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Biomedical subjects

I M Smith

Publications and source records attributed to I M Smith.

At least 19 recordsLinked to original sources
PubMed1996

Pseudoepitheliomatous hyperplasia in Mycobacterium ulcerans infection.

Pseudoepitheliomatous hyperplasia of the epidermis occurring with Mycobacterium ulcerans skin infection may result in localization of the infected area with discharge of necrotic material, followed by healing leaving a depressed scar. The process represents more than simple re-epithelization of an ulcerated skin surface; it is a mechanism which produces active extrusion of necrotic material containing viable mycobacteria and should be seen as part of a protective physiological response to the infection.

Adult↗
PubMed1994

Imitation and action in autism: a critical review.

This article considers the evidence for an imitative deficit in autism and for the possible role of deficiencies in the representation of actions. An argument is developed for the claim that the imitation problem is diagnostic of a basic information-processing rather than a social dysfunction. Reviews are offered of the empirical literature on gestural imitation in autism (and other developmental disorders) and the more anecdotal evidence for problems in the domain of action development in autism. An account that may help to integrate these areas is suggested, as are directions for future research.

Autistic Disorder↗
PubMed1994

An out-patient review of facial palsy in the community.

The true psychological morbidity of facial palsy, including Bell's palsy, is not fully understood. This study addresses this problem by a voluntary questionnaire of ENT out-patients. It is not a representative study but indicates that the long-term sequelae of facial palsy is under-estimated by clinicians.

Ambulatory Care Facilities↗
PubMed1994

The prognostic value of facial electroneurography in Bell's palsy.

Twenty six patients with Bell's palsy were studied at presentation using electroneurography. Ninety-four per cent of those who recovered completely could have been predicted by ENoG within 10 days of onset. Of the 18 patients who recovered completely, 13 had a total palsy at presentation.

Action Potentials↗
PubMed1992

A conservative approach to the management of otitis media with effusion in cleft palate children.

Otitis media with effusion (OME) is almost universal in children born with a cleft palate. Early placement of a ventilation tube to alleviate hearing problems is common. A retrospective study has been carried out to assess whether the practice of tube placement only for definite clinical indications is successful in terms of subsequent hearing levels and speech and language development. This was assessed by a case note review, analysis of speech therapy data and by means of a special follow-up clinic. There was no difference in speech development between those treated with tube insertion for OME and those untreated. Audiological thresholds were worse in the treated group. A similar number in each group required regular speech therapy. More abnormal otological findings were present at follow up in those who had tubes inserted, some of these were directly attributable to the presence of tubes. A conservative management of OME in cleft palate children, with tube insertion for only definite clinical indications, is an appropriate management, and will lead to fewer otological complications of tube insertion.

Adolescent↗
PubMed1992

A comparison of facial grading systems.

There have been several attempts at establishing a grading system to estimate the severity of a facial palsy. This study compares the validity and consistency of all the leading systems. The results indicate that the systems are comparable and overall none had the advantage over the others. Interobserver variation had a significant effect on the consistency of the systems used, but experience of the observer was not a significant factor. The simplest classification studied was the House-Brackman system which is recommended.

Facial Paralysis↗
PubMed1992

Routine nasopharyngeal biopsy in adult secretory otitis media.

This study was to determine whether routine examination under anaesthesia and nasopharyngeal biopsy in adults presenting with deafness due to secretory otitis media (SOM) is necessary for detection of nasopharyngeal malignancy. Two patient groups were studied. The first comprised 72 adults with SOM. Of these patients, 3 had nasopharyngeal tumours, 2 of whom also had cervical lymphadenopathy. The prevalence of malignancy in patients with SOM but no other suspicious signs was 1/72 (1.4%). The second group comprised 66 patients receiving treatment for nasopharyngeal neoplasms. In this group, 8 patients had SOM at presentation, 7 of whom had other features suspicious of malignancy. SOM as the sole presenting feature of nasopharyngeal malignancy was 1/66 (1.5%). EUA and biopsy of the nasopharynx is a cost effective investigation which continues to be indicated in adults presenting with deafness due to SOM.

Adolescent↗
PubMed1992

Triple therapy for advanced squamous cell cancer of the head and neck.

This study presents the results of treatment for Stage III and IV squamous cell carcinoma of the head and neck at the Princess Alexandra Hospital and Queensland Radium Institute, Brisbane. Patients were treated using a programme of sequential chemotherapy, surgery and radiotherapy. Between 1980 and 1988, 116 patients commenced the programme and 85 completed the treatment as planned. The Price-Hill regimen of chemotherapy was used until 1986 after which time it was replaced by cisplatin/5-fluorouracil (5FU). Two courses were usually given achieving an overall response rate of 36% (12% complete response). Cisplatin/5FU produced an overall response rate of 56% compared with 24% for the Price-Hill regimen. Radical surgical resections were performed using a free flap reconstruction in the majority of patients. Radiotherapy fields usually covered the primary site and both cervical lymph node areas to a dose of 50-60 Gy in 5-6 weeks. The lengthy treatment was generally well tolerated although there were two chemotherapy and two perioperative deaths. The overall actuarial survival for the 85 patients completing the triple therapy was 60%. These patients were analysed in more detail for possible prognostic factors.

Antineoplastic Combined Chemotherapy Protocols↗
PubMed1991

Effect of giving enrofloxacin in the diet to pigs experimentally infected with Actinobacillus pleuropneumoniae.

Three groups of 16 pigs were exposed individually when four weeks old to intranasal infection with 10(8.9) viable Actinobacillus pleuropneumoniae (serovar 3, strain 2/(10P2); a fourth group was kept in isolation from the others as uninfected controls. Seven days later the 62 surviving animals were killed and necropsied. The organism had caused typical, mainly subacute disease in 12 of the 16 unmedicated animals but in only two of the 16 which had had continuous access to a diet containing 150ppm of enrofloxacin from four hours before exposure to infection, and in six of the 16 given 32 ppm enrofloxacin. However, only 150 ppm enrofloxacin produced marked control of the infection in terms of reduced average severity of thoracic lesions and much reduced prevalence of the organism in the lung at necropsy, and the mean weight gain (1.55 kg) and feed conversion efficiency (2.08) of this infected group over seven days were similar to those of the unmedicated, uninfected controls (1.67 kg and 2.25). The infected but untreated group on average produced detectable antibody seven days after infection whereas in the infected and medicated groups a specific response against serovar 3 was absent.

4-Quinolones↗
PubMed1991

Facial weakness. A comparison of clinical and photographic methods of observation.

The search for an internationally acceptable facial grading system has resulted in an assessment of existing methods by several investigators. These studies were based on observations of video film taken of patients with varying degrees of facial malfunction. Although the grading systems were evaluated, the use of videotape has never been compared with clinical examination and its suitability for this type of work is, therefore, unknown. We used nine facial grading systems to compare the results of clinical observation with those of photographic methods of presentation. The latter included videotape, photographic slides, and a combination of the two. The correlation between clinical examination findings and findings of any of the photographic methods was poor, suggesting the need for a standard form of presentation when grading patients. The most consistent results were found with either clinical examination or photographic slides; videotape was the least reliable.

Data Interpretation, Statistical↗
PubMed1991

Sleep patterns in rural elders: demographic, health, and psychobehavioral correlates.

Altered sleep patterns, including changes in bedtime, sleep latency, total sleep time, and arising time, have been reported to occur with increasing age. We examine self-reported sleep patterns in a geographically-defined population (n = 3097) of persons aged 65 years and older. Sleep patterns were characterized according to demographic variables, clinical conditions, and physical, psychological, and social functioning. Sleep latency and total hours of sleep increased with age, and older respondents went to bed earlier. The percentage of respondents who reported feeling rested in the morning decreased with age. Women went to bed later, had longer sleep latency, and fewer hours of sleep than men, and were less likely to report feeling rested than men. Sleep patterns were also related to educational attainment, self-perceived health status, physical functional status, psychotropic drug use, alcohol use, depressive symptoms, life satisfaction, and social and recreational activity level. This population study suggests that sleep problems among the elderly are sometimes associated with treatable health conditions and modifiable behavioral and environmental characteristics.

Age Factors↗
PubMed1991

Lateral cephalometric analysis of children with otitis media with effusion: a comparison with age and sex matched controls.

Previous reports from this department have established significant differences in the morphology of the nasopharynx between patients with otitis media with effusion (OME) and normal controls. This study has used lateral cephalometric analysis to investigate these differences in greater detail. Skeletal and soft tissue measurements were recorded in 50 patients with bilateral OME and were compared with 50 age and sex matched normal controls. Various points were plotted enabling 23 different linear dimensions and three angles in and around the nasopharynx to be compared. The results show significant differences between the two groups in the skeletal and soft tissue dimensions of the nasopharynx. The children with OME have a smaller nasopharynx with a suggestion that this may be due to a difference both in the rate and timing of growth.

Aging↗
PubMed1991

Secretory otitis media: a review of management by consultant otolaryngologists.

A questionnaire concerning various aspects of secretory otitis media was completed by a random sample of Consultant Otolaryngologists in the United Kingdom. The replies to questions associated with the management of this condition are presented. The results suggest only a moderate degree of agreement between Consultants in many areas of management and these findings are discussed in the light of current research.

Child↗