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Biomedical subjects

D C Fitzgerald

Publications and source records attributed to D C Fitzgerald.

At least 37 records · Page 2Linked to original sources
PubMed1996

Perilymphatic fistula in teens and young adults: emphasis on preexisting sensorineural hearing loss.

Sudden hearing loss and new-onset vestibular disorders can be caused by perilymphatic fistulas (PLFs). In children, the existence of a severe or profound sensorineural hearing loss (SNHL) has been associated with a perilymphatic fistula when a sudden hearing loss or vestibular disturbance occurs. Likewise, at the other end of the age spectrum, several large series of PLFs in adulthood have been presented. This report focuses on a neglected age group, those in their teens and young adulthood. Twenty-three patients between the ages of 17 and 26 were studied who had a preexisting SNHL and had developed an additional hearing loss, a new vestibular disturbance, or both. An age-matched cohort of 21 patients with normal hearing was examined in relation to their medical history, diagnostic tests, and surgical outcome of a perilymphatic fistula repair. The findings of this report suggest that persons who have a preexisting SNHL are more likely to develop a perilymphatic fistula eventually than are persons with normal hearing.

Adolescent↗
PubMed1996

Endolymphatic duct/sac enhancement on gadolinium magnetic resonance imaging of the inner ear: preliminary observations and case reports.

Twelve patients with auditory and/or vestibular symptoms were examined with a gadolinium magnetic resonance imaging (Gd-MRI) study. They all were found to have enhancement of only the endolymphatic duct/sac structures of the inner ear. Most of these findings were unilateral, but a few were bilateral. The patients underwent auditory, vestibular, and blood tests in an attempt to clarify the reason for this abnormal enhancement. Several specific etiologies were identified, but several cases had unknown causes. In this article we review the concept of inflammation of the inner ear structures with particular attention to the role of the endolymphatic duct/sac in the immune response of the inner ear. The idea of an inflammatory response of the inner ear leading to endolymphatic hydrops (Meniere's disease) is discussed, but these patients did not follow a clear path from inflammation of the endolymphatic duct/sac to endolymphatic hydrops. However, the longest follow-up was only 4 years, and our observations remain preliminary. Finally, the authors have found that Gd-MRI study of the inner ear provides valuable information in the investigation of patients with new auditory and/or vestibular symptoms.

Adult↗
PubMed1995

Persistent dizziness following head trauma and perilymphatic fistula.

A growing body of evidence supports the idea that dizziness that persists for months and even years can be caused by an unsuspected perilymphatic fistula. Perilymphatic fistulas are abnormal ruptures that allow perilymph to leak out of the inner ear into the middle ear space. Most commonly, these ruptures occur secondary to a traumatic event. The term postconcussive syndrome has been used to describe a myriad of symptoms following head trauma. Some of these symptoms, such as cognitive changes, tinnitus, neck stiffness, and dizziness, are also commonly caused by active perilymphatic fistulas. This article discusses the typical history and diagnostic tests for patients with perilymphatic fistula. Common diagnostic tests include audiograms, electronystagmograms, electrocochleograms, and subjective and platform fistula tests. Also, the surgical treatment for the perilymphatic fistula (ie, repair of the oval and round windows) is reviewed, along with the results produced by this relatively minor ear operation. Suggestions are made to help the medical professionals involved in rehabilitative care to be aware of perilymphatic fistulas and seek proper consultations from inner ear specialists if they suspect the existence of this easily cured disorder.

Adult↗
PubMed1992

Labyrinthine enhancement on gadolinium-enhanced magnetic resonance imaging in sudden deafness and vertigo: correlation with audiologic and electronystagmographic studies.

Sudden deafness with or without vertigo presents a difficult diagnostic problem. This article describes 12 patients with enhancement of the cochlea and/or vestibule on gadolinium-diethylenetriamine pentaacetic acid-enhanced magnetic resonance imaging (MRI), correlating the enhancement with the auditory and vestibular function. All patients were studied with T2-weighted axial images taken through the whole brain, enhanced 3-mm axial T1-weighted images taken through the temporal bone, and enhanced T1-weighted sagittal images taken through the whole brain. Cochlear enhancement on the side of hearing loss was found in all the patients. The vestibular enhancement correlated with both subjective vestibular symptoms and objective measures of vestibular function on electronystagmography. In 2 patients, the resolution of symptoms 4 to 6 months later correlated with resolution of the enhancement on MRI. No labyrinthine enhancement was seen in a series of 30 control patients studied with the same MRI protocol. Labyrinthine enhancement in patients with auditory and vestibular symptoms is a new finding and is indicative of labyrinthine disease. While abnormalities on electronystagmograms and audiograms are nonspecific and only indicate a sensorineural problem, enhanced MRI may separate patients with retrocochlear lesions, such as acoustic neuromas, from those in whom the abnormal process is in the labyrinth or the brain.

Adult↗
PubMed1991

Simultaneous intraoperative measurement of cardiac output by thermodilution and transtracheal Doppler.

Intraoperative measurement of cardiac output with transtracheal Doppler (DOP) was compared with that measured by thermodilution (TD). Cardiac output was measured simultaneously with both methods in 17 adult patients. For 86 pairs of measurements, the average difference between the two techniques was -0.21.min-1. This bias had a standard deviation of 1.71.min-1. The average of the absolute value of the difference between measurements made with the two techniques was 1.31.min-1, with a standard deviation of 1.11.min-1. The limits of agreement were -3.6 to 3.11.min-1. Linear regression yielded the following equation: DOP = 0.62 TD + 1.54 l.min-1 (r = 0.63). To evaluate the ability of transtracheal DOP to trend changes in cardiac output, the changes in cardiac output at sequential time points were compared for the two techniques. The average difference in the changes in cardiac output measured by the two techniques was 0.01.min-1. This bias had a standard deviation of 1.71.min-1. In conclusion, the transtracheal DOP technique did not reproduce the measurement of cardiac output by TD intraoperatively. Transtracheal DOP did not accurately trend changes in the TD measurement. These findings were obtained from patients with cardiovascular disease, and the conclusions may depend in part on the patient population and the investigators' experience with the transtracheal DOP technique.

Adult↗
PubMed1985

The aging ear.

Otosclerosis begins in the second and third decades of life but usually does not produce a hearing loss until after the fourth decade. Chalky white plaques in the tympanic membrane may be benign, but when associated with hearing loss may point to tympanosclerosis. Presbycusis is the most common cause of hearing loss. Unilateral hearing loss raises the specter of acoustic neuroma.

Adult↗
PubMed1984

Palatal myoclonus--case report.

Palatal myoclonus is the name of a syndrome characterized by an involuntary rhythmic movement of the soft palate, occasionally involving the facial muscles, pharynx, larynx, and diaphragm. A review of the literature involving the etiology, pathology, symptoms, and treatment is presented. A case is reported with successful treatment with phenytoin sodium and phenobarbital. Also presented and discussed are the influences of acoustic and corneal stimulations on the myoclonic activity.

Adult↗
PubMedDate not supplied

Work load issues in clinical nursing education.

This survey of 22 baccalaureate (BSN) programs was undertaken to describe and analyze work load issues in BSN nursing education. Academic careers of nursing faculty may be at risk because clinical work load policies generally place less value on clinical teaching than on classroom teaching. Research question addressed teaching credit hours received for each clinical contact hour, remaining weekly hours available for clinical faculty to accomplish service and research activities, and student-to-faculty ratios in clinical settings. Seventy per cent of the programs surveyed allocated less than 1 teaching credit hour to 1 clinical contact hour. Nursing faculty who taught clinical courses with 5:1 to .25:1 work load credit for face-to-face contact hour ratios needed to work between 8 and 24 hours more in face-to-face teaching compared with colleagues teaching lecture courses, thus leaving less time for scholarship and service activities. Fifty per cent of the programs reported 10 or more students in some of the clinical courses. Faculty reported concerns about quality of learning experiences and supervisory difficulties as student numbers in clinical courses exceeded 8 students/faculty member.

Education, Nursing, Baccalaureate↗