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Biomedical subjects

I M Smith

Publications and source records attributed to I M Smith.

At least 37 records · Page 2Linked to original sources
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↗
PubMed1990

Papillary adenocarcinoma of the middle ear.

A case of papillary adenocarcinoma of the middle ear is presented. The patient had an unusually short history of otalgia, aural discharge and facial palsy, and, at presentation the tumour was too large for surgical resection to be a feasible option. The management of this rare tumour is discussed and the relevant literature reviewed.

Adenocarcinoma, Papillary↗
PubMed1990

Contact hypersensitivity in patients with chronic otitis externa.

Thirty-seven patients with chronic otitis externa were investigated for contact hypersensitivity to 49 agents using standardized patch testing. Positive reactions were found in 22 (58%) patients. This incidence is higher than the 40% found in the only previous similar study and is within the range of 32-72% found in patients with contact dermatitis. The average age of subjects showing sensitivity was 56.7 years compared with 34.9 years for those with negative tests. This significant age difference suggests that contact hypersensitivity is not an aetiological factor in the younger patient. There was no significant difference in the duration of otitis externa between those with positive and negative tests. This feature has not been previously examined or reported. Neomycin was the commonest sensitizing agent, sensitization occurring in 12 (32%) patients.

Adolescent↗
PubMed1990

A modified screening protocol for the diagnosis of acoustic neuromas.

In many centres the diagnosis of acoustic neuromas relies on a preliminary screening protocol. The current method is a combination of caloric tests, tomography of the internal auditory meati and brain stem evoked response audiometry (BSERA) with 2 positive results indicating the need for further investigation. This protocol, although sensitive lacks specificity and results in a high incidence of normal CT air meatograms. As this procedure is associated with a significant morbidity, we have devised a 'weighted' system of scoring to avoid subjecting large numbers of normal patients to CT air meatography. The proposed system has been derived from screening 61 patients with unilateral sensorineural hearing loss, 24 of whom had an acoustic neuroma. This method reduced the false positive rate of CT air meatography from 68%, using the 2 out of 3 criteria, to 18%, whilst the false negative incidence remained at 8%.

Audiometry, Evoked Response↗
PubMed1990

Post-discharge care planning and rehabilitation of the elderly surgical patient.

Successful discharge planning, home care, and rehabilitation for surgical patients can be very satisfying. However, everyone involved should be aware that it can also be frustrating when, despite careful plans and organization, everything falls apart, often because the patient's disease course is different from that expected or the patient or family are not satisfied with the services. There are multiple other reasons for plans to fail, but with experience the failures should become less frequent. All too often in life we take success for granted and weigh failures twice as much. The danger of this type of thinking becomes especially important in discharge planning--successfully discharged patients may be "invisible" but the failures are back very quickly. Everyone involved in discharge planning should be made aware of the successes in order to prevent "burn out." Certain predictable complications can often be prevented or rapidly reversed, and rehabilitation is achieved by a team of varied health care providers. A home visit is often very helpful before discharge of an elderly surgical patient.

Aged↗
PubMed1990

Use of monoclonal antibodies for classifying Actinobacillus (Haemophilus) pleuropneumoniae.

The serological typing (by enzyme-linked immunosorbent assay) of 119 isolates of Actinobacillus (Haemophilus) pleuropneumoniae (representing in varying numbers the 12 serovars of this taxon) by monoclonal antibodies derived from the reference strains of serovars 1 to 5 in general correlated reasonably with the serotype previously established for these strains by conventional procedures employing polyclonal antisera. However, where there were reasonable numbers of isolates representing a given serovar to provide a decision, there was no instance where the correlation between the monoclonal and the polyclonal antibody was in complete accord. In addition, some of the differences between monoclonal and polyclonal antibody binding with some isolates suggest that the distribution of the serotype-specific antigens within the taxon may be even more complex than has previously been supposed.

Actinobacillus↗
PubMed1989

CT air meatography: review of side effects in 60 patients.

Sixty patients investigated for a suspected acoustic neuroma were questioned on the side effects of CT air meatography, a minimum of three months following the procedure. Twelve per cent of patients found the procedure itself so painful that a repeat examination would only be contemplated under general anaesthesia. Only 20 per cent of patients were asymptomatic after the procedure while 28 per cent of patients required bed rest for 24 hours or more (average 4.4 +/- 2.8 days). Sixty-two per cent of patients took three days or longer to return to normal health. The duration and frequency of side effects is greater than previously reported, and emphasizes the need for full investigation of these patients prior to CT air meatography.

Air↗
PubMed1988

Facial electroneurography. Standardization of electrode position.

Electroneurography is now regarded as a valuable method for quantitatively assessing facial nerve function. Controversy, however, still surrounds some aspects of the technique because of the large number of associated variables. This study establishes by experiment the optimum site for both the recording and stimulating electrodes and recommends that this be adopted as a standard to ensure consistency in results between different study groups.

Action Potentials↗
PubMed1988

Idiopathic facial (Bell's) palsy: a clinical survey of prognostic factors.

Forty-four patients with idiopathic facial (Bell's) palsy were studied. They were assessed by the eventual clinical outcome and on this basis 3 groups were formed. Various clinical parameters were studied and those factors associated with a poor prognosis were identified. The factors of significance include age, initial severity of the palsy and the time taken for spontaneous improvement. All other parameters fail to show any statistically significant correlation with prognosis.

Adult↗
PubMed1988

First report of a Canadian epidemiological study of autistic syndromes.

This report describes an epidemiological investigation of the autistic syndrome using new research diagnostic criteria (Denckla, 1986). The focus here is on the methods of screening and follow-up, and on a description of the cases identified within a circumscribed region of Nova Scotia. Autism, as defined by social deviance, language impairment and repetitive or ritualistic behaviours, has a prevalence of 10 per 10,000 and a male to female ratio of 2.5:1. These findings are discussed relative to those reported previously.

Autistic Disorder↗
PubMed1988

Monozygotic twins concordant for autism and hyperlexia.

The authors describe male monozygotic twins, Jon and Jay, who are concordant for autism and hyperlexia. Autism and mental retardation were diagnosed at the age of 2 years 5 months. Jay was the more advanced twin in motor co-ordination, attention span and receptive abilities, but had frequent tantrums. When psychologically assessed at 7 years 2 months, Jon showed borderline/severe mental retardation on the measure of non-verbal intelligence and Jay was moderately retarded. Their receptive language age was greater than their expressive language age: Jon's speech was less mature but more communicative and Jay's was perseverative and ritualistic. Even though Jon was the more mentally retarded twin, Jay was the more autistic in some behavioral aspects. These twins highlight the relationship between autism and hyperlexia.

Autistic Disorder↗