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Biomedical subjects

S Watt-Smith

Publications and source records attributed to S Watt-Smith.

4 recordsLinked to original sources

Specialist practice for minor oral surgery: a comparative audit of third molar surgery.

Cost efficiency of removing third molars in a practice specialising in minor oral surgery was compared to that of a hospital oral surgery department. A total of 100 patients treated in each locality were prospectively audited during the financial year 1989-90. Surgical complexity, waiting time, complications and patient satisfaction were compared. The hospital cases were costed individually and compared to fees received for the patients treated in the practice. The practice fees were also compared to average expenses as assessed by the Dental Rates Study Group Inland Revenue Enquiry. Patients were treated more promptly and at a lower cost in the specialist practice with no adverse effect on quality as assessed by complications and patient satisfaction. Surgical complexity was not a contraindication to practice treatment but some patients may be better treated in hospital because of medical or social circumstances. Patient charges for treatment carried out under General Dental Service regulations are a serious impediment to the viability of a specialist oral surgery practice.

Adolescent

Comparison of arthrotomographic and magnetic resonance images of 50 temporomandibular joints with operative findings.

Arthrotomography and magnetic resonance imaging (MRI) were carried out on 50 temporomandibular joints (TMJs) in 48 patients who were being considered for surgery for clinically diagnosed internal derangement. The patients presented over a 4-year period with pain and dysfunction which had failed to respond to conservative management. Open surgery was carried out on all TMJs and operative findings compared with the results of imaging. The clinical diagnosis of internal derangement was confirmed in every case by imaging and at surgery. Arthrotomography over-diagnosed non-reducibility of an anteriorly displaced meniscus and perforation. MRI over-diagnosed non-reducibility to a lesser extent and under-diagnosed perforation. MRI demonstrated neither bony changes nor adhesions. Dynamic arthrotomography produced the best images of meniscal derangement in function and the pre-arthrogram tomograms were the best indicator of osseous abnormality. Arthrotomography was the preferred imaging technique.

Adolescent

Long-term venous access.

The aim of this review is to outline the indications and provide a historical perspective of its development. The current complications are emphasized with the hope that greater caution and vigilance will lead to a reduction in their frequency. Finally, details of several techniques are described for gaining long-term venous access for critically ill or injured patients.

Catheterization

Setting up a drip.

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Catheterization