Search PubMed⌕ Search

Biomedical subjects

D R Strachan

Publications and source records attributed to D R Strachan.

At least 19 recordsLinked to original sources
PubMed2006

A clinical review of 128 cases of head and neck tuberculosis presenting over a 10-year period in Bradford, UK.

AIMS: To analyse the epidemiology, presentation and diagnosis of head and neck tuberculosis (TB). METHODS: We conducted a 10-year retrospective study of all cases of tuberculosis of the head and neck region occurring in Bradford, UK. RESULTS: Of a total of 1315 cases of TB, 128 presented with head and neck TB (12 per cent of which (15/128) were in children). Cervical lymph nodes were most commonly involved (87 per cent, 111/128), other sites being: salivary glands (five cases); larynx, oral cavity, eyes and ears (two cases each); and skin, thyroid, nasopharynx and retropharyngeal space (one case each). Patients' ethnic origins were Asian (89 per cent, 114/128), Caucasian (10 per cent, 13/128) and African (one case). Only 26 per cent (33/128) had constitutional symptoms, and 20 per cent (25/128) had a coexistent site of TB. Only 39 per cent (40/105) of surgical specimens were sent for culture. CONCLUSIONS: Isolated head and neck TB is not uncommon. Atypical presentations render diagnosis challenging, so awareness aids early diagnosis. Mycobacterial cultures should be performed, where possible, for diagnosis.

Adolescent↗
PubMed2006

Size-dependent diffusion in an aging colloidal glass.

Colloidal dispersions of Laponite platelets are known to age slowly from viscous sols to colloidal glasses. We follow this aging process by monitoring the diffusion of probe particles embedded in the sample via dynamic light scattering. Our results show that the time-dependent diffusion of the probe particles scales with their size at early times and for the larger particles. This implies that within this regime the measurements can be used to investigate the generalized fluctuation-dissipation theorem for this out-of-equilibrium system, where the bath temperature is replaced with an effective temperature. Simultaneous dynamic rheological measurements reveal that this effective temperature increases as a function of aging time and frequency which suggests the existence of two measured time-scale regimes. In accord with recent work by Abou [Phys. Rev. Lett. 93, 160603 (2004)], our results suggest that at probed time scales longer than the characteristic relaxation time of the Laponite dispersion the system thermalizes with the bath, whereas at shorter time scales the system is out-of-equilibrium with an effective temperature greater than the bath temperature.

Journal Article↗
PubMed2004

Periorbital swelling: the important distinction between allergy and infection.

Orbital cellulitis and abscess formation are rare complications of sinusitis, however acute orbital inflammation is secondary to sinusitis in about 70% of cases. Delay in diagnosis must not occur to avoid serious complications such as blindness and life threatening intracranial sepsis. A case is reported in which despite late referral, emergency surgical intervention was sight saving.

Adolescent↗
PubMed2004

Long-term ventilation of the middle ear using a subannular tympanotomy technique: a follow-up study.

The results of a nine-year series of patients who underwent long-term middle ear ventilation using a tympanotomy technique are presented. The original series of 26 cases was published in 1995. The same series has now expanded to 37 cases, which form the basis of this follow-up study. In contrast to the original series we found a high spontaneous extrusion rate (68 per cent) and in 27 per cent of cases complications necessitated removal of the subannular T tube. In favour of the technique was a low perforation rate after extrusion or removal (eight per cent). Although only nine per cent underwent re-ventilation this is unlikely to represent resolution of the middle ear effusion in the remaining cases. We conclude that the adverse effects of the subannular tympanotomy technique for long-term ventilation of the middle ear outweigh the benefits when compared with the traditional technique of placing a T tube through a myringotomy incision.

Adolescent↗
PubMed2003

Dentures may be radiolucent.

Diagnosing ingested dental prostheses can be difficult and delays in treatment may result in serious complications. Patients often present with a vague history and very few reliable clinical signs. In addition, the fact that dental plates are often radiolucent may lead to the diagnosis being overlooked with disastrous consequences. A case of successful diagnosis and treatment is presented, and the importance of a high index of clinical suspicion to avoid the morbidity and mortality associated with missed impacted dentures is discussed.

Deglutition↗
PubMed2002

Allergic otitis externa.

Chronic otitis externa is a common condition, which is usually successfully treated by topical medications and aural toilet. In cases that persist despite conventional treatment, a diagnosis of allergic otitis externa should be considered. Sensitization to otic medications (secondary contact otitis) is not uncommon. Topical aminoglycosides are the most common sensitizers although many components of topical preparations can cause sensitization. Patients who may have developed allergic otitis externa should undergo patch testing. Otolaryngologists should consider using topical antibiotics with a low allergenic potential and avoiding neomycin when treating patients with otitis externa. Primary contact otitis may occur to metals used in earrings and also to hearing aid moulds. Treatment of both primary and secondary contact otitis consists of identifying the allergen, avoiding further contact and use of simple preparations avoiding common sensitizers.

Chronic Disease↗
PubMed2001

Do superconductors have zero resistance in a magnetic field?

We show that dc voltage versus current measurements of a YBa(2)Cu(3)O(7-delta) film in a magnetic field can be collapsed onto scaling functions proposed by Fisher et al. [Phys. Rev. B 43, 130 (1991)] as is widely reported in the literature. We find, however, that good data collapse is achieved for a wide range of critical exponents and temperatures. These results strongly suggest that agreement with scaling alone does not prove the existence of a phase transition. We propose a criterion to determine if the data collapse is valid, and thus if a phase transition occurs. To our knowledge, none of the data reported in the literature meet our criterion.

Journal Article↗
PubMed2000

Neonatal hearing screening using the auditory brainstem response.

A targeted screen of babies at risk of having a sensorineural hearing loss (SNHL) using the auditory brainstem response has been in place since 1987 in Bradford and Airedale. The aims of this paper were to ascertain what proportion of a 4-year cohort of children with SNHL should have been identified by the programme; was identified by the programme; and the reasons for failing when children were missed. The cohort of 49 children had moderate to profound SNHL (> 50 dB) and were born between 1 April 1991 and 31 March 1995. Although 92% had at risk factors (higher than in other series), 80% was the maximum that could have been prospectively detected by the programme and only 37% were actually diagnosed as a result of the screening programme. Apart from a generalised under-recruitment, children with risk factors arising because of in utero, perinatal and postnatal events (as opposed to family history, craniofacial abnormalities and syndromes) tended to be missed (P < 0.01). The overall yield of the screening programme was 0.5/1000/year. While the yield of a universal neonatal screening programme based on otoacoustic emissions should be double this, a targeted infant distraction test later in infancy will be an essential backup. Improved liaison with paediatricians in particular as well as simplification of the referral criteria should improve targeting children at risk.

Cohort Studies↗
PubMed1999

A case of Plummer-Vinson syndrome in childhood.

The Plummer-Vinson syndrome is characterized by an association of dysphagia, iron-deficiency anemia, and esophageal webs. The authors report the case of a 6 year old with Plummer-Vinson syndrome. Plummer-Vinson syndrome usually occurs in adults, rarely in adolescents, however, there have been no previous reports in the English-language literature of the syndrome occurring in childhood.

Child, Preschool↗
PubMed1997

Endoscopic laser myotomy in the treatment of pharyngeal diverticula.

The endoscopic approach is a simple and cost-effective option in the treatment of hypopharyngeal diverticula. Whereas almost a third of all endoscopic myotomies performed by UK otolaryngologists are carried out with the stapling technique, CO2 laser diverticulotomy has not been given as much consideration (Koay et al., in press). We report on the first British series of 15 patients treated between 1985 and 1993 with microscopic laser diverticulotomy. The follow-up period was four to 11 years. Complications occurred in three patients, two patients required a repeat myotomy and 11 patients have been satisfied with their swallow since the operation. Our results are similar to those of larger studies. The laser technique is more established than the stapling gun myotomy and it has the advantage of superior visualization. It may also be used in small pouches which do not admit the insertion of a stapling gun.

Aged↗
PubMed1997

Temporalis fascia grafts shrink.

Temporalis fascia, placed as an underlay graft, is commonly used to repair tympanic membrane perforations. Graft failure, however, is a well recognized complication. Grafts are often allowed to dry out during the procedure and, therefore, are often positioned in a dry or partially dehydrated state and only become fully rehydrated after placement. This study looked at how the size of the temporalis fascia alters with its state of hydration. The size of 20 temporalis fascia grafts was measured when fresh, after flattening and allowing them to dry, and finally after rehydrating the grafts with 0.9 per cent saline solution. Significant shrinkage was demonstrated. It is therefore proposed that a cause of increased failure rates, particularly in anterior myringoplasties, is loss of underlay due to graft rehydration and shrinkage. Thus graft shrinkage should be considered when positioning the graft.

Dehydration↗
PubMed1997

Streptococcal tonsillitis and its association with psoriasis: a review.

Lancefield group A streptococcal upper respiratory tract infections are well known to be precursors of a number of disease processes. That they frequently herald a first attack of guttate psoriasis or a reactivation of chronic plaque psoriasis is well recognized, though this is perhaps more true among dermatologists than otolaryngologists. This paper briefly summarizes the historical background, recent research into, and current understanding of the connection between the two pathological phenomena.

Humans↗
PubMed1994

Use of the Carden anaesthetic tube for surgery around a tracheostome.

This short communication describes the use of the Carden anaesthetic tube during surgery in and around a tracheostome. The technique, which greatly facilitates access to the operating field, is described along with it's indications and contraindications. We would like to recommend extending the use of the Carden tube to operations around a tracheostome, thereby maximizing surgical access.

Anastomosis, Surgical↗
PubMed1994

The hearing-aid battery: a hazard to elderly patients.

Owing to the severity of its corrosive effects, an alkaline hearing-aid battery in the external auditory meatus is an otological emergency. This report emphasizes the particular risk to confused elderly patients and points out that a delay in diagnosis is common. Aetiology, clinical features and treatment are discussed with reference to three recent cases.

Aged↗
PubMed1989

Life-threatening stridor presenting in a patient with rheumatoid involvement of the larynx.

A case of a female patient with extensive rheumatoid arthritis who presented to the Accident and Emergency Department with life-threatening stridor is described. Although clinical involvement of the larynx is found in over a third of patients with severe rheumatoid arthritis, acute airways obstruction is fortunately a very rare complication. Stridor is probably precipitated in the acute situation in such patients as a result of upper respiratory tract infection.

Acute Disease↗