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Biomedical subjects

A Curran

Publications and source records attributed to A Curran.

At least 19 recordsLinked to original sources
PubMed2006

Endoscopic sinus surgery outcome in patients with symptomatic chronic rhinosinusitis and minimal changes on computerised tomography.

This study evaluated the benefit of Functional Endoscopic Sinus Surgery (FESS) in relieving symptoms of chronic rhinosinusitis in patients with minimal preoperative disease involvement as evident on C.T scan and assesses the accuracy of C.T in predicting the outcome of FESS using the Lund-Mackay staging system. 78 patients were stratified according to the extent of their pre-operative C.T disease involvement. Pre and Post operative symptom status were evaluated using Visual Analogue Score (V.A.S) Questionnaire. Using a chi-square test, no statistically significant difference in outcome following FESS was found between those with minimal changes and those patients with more extensive involvement on C.T. Patients benefited from surgery irrespective of pre-operative C.T score. We conclude from this study that FESS appears to have a beneficial role in relieving symptoms of chronic rhinosinusitis in patients with minimal as well as more extensive preoperative C.T disease involvement.

Chi-Square Distribution↗
PubMed2004

The ultrasonically activated scalpel versus bipolar diathermy for tonsillectomy: a prospective, randomized trial.

Among patients undergoing tonsillectomy, the ultrasonic scalpel has been reported to lead to less intraoperative blood loss than cold dissection, and less postoperative pain and faster recovery than monopolar electrocautery. However, the ultrasonic scalpel has not been compared with bipolar diathermy. The present study was a prospective, randomized, single-blind trial, comparing these two techniques with respect to postoperative pain. Twenty-one adults underwent tonsillectomy on one side using the ultrasonic scalpel, and on the other using bipolar diathermy. Pain scores were obtained on postoperative days 1, 2, 7 and week 3. There was no difference between the two treatments at any of the time points (P = 0.6047, 0.4018, 0.6047 and 0.5000, respectively). Inability to control bleeding with the ultrasonic scalpel resulted in the rescue use of an alternative technique of haemostasis in 14 cases. We conclude that the use of the ultrasonic scalpel in adult tonsillectomy is likely to be limited by its substantial costs and difficulties with haemostasis.

Adolescent↗
PubMed2004

Endoscopic stapling vs conventional methods of surgery for pharyngeal pouches: results, benefits and modifications.

Endoscopic stapling of pharyngeal pouches using the Endo GIA-30 stapling gun is a relatively new technique. We compared the outcome of patients who had endoscopic stapling of their pharyngeal pouch with those who had excision of the pouch along with a cricopharyngeal myotomy using conventional methods. A total of 19 patients were included in the study, 9 in the conventional technique group and 10 in the endoscopic stapling group. Data was collected by reviewing patient records and a postal questionnaire. Median stay in hospital for the conventional technique group was 10 days while in comparison the average stay in hospital for the endoscopic stapling group was 3.9 days. The median fasting time for the conventional technique group was 6 days while all patients in the endoscopic stapling group commenced oral feeding on day one post surgery. The postal questionnaire showed that endoscopic stapling was associated with a high patient satisfaction rate. We conclude that endoscopic stapling of pharyngeal pouches has similar results to the conventional open technique, but is less invasive and associated with a shorter stay in hospital. We also discuss a technical modification employed in the stapling of small pouches with thick anterior walls.

Adult↗
PubMed2004

Clinico-pathological conference 2002.

INTRODUCTION: Six cases are reported, each presented at the 11th Biennial Congress of the International Association of Oral Pathologists as an instructive case for differential diagnosis on the basis of clinical, imaging or histological features. CLINICAL PICTURE: Case diagnoses included a large, possibly intraosseous, myofibroma presenting with an oral mass; Langerhans cell histiocytosis with facial skin lesions; an intraosseous vascular hamartoma of the maxilla with worrying radiological features; an unusual mixed radiolucency of the jaw caused by cemento-ossifying fibroma; an osteosarcoma of the posterior mandible causing a well-defined radiolucency and an intraoral squamous cell carcinoma in a child.

Adolescent↗
PubMed2002

The PATRIARCH Study. Using outcome measures for league tables: can a North American prediction of admission score be used in a United Kingdom children's emergency department? PRISA And Triage In A Regional Children's Hospital.

OBJECTIVES: The use of league tables has become predominant in the healthcare culture of the United Kingdom. These tables are often based on measures that are viewed with scepticism by clinicians. This study was designed to test the validity of a North American risk of admission score, the PRISA, for use in a United Kingdom population of accident and emergency (A&E) attendees. METHODS: All attendees to a children's A&E department were scored using the PRISA for a single calendar month (November 2000) RESULTS: 701 children were studied in total. The results show that the PRISA applied to this population gives an area under the receiver operator curve of 0.76. Of the 701 patients studied, 206 (29.4%) were admitted. The PRISA predicted a total of 206.10 admissions. Of the 50 patients discharged with the highest PRISA scores (that is, with the highest likelihood of admission), none were admitted in the 48 hours after their original attendance. CONCLUSIONS: These results show that the PRISA is suitable as a measure of paediatric A&E department performance in the United Kingdom and it is highly promising as a future measure of quality.

Adolescent↗
PubMed2001

Hyperkinetic movement disorder in an 11-year-old child treated with bilateral pallidal stimulators.

Pallidal stimulation is widely used in the treatment of movement disorder in adults but is less well reported in the treatment of dystonia in children. Despite inconsistent results in the past, its use in dystonia in Parkinson's disease is again attracting interest with promising results. Bilateral as well as unilateral pallidotomies have been performed and are felt to be required in some cases of dystonia. Use of depth electrodes to provide long-term electrical stimulation to pallidum and other basal ganglia structures has recently become more widespread. This technique is felt to have a lower morbidity, especially in bilateral procedures. Here we present the case of an 11-year-old boy with severe hyperkinetic movement disorder who showed sustained improvement after bilateral pallidal stimulation implantation.

Cerebral Palsy↗
PubMed2001

The use of fibrin glue in refractory coagulopathic epistaxis.

Epistaxis can be particularly difficult to treat when a patient has a coagulopathy, even if the area bleeding is visible. Where routine measures fail to arrest the bleeding (e.g., nasal cautery and packing), the application of fibrin glue is successful in stopping the bleeding without having to address the underlying coagulopathy. Ten patients with epistaxis secondary to an underlying coagulopathy were treated by local application of fibrin glue to the area bleeding. The bleeding stopped immediately in all patients when the fibrin glue was applied. No patients suffered complications. Fibrin glue application should be considered as a cost-effective means of controlling epistaxis from an identifiable area in the nasal cavity in patients with a coagulopathy.

Cost-Benefit Analysis↗
PubMed2000

Mesenteric angina complicating a mesodermal anomaly.

A child with macrocephaly-cutis marmorata developed severe abdominal pain thought to represent mesenteric angina. There were abnormalities of the aortic and mesenteric vasculature not previously reported in this condition. Angina therapy afforded amelioration of his symptoms. Mesenteric angina should be considered as a cause for abdominal pain in children with mesodermal anomalies.

Abdominal Pain↗
PubMed1999

Leukoplakia of the maxillary vestibule--an association with Viadent?

OBJECTIVE: This report investigates a possible correlation between chronic use of Viadent products and the subsequent development of leukoplakia in the maxillary vestibule. STUDY DESIGN: A retrospective review of 88 patients with leukoplakia of the maxillary vestibule is presented. Prevalence of Viadent use was determined in this group and in a group of 100 randomly selected adults who presented themselves for routine preadmission screening at a dental school. RESULTS: Of the patients diagnosed with leukoplakia of the maxillary vestibule, 84.1% reported having used Viadent, whereas the prevalence of use was only 3% in the 100 randomly selected adults. CONCLUSIONS: Use of Viadent products appears to be associated with an increased prevalence of leukoplakia in the maxillary vestibule.

Adult↗
PubMed1996

Pitfalls in the determination of intracranial spread of complicated suppurative sinusitis.

We present two cases of suppurative sinusitis that presented to our casualty department over a one-week period. Both patients suffered complications of the disease secondary to extension of the inflammatory process beyond the bony confines of the sinus. Neither of the patients had a previous history of sinus disease. The first patient deteriorated suddenly 24 hours after admission. The initial computed tomography (CT) scan failed to demonstrate a developing subdural empyema. This complication was confirmed following repeat scanning 24 hours later and the patient required urgent neurosurgical intervention and drainage. The second patient presented with periorbital cellulitis secondary to sinusitis and suffered a grand mal seizure on admission. Once again initial CT scan changes were subtle and significant intracranial extension was not noted until the subsequent magnetic resonance imaging (MRI) scan was performed. The purpose of this paper is to highlight the potential dangers over reliance on CT scanning in diagnosing early intracranial spread of sinus disease and we emphasise that the clinician must interpret any radiological investigations in light of the associated clinical findings.

Adolescent↗
PubMed1993

Cystic fibrosis presenting as kwashiorkor with florid skin rash.

Two infants with a florid erythematous rash and generalised oedema, hypoalbuminaemia, and anaemia were found to have cystic fibrosis. This rare presentation is associated with false negative sweat tests, delays in diagnosis, and a considerable mortality. It is proposed that this presentation represents a manifestation of kwashiorkor secondary to malabsorption. The recognition that these infants have kwashiorkor provides some insight into the pathogenesis and management of their illness.

Cystic Fibrosis↗
PubMed1989

Effects of heparin and chlorbutol on bacterial colonisation of intravascular cannulae in an in vitro model.

An in vitro model was used to study the effects of heparinised saline, with or without the preservative chlorbutol, on the colonisation of intravascular cannulae. Chlorbutol significantly reduced cannula colonisation by Staphylococcus epidermidis. Flushing colonised cannulae with heparinised saline plus chlorbutol significantly reduced the number of organisms adhering to the inner surface of cannulae, when compared with the use of heparinised saline without preservative. Chlorbutol-preserved heparinised saline may not only maintain cannula patency by the prevention of thrombus formation, but may also reduce the incidence of bacterial colonisation of cannulae in vivo.

Bacterial Infections↗