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Biomedical subjects

J David Osguthorpe

Publications and source records attributed to J David Osguthorpe.

11 recordsLinked to original sources
PubMed2004

Salivary gland neoplasms.

Treatment and cure of salivary gland neoplasms requires surgical intervention in most cases. For parotid neoplasms, the most common surgical procedure performed is the superficial parotidectomy with facial nerve preservation. Postoperative radiation therapy is indicated in high-grade salivary gland malignancies and malignancies with increased risk of locoregional recurrence. Primary radiation, including neutron beam techniques, may play a role in certain histologic types or nonoperative candidates. Chemotherapy has yet to result in improvements in survival or quality of life in the treatment of salivary gland malignancy. Advances in radiation therapy techniques, including intensity-modulated radiation therapy, provide opportunities for reduced morbidity.

Chemotherapy, Adjuvant↗
PubMed2004

Techniques of intranasal steroid use.

OBJECTIVE: The effectiveness of topical intranasal steroids (INS) sprays for the treatment of allergic and nonallergic rhinitis may be limited by lack of instruction in the optimal spray technique. To determine whether the technique used affects the efficacy and safety of the product, this review of evidence had the goal of identifying and establishing a preferred method of applying INS sprays. STUDY DESIGN: A MEDLINE search of pertinent literature on 7 INS and 1 intranasal antihistamine spray preparations conducted with the use of appropriate search terms, yielded an initial 121 articles, 29 of which were identified as appropriate for review and grading for quality of evidence. RESULTS: The analysis provided no definitive evidence regarding how best to instruct patients to use INS or antihistamine spray devices. CONCLUSIONS: On the basis of a lack of clear evidence regarding instructions to maximize efficacy and safety of these drugs, the panel recommended a 7-step standard technique.

Administration, Intranasal↗
PubMed2003

Anaphylaxis.

Anaphylaxis is an amplified, harmful immunologic reaction that occurs after re-exposure to an antigen to which an organism has become sensitive. True anaphylaxis is a systemic reaction caused by antigen-specific cross-linking of IgE molecules or complement proteins on the surface of tissue mast cells and peripheral blood basophils, resulting in the immediate release of potent mediators. Immediate systemic reactions that resemble anaphylaxis but are not caused by an IgE-mediated immune response are referred to as anaphylactoid reactions. It is important for physicians, especially those who treat allergies, to understand the pathophysiology, know the treatment for, and recognize the clinical signs of anaphylaxis.

Adrenergic beta-Agonists↗
PubMed2003

Nonmelanoma cutaneous malignancy with regional metastasis.

OBJECTIVE AND STUDY DESIGN: We performed a retrospective study of 28 patients to evaluate the management and outcome of regional metastasis from nonmelanoma cutaneous malignancies. RESULTS: There were 25 squamous cell, 1 basal cell, and 2 eccrine carcinomas. The most common primary locations were the temple, ear, and cheek. Median interval from primary resection to regional metastasis was 9 months, and such were commonly of the parotid, level IB, and level IIA nodes. Twenty-four patients underwent parotidectomy and/or neck dissection; 19 patients, postoperative radiation. Ten patients (36%) died from the disease, 2 patients (7%) have persisting disease, 5 (18%) have died from intercurrent disease, and 11 (39%) have no evidence of disease (minimum follow-up, 22 months; median, 34 months). CONCLUSIONS AND SIGNIFICANCE: Nonmelanoma cutaneous malignancies with regional metastasis have a poor prognosis despite aggressive therapy. When high-risk characteristics are detected, examination of the nearest "sentinel node," prophylactic lymphadenectomy, and/or regional irradiation might be justified; further study is warranted.

Basal Cell Carcinoma↗
PubMed2002

Pericranial flap for closure of paramedian anterior skull base defects.

OBJECTIVE: We sought to examine the position of a pericranial flap reconstruction of anterior skull base defects with respect to the original floor of the anterior cranial fossa. STUDY DESIGN: A retrospective chart and radiology review of 17 patients (1993-2001) with pericranial flap reconstruction for anterior skull base defects and 17 controls was performed. RESULTS: At 6 or more months after surgery, the new positions of the pericranial flaps ranged from 5 mm above to 11.3 mm below the positions of the original cribriform plates. There were no complications related to the pericranial flaps such as hemorrhage, flap loss, or brain herniation except for 2 (11.8%) cerebrospinal fluid leaks, 1 of which required operative correction. CONCLUSION: Pericranial flap reconstruction is a reliable method with low morbidity for closure of the most common skull base defect from the craniofacial resection that entails removal-unilateral or bilateral-of the fovea ethmoidalis, cribriform plate, and/or superior septum. This flap creates a watertight seal between the extradural space and the nasal cavity, prevents clinically significant brain herniation, and is associated with a low rate of cerebrospinal fluid leakage even without postoperative lumbar subarachnoid drainage of the cerebrospinal fluid.

Adolescent↗
PubMed2002

Pharmacological treatments for rhinosinusitis.

Acute bacterial rhinosinusitis (ABRS) is a well-recognised and common problem confronting many primary care physicians but the abuse of antibiotic therapy for viral aetiologies of ABRS has lead to widespread bacterial resistance. The once easily-eradicated pathogens have developed many mechanisms to resist antimicrobial therapies. The most common pathogens Streptococcus pneumoniae, Haemophilus influenzae and Moraxella catarrhalis are still found in cultures of sinus cavities but Staphylococcus and possibly some anaerobes play an important role in the development of the chronic stage of rhinosinusitis. The choice of antibiotic therapy for both ABRS and chronic rhinosinusitis (CRS) are reviewed, along with considerations for ancillary therapy. Note is made of the role of chemical mediators in the inflammatory stage possible strategies to reduce this problem. Allergic fungal rhinosinusitis results from a hypersensitivity reaction to demetiaceous fungi. Cure of the effects of rhinosinusitis depends on the establishment of a healthy sinus cycle.

Anti-Bacterial Agents↗