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Biomedical subjects

J S Reilly

Publications and source records attributed to J S Reilly.

16 recordsLinked to original sources
PubMed1992

Consumer product aspiration and ingestion in children: analysis of emergency room reports to the National Electronic Injury Surveillance System.

Inadvertent aspiration or ingestion of products in children is a reportable problem. The National Electronic Injury Surveillance System (NEISS) monitors 119 hospitals for product (nonfood) hazards through a network of emergency room physicians. Coins (52%) remain the most frequently ingested object (1988-1989). Pins, including nails and bolts, are second in rank. Spheres (eg, balls) are the most common cause of death. Most deaths (97%) occur in the home. Younger children (13.4 versus 22.7 months) are more at risk for death. This analysis suggests that shape, as well as availability, is important in children's injuries and deaths. Accurate reporting to NEISS of all aspirated objects remains essential so that product safety and the public's health can be improved. Food product injuries, however, are not reported to NEISS.

Accidents, Home↗
PubMed1991

Assessment of histamine, bradykinin, prostaglandins E1 and E2 and carrageenin as vascular permeability agents in the horse.

The vascular leakage induced by histamine, bradykinin, serotonin and prostaglandin E1 and E2 was assessed. The test agents were injected intradermally into the shaved thoracic skin of horses and the vascular leakage estimated either semi-quantitatively by recording the diameter of the lesions or by measuring the actual volume of extravasated plasma in microliters using iodine-125-labelled human serum albumin (125I-HSA) as a marker in the blood plasma. Using the latter method, the vascular leakage induced by carrageenin and the effect of coadministered prostaglandins E1 and E2 upon the vascular leakage of both histamine and bradykinin were also investigated. No obvious lesions resulted when serotonin (10(-2) mol/l) was injected but histamine and bradykinin produced circular lesions which increased in diameter for approximately 30 min. The size of the lesions and volume of extravasated plasma was dose dependent. On a molar basis, bradykinin (10(-6) mol/l, 10(-5) mol/l) was more potent than histamine but they were equipotent at 10(-4) mol/l. The size of the lesions induced by carrageenin were independent of their anatomical location on the thorax. Except for the second hour, the hourly volume of vascular leakage increased until the fifth hour when the experiment was concluded. The maximum vascular leakage resulting from the injection of prostaglandin E1 or E2 (1, 10, 100 or 1000 ng) was 7 microliters but when co-administered with bradykinin (10(-6) mol/l), the volume of leaked plasma increased from 29 to 78 microliters. No synergy was observed when either prostaglandin was co-administered with histamine (10(-5) mol/l).

Administration, Cutaneous↗
PubMed1990

A staged laryngotracheal reconstruction using alloplast (Proplast) in the canine model.

Standard laryngotracheal reconstructive procedures are constrained by the availability of grafting materials and the ability to repair large defects. Reconstruction utilizing alloplasts may be ideal, but previous results have generally been poor. We present a two-stage procedure using Proplast to reconstruct large laryngotracheal defects in 6 dogs. A custom-made Proplast implant was inserted into a strap muscle pocket and buccal mucosa was placed in the adjacent peritracheal tissue. The muscle-Proplast composite graft was rotated to repair a large defect (3.25 cm by 2.25 cm). All 6 dogs survived. Endoscopic and histologic studies over 12 months showed continued stabilization and maturation of the implant. We feel that Proplast may be used as an alternative to autograft for reconstructing large laryngotracheal defects when the procedure is staged to allow maximal fibrous ingrowth and the implant is protected from infection.

Aluminum↗
PubMed1990

High resolution computed tomography of the temporal bone in infants and children: a review.

Pathologic conditions involving the temporal bone in infants and children are now commonly diagnosed by computed tomography (CT). The importance of utilizing high resolution computed tomography (HRCT) with magnified, thin (1.5 mm) scans in both the axial and coronal planes is stressed in order to obtain the maximal anatomic information that is critical for proper diagnosis. A retrospective analysis of 388 cases reveals a positive diagnostic yield ranging from 65% in temporal bone trauma to 20% in clinically suspected neoplasm. Selected case reports of congenital abnormalities, inflammatory processes, traumatic lesions, and tumors will be presented. We conclude that HRCT is an excellent diagnostic modality and should be used liberally to evaluate the temporal bone in children.

Adolescent↗
PubMed1990

Prevention of aspiration in infants and young children: federal regulations.

Aspiration of and asphyxiation from small objects is a well-known danger to young infants and children. At present, there are three different federal regulations that address this problem, by specifying different dimensions of height, width, and length. The Small Parts Regulation, which affects toy size, is the least stringent and is being challenged. The anatomic and physiologic concepts behind these important regulations are analyzed and discussed. The idea of a single generic standard is also reviewed.

Airway Obstruction↗
PubMed1990

The sinusitis cycle.

Recent discoveries make it necessary to reevaluate many of the traditional assumptions concerning sinusitis. Within the past 10 years, investigators have detailed the pathophysiology of sinusitis. Occlusion of the sinus ostia initiates the sinusitis cycle; untreated, this leads to chronic sinusitis. Anatomic abnormalities also predispose the patient to chronic sinusitis because of ostial blockage. Investigators have identified and detailed the prevalence of both aerobic and anaerobic environments within the sinuses, demonstrating that ostial blockage creates an ideal culture medium within the sinus. Keeping the ostial passageways open is essential to allow reversal of the sinusitis cycle, especially in the presence of predisposing factors.

Humans↗
PubMed1989

Microsurgery in otolaryngology: benign laryngeal disease.

Treatment of benign and malignant laryngeal lesions has been advanced through microsurgical visualization. Using suspension laryngoscopy, combined with the appropriate anesthetic techniques, precise surgical treatment of vocal cords can be properly undertaken. Microscopically controlled excision can be performed to within 0.2 mm of the lesion using a CO2 laser. Additional applications of microscopically controlled laser will be applied to laryngeal lesions in the future and will further enhance precise and safe treatment.

Granuloma↗
PubMed1989

Use of ultrasound in detection of sinus disease in children.

A prospective study utilizing a small, portable A-Mode ultrasound apparatus (Sinus-V 2500 Radionics Medical) was undertaken to screen children with signs and symptoms of sinusitis. Fifty-three children (age 2-16 years) were tested both by ultrasound and compared to standard radiographs of the paranasal sinuses. The sensitivity of the ultrasound to evaluate small, developing paranasal sinuses in children was low (22%). Sinus pathology, particularly mucosal thickening, was difficult to confirm. However, even opacified sinuses were only detectable in 58% of the time. Therefore, portable ultrasound devices to detect sinus disease in children, have limited usefulness for this particular population.

Adolescent↗
PubMed1989

Sensorineural hearing loss.

The authors emphasize the importance of early identification and early intervention concerning the management of children with Sensorineural Hearing Loss. The pediatrician plays a critical role in initiating the necessary clinical and audiological evaluations. Guidelines and treatment options are reviewed.

Child, Preschool↗
PubMed1989

Congenital perilymphatic fistula: an overlooked diagnosis?

Congenital perilymphatic fistula (CPLF) often is the sole cause of sensorineural hearing loss in children that is both progressive and subtle and, therefore, can elude detection by physicians. A 3-year prospective study of 244 children with sensorineural hearing loss of unknown etiology demonstrated that at least 6% (15/244) had CPLF. Close audiologic monitoring and radiologic imaging of the temporal bone of children with sensorineural hearing loss are recommended to detect CPLF.

Child↗
PubMed1989

Congenital perilymphatic fistula: a prospective study in infants and children.

A 3-year prospective study of 244 children (aged 5 months to 17 years) with sensorineural hearing loss of unknown cause revealed that 57 children (23%) had radiographic evidence of abnormalities of the temporal bone, detected by computed tomography scan, and/or progression of sensorineural hearing loss. Of these 57 children, 42 (74%) underwent surgical exploration, with 15 children (26%) of this subgroup demonstrating active congenital perilymphatic fistula. The prevalence of congenital perilymphatic fistula in a large, closely monitored population of children with unexplained sensorineural hearing loss appears to be at least 6% (15 of 244 children). The incidence may be higher because some congenital perilymphatic fistulae may leak intermittently and not be observed during middle ear surgery. Therefore, in children with suspected sensorineural hearing loss, early and frequent audiological evaluations should be made to rule out progressive/fluctuating sensorineural hearing loss. These children should also have radiographic imaging of their temporal bone by computed tomography scan. The use of both methods is the best indicator for congenital perilymphatic fistula.

Adolescent↗
PubMed1989

Nasal obstruction in children.

Acute nasopharyngitis and adenoidal hypertrophy, common causes of nasal obstruction in children, are reviewed. The less common, but equally important, congenital and neoplastic lesions that result in blocked nasal airways in children are discussed in detail.

Airway Obstruction↗
PubMed1986

Duration of intubation in children with acute epiglottitis.

Nasotracheal intubation has been demonstrated to be effective in supporting the airways of children with acute epiglottitis. Length of intubation and criteria used for extubation are still controversial. A 6-year retrospective review at Children's Hospital of Pittsburgh identified 100 cases of acute epiglottitis, which were initially managed with nasotracheal intubation. Extubation was based on direct laryngeal inspection performed in the operating room (1979-1981) and, more recently, in the intensive care unit (1982-1984). Length of intubation decreased from 63.8 hours in 1979 to 42.1 hours in 1984. The percent of children intubated longer than 48 hours decreased from 69% to 22% in the same time period. These data indicate that a shorter period of intubation is aided by daily laryngeal inspection in the ICU. We propose a staging system for acute epiglottitis to aid in the decision to safely extubate these children.

Acute Disease↗
PubMedDate not supplied

Sulbactam/ampicillin in the treatment of acute epiglottitis in children.

Acute epiglottitis, a life-threatening illness, is characterized by the sudden onset and rapid progression of respiratory obstruction. The etiologic agent is almost exclusively Haemophilus influenzae type b (Hib). During the past decade as many as 25% of strains of Hib have been shown to produce beta-lactamase and be resistant to ampicillin. Recommendations for treatment, in addition to the immediate intubation of the airway, include the administration of chloramphenicol in combination with ampicillin. The combination of sulbactam and ampicillin was evaluated in an effort to develop a safer, but equally effective, regimen. Thirty-one infants and children (mean age, three years six months) with documented acute epiglottitis received parenteral sulbactam sodium (30 mg/kg per day) in combination with ampicillin (200 mg/kg per day). Of the 31 subjects, 26 (84%) had Hib isolated from the blood; seven (27%) of the 26 strains of Hib isolated were beta-lactamase-positive. Twenty-five cases (96%) of Hib epiglottitis responded rapidly to treatment. The combination of sulbactam and ampicillin appeared to be an effective and safe alternative to chloramphenicol/ampicillin therapy for acute epiglottitis in infants and children.

Acute Disease↗