Our institution has rapidly and successfully expanded screening mammography. Higher mammography volumes have been associated with increased use of non-VA breast care services and increased time to definitive treatment. Appropriate counseling regarding BCT was consistently documented, and mastectomy in BCT-eligible patients was largely the result of patient preference or clinical/social factors. Our data suggest that as patient volumes increase with intensified screening, VA hospitals may benefit from acquiring a full complement of on-site breast care services rather than improving flow between VA hospitals and non-VA breast care centers having specialized resources.

No abstract

No abstract

Respiratory obstruction is a lethal complication of thyroidectomy for giant goitre. Prophylactic tracheal splintage by retaining the endotracheal tube in situ for 24 h post-operatively and its meticulous management in the intensive care unit (ICU) is a safe and rewarding practice. Over a 7-year period, 33 patients, all women who had standard thyroidectomy for giant goitre were managed accordingly. There was no incidence of post-operative respiratory distress, nor mortality in the series. The average duration of stay in ICU was 2 days for all patients and the average hospital stay was 6 days for 27 of the 33 patients (81.8%). We suggest that judicious post-thyroidectomy management of giant goitre patients in ICU with endotracheal tube in situ for 24 h improves their survival chances.

No abstract