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Biomedical subjects

T E Wiley

Publications and source records attributed to T E Wiley.

4 recordsLinked to original sources
PubMed1996

Comparison of rigid and flexible esophagoscopy in the diagnosis of esophageal disease: diagnostic accuracy, complications, and cost.

Rigid esophagoscopy has been used by otolaryngologists for evaluation of the esophagus for over 100 years. Few studies have examined the diagnostic accuracy of rigid esophagoscopy in patients with carcinoma of the head and neck. The goal of our study was to compare the diagnostic accuracy, complication rate, and costs of rigid esophagoscopy and flexible fiber-optic endoscopy in the evaluation of the esophagus in patients with head and neck carcinoma. We retrospectively reviewed the records of 195 patients with head and neck carcinoma who underwent both rigid esophagoscopy and flexible fiber-optic endoscopy within a 6-month period. We discovered 10 cases with discordant findings, of which 5 (50%) were esophageal carcinoma. The estimated cost was less for flexible endoscopy. No complications were reported in either procedure. Our study suggests that flexible fiber-optic endoscopy should replace rigid esophagoscopy in the evaluation of the esophagus in patients with head and neck carcinoma.

Cost-Benefit Analysis↗
PubMed1995

Diagnosis and management of fulminant hepatic failure.

Fulminant hepatic failure is defined as the development of hepatic encephalopathy within 8 weeks of the onset of illness. While there are many causes of FHF, viral hepatitis, particularly hepatitis B, remains the most common etiology. Several drugs and toxins can also lead to FHF, most notably acetaminophen. Even with improvements in ICU care, mortality remains very high for these patients. Conservative management focuses on invasive monitoring and the prevention and treatment of complications like cerebral edema, infection, renal failure, and coagulopathy. Only orthotopic liver transplantation has reduced mortality from 80% to 30% to 50%. Therefore, the goals of management and treatment now include determining which patients are appropriate for liver transplant and finding a donor in a timely fashion.

Acetylcysteine↗