Bennedsenlynge0036

INTRODUCTION AND OBJECTIVES Allergic rhinitis is a common disorder. Intranasal corticosteroid sprays are used to control symptoms. However, incorrect use of these sprays can decrease efficacy and lead to side effects such as nose bleeding. We studied if watching an age-adjusted instruction video is effective to improve administration technique. MATERIALS AND METHODS We invited children who used intranasal corticosteroid sprays. We examined their administration technique before, directly after, and one month after showing them an age-adjusted instruction video. We compared their administration technique with the instructions in the patient information leaflet. We assessed whether the children performed the seventeen maneuvers mentioned in the patient information leaflet and the eight we considered essential. RESULTS Of the 99 eligible children, 23 (15 boys, median age nine years) participated. Before watching the instruction video none of them administered according to all maneuvers in the patient information leaflet or showed all essential maneuvers. Afuresertib supplier One month after seeing the instruction video, three children demonstrated correct inhalation as per the patient information leaflet. Three performed the essential maneuvers. When a 75% threshold level for carrying out all 17 maneuvers was used, still none showed 75% of all or of the essential maneuvers before watching the video. Yet, after one month 12 children showed sufficient administration technique (52%, 95% confidence interval (CI) 31%-73%, p = 0.004). Nine showed all essential manoeuvres (47%, 95%CI 24%-71%, p = 0.004). CONCLUSIONS An age-adjusted instruction video is a useful and easy method to teach children to administer nasal intranasal corticosteroid sprays correctly. BACKGROUND Studies have shown that Q angle measurements were unreliable. Imaging studies have largely replaced the Q angle for measuring tibial tubercle lateralization. Creating a standardized protocol to measure the Q angle, with normative values, would provide a reliable reference without expensive imaging techniques. METHODS Thirty men and 27 women without history of knee problems or family history of dislocating kneecaps were subjects. Exclusion criteria were patellofemoral abnormalities upon examination. We measured the Q angles of both knees using a standardized protocol and a long-armed goniometer. These data were analyzed to calculate normative values. RESULTS For all subjects, the mean was 14.8° (≈15°), 95% confidence interval (CI) ±5.4°. The male mean was 13.5°, 95% CI ±5.2°. The female mean was 15.9°, 95% CI ±4.8°. There was no significant difference between the right and left knees of the males (p = 0.52), nor of the females (p = 0.62), Beta = 0.14. The 2.4° difference between male and female means was due to the average height difference between the men and women. CONCLUSIONS This study provides a standardized Q angle measurement protocol to assess tibial tubercle lateralization at a patient's first encounter (and intra-operatively) without resorting to expensive imaging studies. These values provide a reliable reference for clinical comparison, and will allow all clinicians and sports medicine personnel to assess tubercle lateralization with reliability and validity. When using this protocol, the term "Standard Q Angle" (SQA) should be used, to avoid confusion with other measurement protocols. The Avian retina is far less known than that of mammals such as mouse and macaque, and detailed study is overdue. The chicken (Gallus gallus) has potential as a model, in part because research can build on developmental studies of the eye and nervous system. One can expect differences between bird and mammal retinas simply because whereas most mammals have three types of visual photoreceptor birds normally have six. Spectral pathways and colour vision are of particular interest, because filtering by oil droplets narrows cone spectral sensitivities and birds are probably tetrachromatic. The number of receptor inputs is reflected in the retinal circuitry. The chicken probably has four types of horizontal cell, there are at least 11 types of bipolar cell, often with bi- or tri-stratified axon terminals, and there is a high density of ganglion cells, which make complex connections in the inner plexiform layer. In addition, there is likely to be retinal specialisation, for example chicken photoreceptors and ganglion cells have separate peaks of cell density in the central and dorsal retina, which probably serve different types of behaviour. OBJECTIVE This study presents the results of an updated clinical protocol for orbital blow-out fractures, with a special emphasis on nonsurgical treatment and orthoptic evaluation of functional improvement. METHODS A two-centre multidisciplinary prospective cohort study was designed to monitor the results of a clinical protocol by assessing ductions, diplopia, globe position, and fracture size. Patients underwent clinical assessment and orthoptic evaluation at first presentation and then at 2 weeks and 3/6/12 months after nonsurgical or surgical treatment. Outcome parameters were field of binocular single vision (BSV), ductions, degree of enophthalmos, a diplopia quality-of-life (QoL) questionnaire, and other sequelae or surgical complications. RESULTS 46 of the 58 patients who completed the 3, 6 and/or 12-month follow-up received nonsurgical treatment. There was full recovery without diplopia or enophthalmos (>2 mm) in 45 of the 58 patients. The other 13 patients had limited diplopia, mainly in extreme upward gaze (average BSV 90). Five of those 13 patients did not experience impairment of diplopia in daily life. The average QoL score at the end of follow-up was 97. No patients developed late enophthalmos. CONCLUSION This study showed that a high percentage of patients with orbital floor and/or medial wall fracture recovered spontaneously without lasting diplopia or cosmetically disfiguring enophthalmos. The conservative treatment protocol assessed here underlines the importance of orthoptic evaluation of functional parameters. PURPOSE This study aims to describe how firearm homicides among adolescents change over a five-year period. METHODS This serial cross-sectional analysis uses surveillance data collected by the Illinois Violent Death Reporting System. Decedent selection criteria included the following manner of death was homicide, weapon type was firearm, age was 15-19 years, and location of fatal injury was Chicago. Data collected between 2013 and 2017 were used. Multiyear rates per 100,000 and rate ratios were calculated by sex and race/ethnicity. Joinpoint regression analysis and chi-squared tests of linear-by-linear association were used to identify trends over time (by year, month, and weekday). Geographic Information System mapping was used to visualize data. RESULTS There were 509 victims of firearm homicide aged 15-19 years in Chicago between 2013 and 2017. Overall rates were significantly higher in 2016 than in all other years. Victims were disproportionately black males, comprising 75.6% of total adolescent homicides and increasing by 87.