. In this case, the vein graft replacement was necessitated by changes of somatosensory evoked potentials after the aneurysm was clipped, demonstrating the need to preserve the patency of the artery. Vein graft replacement of the proximal intradural vertebral artery is feasible by the combination of standard cerebro-vascular techniques and the exposures afforded by skull base surgery.
Adult↗
The effects of the referral process on hospital in-patients.
Decisions relating to the preparation for hospital discharge of medical patients can take place at any time after admission to hospital. Referrals to the hospital departments of social work, occupational therapy and physiotherapy, and to community nursing, health visiting and social services are a key factor in this preparation. The referral process is complex and multifaceted and can be analyzed in terms of the questions of who initiates the referral, for what reasons, and at what point in the patient's career. The variant views of role of those professionals involved in the referral process and their perceptions of the situation affect what subsequently takes place and can be examined in relation to each other and to the referral process itself. The complexity may be increased further by the intervention of a patient's relatives. Referrals are made on the basis of a social diagnosis, the sources of information for which are diverse, with the result that the referral process is unstandardized and unpredictable.
Adaptation, Psychological↗