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Biomedical subjects

E O Pelausa

Publications and source records attributed to E O Pelausa.

13 recordsLinked to original sources
PubMed1999

Otolaryngology in Atlantic Canada: practitioners' perspectives.

OBJECTIVE: A survey was conducted to assess practice conditions in Atlantic Canada for 1996. METHOD: Otolaryngologists in Nova Scotia, New Brunswick, Prince Edward Island, and Newfoundland/Labrador with at least 1 year of practice experience in the area were canvassed regarding general work concerns, office and OR waiting lists, income, support services, job satisfaction, future plans and personal recommendations for improvement. Nineteen of 40 surveyed responded (47.5%). RESULTS: The results revealed that Atlantic Canadians had to wait considerably longer than average Canadians for ENT services. This was particularly true for Nova Scotians who had to wait often more than double the national average. Forty-seven and a half percent of practitioners were dissatisfied with the practice climate, with many merely trying to maintain status quo. Increasing government constraints and budget cuts have led to practice protectionism and the loss of collegiality. There is little optimism for the future, with 42% predicting continued deterioration in the next 5 years. As a result, up to 58% are considering relocating elsewhere. CONCLUSION: Despite diminishing returns, these specialists continue to provide the best possible care for their patient patients--hoping for a better tomorrow.

Adult↗
PubMed1995

Orbital complications of functional endoscopic sinus surgery.

Sinus disease and its surgical treatment carry the risk of orbital complications, including the possibility of blindness. These complications apply to traditional sinus procedures and the more recent endoscopic approach. Two recent endoscopic cases resulted in eye complications, and the lessons learned in their management are herein shared. One case was complicated in the immediate postoperative period with an orbital haematoma that required urgent decompression through lateral canthotomy/cantholysis. The second case involved a patient who complained of visual changes starting 5 days after an uncomplicated procedure. Ophthalmologic consultation diagnosed amblyopia, which he had preoperatively. A preoperative visual assessment is highly recommended to avoid possible medicolegal misadventures.

Adult↗
PubMed1995

Prevention of noise-induced hearing loss in the Canadian military.

A prospective study was undertaken to investigate the development of noise-induced hearing loss in Canadian military recruits, and to assess the effectiveness of the hearing conservation program currently in place. The participants were 134 men and women, 20 to 30 years of age, employed in four trades, three of these (infantry, artillery, and armour) associated with high noise levels. The data comprised audiometric measurements made at the time of entry and after 3 years of employment, and responses to a questionnaire mainly relating to noise exposure in the workplace and during leisure activities, and the utilization of personal hearing protective devices. The findings showed that group audiograms at entry and at the 3-year recall were characterized by a 6-kHz notch that was indicative of noise-induced hearing loss, although mean threshold values were within normal limits. By the 3-year recall, 11% of the infantry had sustained a mild-to-moderate hearing loss in the left ear, greater than 25-dB HL, that was consistent with the use of small-calibre weapons. Responses to the questionnaire indicated that, while subjects appreciated the potential benefit of wearing hearing protectors, instructions in their proper use and education on the hazards of noise exposure were poor. The results suggested methods to strengthen the existing scheme for hearing conservation to further minimize risk.

Adult↗
PubMed1993

Massive pericardial effusion as a cause for sudden deterioration of a very low birthweight infant.

We describe the successful resuscitation of a very low birthweight infant after sudden deterioration caused by a massive pericardial effusion. The neonatal course of this 740 gm, 26-week gestational age infant had been complicated by moderate respiratory distress syndrome, apnea, and bronchopulmonary dysplasia. A Silastic catheter was placed percutaneously in the right axillary vein on day 6 of life and documented to be in the superior vena cava prior to continuous parenteral nutrition. On day 38, her cardiorespiratory status abruptly deteriorated, blood return could not be obtained from the central line, and it was removed. Chest radiograph and subsequent echocardiogram confirmed a massive pericardial effusion. Under echocardiographic guidance, an emergency percutaneous pericardiocentesis allowed aspiration of 23 ml of straw-colored fluid. Her vital signs immediately returned to normal and reaccumulation of the effusion did not occur. Despite the high mortality of premature infants from pericardial effusion as a complication of central venous catheterization, early diagnosis and prompt therapy can assure a good outcome. As a cause of sudden deterioration of very low birthweight infants, tamponade must not be forgotten, since it is now a rapidly treatable complication of central venous cannulation.

Cardiac Tamponade↗
PubMed1993

Problem-based learning: perspectives for otolaryngology--head and neck surgery.

The concept of problem-based learning (PBL) is sweeping through many schools of medicine in North America. Medical curricula are undergoing significant changes to reflect this learning philosophy. This paper analyzes the rationale behind this approach with emphasis on its impact on the teaching of otolaryngology--head and neck surgery in both the undergraduate and postgraduate levels. The "new pathway" curriculum of Harvard Medical School forms the basis for discussion. The University of Ottawa's new "Curriculum 2000" inaugurated in September 1992 is presented. An open-minded approach to the dramatic changes may reap unexpected benefits for the "orphan specialties" including our own.

Curriculum↗
PubMed1992

Schneiderian papilloma of the nose and paranasal sinuses: the University of Ottawa experience.

Schneiderian papillomata of the nose and the paranasal sinuses are uncommon neoplasms. Although histologically benign, malignancy can occur. The likely etiologic agent is the human papilloma virus. We reviewed the cases treated at University of Ottawa-affiliated hospitals from 1969-1989. There were 35 patients consisting of 26 men and nine women with an average age of 55.8 years. The most common presenting symptom was unilateral nasal obstruction (71.4%). This was caused in most cases by an ipsilateral polypoid mass (82.9%). CT scan study was helpful in delineating the size and extent of the lesion. Four cases of malignancy were found (11.4%). Whether malignant transformation had occurred or whether a synchronous or metachronous malignancy had been serendipitously discovered is open to debate. Thorough examination with biopsy is mandatory to obtain a definitive histologic diagnosis. Intranasal papilloma-plucking (polypectomy) is useful for biopsy purposes but grossly inadequate as definitive treatment. The high recurrence rate is due to inadequate resection. Radical surgery consisting of medial maxillectomy via the lateral rhinotomy approach has the lowest recurrence rate (7.1%) and is the treatment of choice.

Adult↗
PubMed1991

Otolaryngology-head and neck surgery in the Canadian military: practice trends.

The practice of medicine in the Canadian military is poorly publicized except in times of war. The specialty of otolaryngology-head and neck surgery is not well known, even in medical circles. To correct this deplorable ignorance, a review was conducted on the otolaryngologic activities within the Canadian Forces. This revealed a dynamic specialty whose many contributions warrant acknowledgment. Starting with Major-General M.J.C.E. Fiset, who was the first such specialist in Canada, military otolaryngologists have maintained excellent standards of medical practice for the benefit of the Canadian soldier. This paper traces the development of military otolaryngology in Canada. Trends in the practice of this versatile specialty are presented.

Canada↗
PubMed1991

Percutaneous tracheostomy: ready or not?

A novel approach to tracheostomy has recently been introduced, based on the Seldinger guide-wire technique. A well-packaged percutaneous tracheostomy kit promises a rapid and safe alternative to the traditional surgical tracheostomy. At the National Defence Medical Centre, this percutaneous approach was tried on four patients. Deficiencies in the kit instruments were discovered which, with the expected "learning curve," led to unexpected difficulties. Thus, the promise of percutaneous tracheostomy remains as yet unfulfilled.

Aged↗
PubMed1989

Surgery for snoring.

Snoring is a common obnoxious disturbance in human society. Although considered a mere nuisance by most, it can have significant social and medical effects. Snoring has caused marriage breakdown and murder. It can lead to hypertension, heart failure, and the obstructive sleep apnea syndrome. Since Ikematsu developed palatopharyngoplasty (PPP) in 1952 and Fujita introduced it to North America in 1981, numerous reports have alluded to its efficacy in the management of snoring. From June 1986 to February 1988, 110 PPP operations were performed at The Wellesley Hospital, University of Toronto. Of these, 58 patients responded to review and questionnaire. Elimination or improvement of their snoring was reported by 75.9% of patients. Complications encountered are discussed. We conclude that palatopharyngoplasty (PPP) is a safe and effective technique in the treatment of problematic snoring.

Female↗
PubMed1988

Fibrin glue in facial plastic and reconstructive surgery.

Fibrin glue has gained extensive use in Europe in the past decade but remains fairly new to North America. Fibrin glue physiology, its historical background, experimental findings, its present uses and the question of safety are addressed. Results of its use in facial plastic and reconstructive surgery at the Toronto Western Hospital are presented. The authors conclude that fibrin glue is a safe bioadhesive and sealant. It is an excellent adjunct but not a substitute for good surgical techniques.

Adult↗