Search PubMed⌕ Search

Biomedical subjects

I S Mackay

Publications and source records attributed to I S Mackay.

At least 55 records · Page 3Linked to original sources

Long-term safety and efficacy study of intranasal ipratropium bromide.

Forty patients presenting with watery rhinorrhoea as their main complaint were entered in an open trial of long-term intranasal ipratropium bromide. Fourteen of these (35 per cent) found it to be beneficial and completed one year of treatment. Side-effects were seen in 28 patients (70 per cent) but these were local and mild in nature. All resolved during the trial as patients adjusted the dosage to individual severity and frequency of symptoms. No significant systemic effects were noted during the course of therapy. Ipratropium is a useful drug in the treatment of watery rhinorrhoea and appears safe for long-term use.

Administration, Intranasal↗

Multiple submucosal out-fractures of interior turbinates.

Nasal obstruction caused by the inferior turbinate is a common clinical problem. There are many surgical procedures which attempt to relieve it, but all of them have associated difficulties. We describe, for the first time, a new method, namely multiple submucosal out-fractures of the inferior turbinates, which is both effective and free from serious complication.

Humans↗

How safe is submucosal diathermy?

Submucosal diathermy (SMD) is a common surgical procedure carried out to improve the nasal airway. A case is presented in which it was followed by profuse epistaxis which required transfusion of 28 units of blood, eight units of fresh frozen plasma (FFP) and four units of platelets within 14 days.

Adult↗

The effect of vidian neurectomy on nasal mucociliary clearance.

The physiological factors controlling mucociliary transport are largely unknown. Nasal mucociliary clearance was measured using the saccharin test in seven patients who had previously undergone vidian neurectomy for vasomotor rhinitis. Persistent denervation was suggested by impaired tear secretion. The control group consisted of thirty-four patients with vasomotor rhinitis who had not had surgery. There was no significant difference in clearance times between the two groups, suggesting that mucociliary transport is well preserved in the absence of neural control.

Adult↗

Upper respiratory tract involvement in sarcoidosis and its management.

Of some 750 sarcoidosis patients, 27 were found to have involvement of their nasal mucosa. Most had multisystem disease, which was usually chronic. Nasal stuffiness or blockage and crusting were the major symptoms, and were usually present at the first presentation with sarcoidosis. The larynx was involved in five cases. The Kveim test was positive in twelve of the fourteen patients in whom it was performed, serum angiotensin converting enzyme was frequently elevated and sinus radiographs were often abnormal. Topical medication improved symptoms in some patients, but the majority required systemic corticosteroids. It was possible to withdraw medication completely after seven years in only one patient. Relapse was encountered during reduction of dosage in other patients. Random biopsy of macroscopically normal nasal mucosa did not yield histological support for a diagnosis of sarcoidosis in twelve out of thirteen patients, but upper respiratory tract lymphoid tissue may contain granulomas in patients with sarcoidosis.

Adenoids↗

Sinoscopy.

Explore the source record for details and available documents.

Endoscopy↗

Fibrin glue in nasal septal surgery.

We have successfully used fibrin glue to avoid operative nasal packing in 30 cases of septal surgery. Avoiding a nasal pack is not only more acceptable to the patient but may also reduce hospital stay. Analysis of our results showed some minor short-term complications but initial post-operative septal deviation tended to resolve spontaneously. Transient oedema and hyperaemia occurred in 37 per cent of cases and may represent an allergic response despite few classical allergic reactions having been reported.

Adolescent↗

Relative importance of antibiotic and improved clearance in topical treatment of chronic mucopurulent rhinosinusitis. A controlled study.

50 patients with chronic mucopurulent rhinosinusitis were randomly allocated to treatment with nasal sprays of dexamethasone, tramazoline, and neomycin, dexamethasone and tramazoline with no antibiotic, or matched placebo (propellant alone) four times daily to both nostrils for 2 weeks. The patients were assessed in a double-blind manner for symptomatic response and improvement in nasal mucociliary clearance, nasal airway resistance, sinus radiographs, and intranasal bacteriology and appearance. Both active preparations (with antibiotic 14 of 20 patients responded; without antibiotic 12 of 20 patients responded) were more effective than the placebo (2 of 10 patients responded). There was no significant difference in response between the active preparations with and without antibiotic. Thus, in treatment of chronic mucopurulent rhinosinusitis, reduction of the inflammatory response and decongestion make topical antibiotic unnecessary, probably by allowing host clearance mechanisms to recover.

Administration, Intranasal↗

Abnormal nasal mucociliary clearance in patients with rhinitis and its relationship to concomitant chest disease.

Nasal mucociliary clearance was measured using a saccharin technique in 172 patients with perennial rhinitis (76 also had asthma) and in 121 patients with chronic infected rhinosinusitis (40 had asthma, 35 had bronchiectasis). All patient groups had significantly longer mean nasal mucociliary clearance times than that of a group of healthy subjects. Grossly prolonged clearance (greater than 60 minutes) occurred in significantly more patients with the clinical syndrome of chronic infected rhinosinusitis and bronchiectasis than in the syndromes of chronic infected rhinosinusitis with or without asthma, and perennial rhinitis with or without asthma. The abnormal clearance was shown not to be due to an intrinsic ciliary defect by in vitro examination of nasal cilia but probably to be due to a combination of mucus and ciliary factors in vivo.

Adolescent↗

Effect of betamethasone and betamethasone with neomycin nasal drops on human nasal mucociliary clearance and ciliary beat frequency.

The effects of two topical nasal preparations on human nasal ciliary beat frequency in vitro and on nasal mucociliary clearance in vivo were investigated. Betamethasone and betamethasone with neomycin drops were found to be ciliotoxic when ciliated epithelium was exposed to them in vitro, mainly owing to the effects of the preservatives benzalkonium chloride and thiomersal. The nasal mucociliary clearance and in vitro ciliary beat frequency of nasal ciliated epithelium taken from healthy subjects were not adversely affected after topical application; neither did treatment with betamethasone, with or without neomycin, for four weeks affect these indices in two groups of patients with rhinitis. Thus, despite a ciliotoxic effect when ciliated epithelium is exposed to these preparations in vitro, they do not affect nasal clearance or ciliary beat frequency (as measured in vitro) adversely when administered topically to the nose.

Administration, Intranasal↗

Pre- and post-operative brainstem responses in a case of acoustic neuroma, sparing the VIII nerve.

A case is reported of a patient with an acoustic neuroma presenting with a 2 month history of tinnitus and a 25dB hearing loss with evidence of recruitment. The neuroma was removed via a posterior fossa approach with preservation of hearing. Preoperative and postoperative brainstem electric response (BSER) studies are compared. The preoperative results demonstrated a marked reduction in amplitude and increase in latency on the affected side which returned to normal after removal of the neuroma.

Action Potentials↗