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Biomedical subjects

C M Fernandes

Publications and source records attributed to C M Fernandes.

At least 37 records · Page 2Linked to original sources
PubMed1995

Sotalol-induced bradycardia reversed by glucagon.

Glucagon is considered the drug of choice for treating bradycardia and hypotension encountered during beta-blocker poisoning. Its potential usefulness in reversing adverse effects encountered during therapeutic dosing with beta-blockers has not been well characterized. We present a case of sotalol-induced bradycardia reversed by glucagon.

Aged↗
PubMed1994

Emergency department patients who leave without seeing a physician: the Toronto Hospital experience.

STUDY OBJECTIVES: To determine why emergency department patients leave without being seen by a physician and whether they receive alternate medical care. DESIGN: A prospective, cross-sectional study of patients who left without being seen. Charts were reviewed for population demographics, presenting complaints, and clinical acuity rating. Follow-up was achieved within 6 weeks through mailed survey questionnaires and telephone interviews. SETTING: Two inner-city EDs of the Toronto Hospital, a quaternary care facility. PARTICIPANTS: All 423 patients who registered for care and left without being seen during a 16-week period from January to May 1991. RESULTS: Of 23,933 registered patients, 423 (1.4%) left without being seen. Follow-up was achieved on 39% of patients (165 of 423). Sixty-seven percent of those who left (284 of 423) had low acuity ratings. Of the 165 survey respondents, 107 (65%) left between 30 minutes and 2 hours after registration. The major reasons cited for leaving included prolonged waiting time (99 of 165, 60%), perceived difficulties with hospital staff (46 of 165, 28%), and pressing commitments elsewhere (45 of 165, 27%). Ninety-two percent (152 of 165) believed they should be evaluated by a physician within 1 hour of presentation. Forty-eight percent (80 of 165) sought further medical attention within 24 hours. Personal physicians (65 of 165, 39%) and other EDs (29 of 165, 18%) were the most common sources of further medical care. CONCLUSION: The majority of survey respondents had a low acuity rating and left because of prolonged waiting times. Most of these patients sought alternate medical care through their personal physician or other EDs.

Adolescent↗
PubMed1994

Bilateral transnasal vidian neurectomy in the management of chronic rhinitis.

Bilateral transnasal vidian neurectomy was performed on 276 patients between 1983 and 1991. The indications for operation were intractable vasomotor rhinitis, resistant allergic rhinitis and recurrent nasal polyposis. Two hundred and fifty-eight patients were contacted and long-term results showed that 88 per cent of the patients had an excellent result.

Adolescent↗
PubMed1994

A roller coaster headache: case report.

There are few reports of adverse outcomes associated with roller coaster rides. We present the case of a 26-year-old man who complained of a gradually worsening headache following a roller coaster ride. A computed tomographic scan of the head demonstrated bilateral chronic subdural hematomas. The clinical course and probable mechanism of injury are reviewed.

Adult↗
PubMed1993

Singular neurectomy in South African practice.

Singular neurectomy was used in intractable or prolonged benign paroxysmal positional vertigo, which was incapacitating in 7 patients. Six patients were cured, 1 patient suffered a severe sensorineural loss and 1 patient a mild-to-moderate loss. Singular neurectomy is an effective treatment for this condition.

Adult↗
PubMed1989

Surgical experience with juvenile nasopharyngeal angiofibroma.

Our experience with 18 cases of juvenile nasopharyngeal angiofibroma (JNA) over a period of 9 years is discussed. All cases were managed surgically: 17 via a transpalatal approach and one case by a combined transpalatal, lateral rhinotomy, and transantral approach. In this series there were two recurrences following primary surgical procedures and these required a second procedure. There were no major complications and all 18 patients are alive. We believe that surgical excision should be the treatment of choice for JNA and that radiotherapy should be used adjunctively for cases wherein intracranial extension of the tumors prevents total excision.

Adolescent↗
PubMed1988

The management of intractable vasomotor rhinorrhoea by transnasal vidian neurectomy.

The performance of transnasal vidian neurectomy in cases of intractable vasomotor rhinorrhoea is described. Of the 66 patients who underwent the procedure, 58 have been followed up and 96% of these reported total or marked improvement in nasal obstruction, 87% reported total or marked improvement in rhinorrhoea and sneezing and 90% reported improvement in post-nasal drip. The procedure is recommended for patients in whom medical treatment has failed.

Adolescent↗
PubMed1987

Bacteriology in acute mastoiditis.

During the period from July 1979 to December 1979, the bacteriology of 35 consecutive patients undergoing surgery for acute mastoiditis was studied. The patients' ages ranged from 3 to 13 years. All patients presented with a purulent otorrhea and a postauricular subperiosteal abscess and were subjected to a mastoidectomy within 12 hours of presentation. Specimens were obtained intraoperatively from the mastoid cavity and, using appropriate technology, were cultured for aerobic and anaerobic organisms. Bacteria were isolated from specimens of 32 patients (91.4%); specimens from three patients (8.6%) yielded no growth. Aerobes alone were cultured from four patients (11.4%); six patients' cultures (17.1%) yielded only anaerobes; and 22 patients' cultures (62.8%) had both aerobic and anaerobic organisms. Thus, anaerobes were cultured from a total of 28 patients (80.0%).

Acute Disease↗
PubMed1987

Nerve/muscle pedicle graft for bilateral vocal cord palsy.

The nerve-muscle pedicle graft was successfully used in six of the seven patients admitted with bilateral vocal cord palsy. The diagnostic evaluation included bilateral vocal cord palsy for more than six months; passive mobility test of the arytenoids under general anaesthesia; and exclusion of an organic lesion as a cause of the vocal cord paralysis. The post-operative assessment was done by indirect or direct laryngoscopy. An improvement in phonation and respiration was noted 4 to 10 weeks after the operation. An exertional test was performed. Identification of the origin of ansa cervicalis from the hypoglossal nerve facilitated the operation.

Adult↗
PubMed1987

Laryngopyocele (a report of two cases).

A laryngocele is an air-filled dilatation of the saccule of the larynx. An infected laryngocele is called a laryngopyocele. Our experience with two cases of laryngopyoceles are presented. Only 29 cases of laryngopyoceles have so far been reported in the literature (Illum and Nehen, 1980). Case one had a right-sided combined laryngopyocele and case two had a right-sided combined laryngopyocele and a left-sided combined laryngocele. Both our cases had their lesions excised via an external approach, as described by Yarington and Frazer (1966), with case two having a bilateral excision.

Cysts↗
PubMed1987

Lateral sinus thrombosis (a review of 45 cases).

Forty-five cases of lateral sinus thrombosis were recorded in King Edward VIII Hospital from 1978 to 1984. Eighty-two per cent of the patients were under the age of 15 years. Associated complications recorded were: 9 patients with meningitis, 4 with posterior-fossa abscess, 1 patient suffering from posterior fossa empyema; 4 presented with facial palsy and 1 with tuberculous mastoiditis. Four deaths were recorded. Findings at mastoidectomy showed a prevalence of infective granulations (60 per cent) over cholesteatoma (40 per cent) as a cause of the extension of infection. The surgical protocol for the management of lateral sinus thrombosis was mastoidectomy, needling the sinus and removal of the thrombus, if necessary. Medical treatment consisted of Ampicillin and Metronidozol.

Adolescent↗
PubMed1986

Anatomy of the recurrent laryngeal nerve: a redescription.

The recurrent laryngeal nerves on each side of the neck consist of numerous branches. The demonstration of the diverse relationships of the recurrent laryngeal nerve in the thyroid area explains the variation in vocal cord and cricopharyngeal muscle paralysis produced by surgical or other trauma to this area. The anastomosis of the middle cervical ganglion with the recurrent laryngeal nerve adds a new dimension to the already confused theories on vocal cord and laryngeal function. Both the motor and sensory supply of the larynx inferior to the cords, lower pharynx, cervical oesophagus and cervical trachea are supplied by the recurrent laryngeal nerve branches and their sympathetic anastomoses. The blood vessel-nerve relationship in these neck dissection specimens is quite different from that documented in the standard literature in that there are numerous blood vessels from the inferior thyroid artery that interdigitate with the branches of the recurrent laryngeal nerve.

Adolescent↗
PubMed1986

Intracranial otogenic complications: a persisting problem.

Three hundred thirty-five cases of acute mastoiditis with complications due to extension of infection beyond the mastoid are reported. Two hundred twenty-four of those presented with intracranial sepsis. Meningitis occurred in 83 cases, brain abscess in 53, extradural abscess in 49 cases, and lateral sinus thrombosis in 39 cases. Intracranial complications are frequently seen in this group of patients with neglected otitis media. The complications occurred frequently in children and young adults (74%) with an overall mortality rate of 14%. Meningitis was the most common complication (37%); brain abscess had the highest mortality rate (36%). The overall mortality rate from intracranial complications was reduced in comparison with previous reported series. This is attributed to antibiotic treatment, the use of CT scan in excluding other intracranial complications, and close cooperation between the otologist and neurosurgeon.

Adolescent↗