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Biomedical subjects

M A Walsh

Publications and source records attributed to M A Walsh.

11 recordsLinked to original sources
PubMed1992

Post-tonsillectomy bacteraemia.

Post-tonsillectomy bacteraemia is a well recognized aetiological factor in streptococcal endocarditis. Prophylactic penicillin has been recommended to reduce its incidence in susceptible patients undergoing tonsillectomy. Recent studies have shown a change in the microflora and an increase in the number of penicillin resistant organisms in the tonsils of patients undergoing tonsillectomy. The aim of this study has been to assess the incidence of post-tonsillectomy bacteraemia, identify the organisms associated with it and review the suitability of penicillin in prophylactic regimens. Of the 32 patients included in the study, 11 (34.4%) had positive post-tonsillectomy blood cultures. We were surprised at this low incidence of bacteraemia and have postulated a possible reason. Haemophilus influenzae was isolated from 4 (36.4%) of the positive cultures and Streptococcus viridans in only 1 (9%). Rather than using penicillin for prophylaxis a beta-lactamase stable antibiotic would be more appropriate.

Bacteremia↗
PubMed1992

Amplitude rise time and the perception of the voiceless affricate/fricative distinction.

Variation of amplitude envelope at stimulus onset has been considered to be of primary importance for distinguishing voiceless affricates from fricatives (e.g., [symbol: see text]). In earlier perceptual experiments, however, variation in amplitude rise time was confounded with variation in frication duration. In two experiments, these variables were independently manipulated, and their individual and combined effects for perception of magnitude of [symbol: see text] were examined. Variation in amplitude rise time alone was not sufficient to signal the voiceless affricate/fricative contrast in these experiments, but variation in frication duration alone was sufficient.

Humans↗
PubMed1991

Differences in tonsil core bacteriology in adults and children: a prospective study of 262 patients.

The tonsillar microflora of 262 patients with recurrent acute tonsillitis studied in 1989-1990 is presented. The patient population was divided into three age groups to determine any age-related features. One-hundred and forty-nine patients (57%) were in the 2-7-year-old group, 72 (28%) the 8-14-year-old age group, and the remaining 41 (15%) were over 15 years of age. H. influenzae was the single most common bacterium isolated from the centre of the tonsil (referred to as 'tonsil core'), and this was more prevalent in the 2-7-year-old age group. Staph aureus was the next most commonly isolated bacterium and was most frequently seen in the 8-14-year-old age group (29%). Anaerobic bacteriology was performed in 120 patients. Strict anaerobic species were isolated in significant numbers from the tonsil core in 5% but were present in the superficial culture in all. Anaerobes were present in moderate to heavy numbers in 32% of superficial swabs overall and this was more frequently seen in the older age groups. Mixed pathogens were found throughout all age groups and were most prevalent in the 8-14-year-old age group at 46%. The commonest mixture was H. influenzae and Staph aureus. Normal flora only was commonly found in the superficial swab and rarely in the tonsil core. The number of specimens containing a beta-lactamase producer was assessed for each group; this was similar in all of the groups ranging from 43% in the 2-7-year-old group and 53% in the 8-14-year-old group to 39% in the greater than 15-year-old group.

Adolescent↗
PubMed1991

Formant transition duration and amplitude rise time as cues to the stop/glide distinction.

There is some disagreement in the literature about the relative contribution of formant transition duration and amplitude rise time in signalling the contrast between stops and glides. In this study, listeners identified sets of /ba/ and /wa/ stimuli in which transition duration and rise time varied orthogonally. Both variables affected labelling performance in the expected direction (i.e. the proportion of /b/ responses increased with shorter transition durations and shorter rise times). However, transition duration served as the primary cue to the stop/glide distinction, whereas rise time played a secondary, contrast-enhancing role. A qualitatively similar pattern of results was obtained when listeners made abrupt-onset/gradual-onset judgements of single sine-wave stimuli that modelled the rise times, frequency trajectories, and durations of the first formant in the /ba/-/wa/ stimuli. The similarities between the speech and non-speech conditions suggest that significant auditory commonalities underlie performance in the two cases.

Adult↗
PubMed1991

On the interpretability of speech/nonspeech comparisons: a reply to Fowler.

Fowler [J. Acoust. Soc. Am. 88, 1236-1249 (1990)] makes a set of claims on the basis of which she denies the general interpretability of experiments that compare the perception of speech sounds to the perception of acoustically analogous nonspeech sound. She also challenges a specific auditory hypothesis offered by Diehl and Walsh [J. Acoust. Soc. Am. 85, 2154-2164 (1989)] to explain the stimulus-length effect in the perception of stops and glides. It will be argued that her conclusions are unwarranted.

Auditory Perception↗
PubMed1991

Head and neck cancer localization with indium labelled carcinoembryonic antigen: a pilot project.

Antibodies reacting with cancer cells are playing an increasing role in cancer detection. Most antibodies under study are directed at onco-fetal proteins, principally carcino-embryonic antigen (CEA). In terms of imaging, most work has concentrated on the abdominal and pelvic regions. Although the majority of primary head and neck cancers are amiable to clinical identification, detection of regional metastases and recurrences following radiotherapy can be difficult. Antibody to CEA was radiolabelled with Indium-111 and used to identify proven head and neck tumors by external imaging. In seven patients with squamous cell tumors, five of five primary sites and two of three secondary sites were imaged satisfactory. Comparison with conventional scanning showed good correlation. There were no false positive scans, no consistent relationship between serum or tissue CEA levels and the success of imaging was evident. The success of this pilot study should encourage the search for more tumor-specific antigens, and further studies of external scintigraphic techniques in the localization of head and neck cancers.

Aged↗
PubMed1991

Surgical treatment of hypopharyngeal tumours.

A review of 51 patients who underwent total pharyngolaryngectomy between 1972 and 1989 was undertaken and factors influencing hospital mortality and long-term survival were examined. All patients had advanced hypopharyngeal or cervical oesophageal cancer, and alimentary continuity was restored with either subcutaneous colon (39 patients) or stomach (12 patients). The overall hospital mortality rate was 25% (13 patients). Mortality was mainly caused by cardiac problems or sepsis. The 1-year survival rate was 36% and two of 26 patients (8%) survived more than 5 years. Survival was better when gastric transposition was used for reconstruction (P = 0.01). Other significant factors affecting survival were operative year, presence of metastatic cervical lymphadenopathy and microscopic pharyngeal penetration. It is concluded that surgical ablation is a viable option for advanced hypopharyngeal and cervical oesophageal neoplasia, with stomach interposition the preferred method of reconstruction. Although the prognosis is poor, satisfactory short-term palliation can be achieved.

Adult↗
PubMed1989

Surgical management of drooling in the neurologically damaged child.

Continuous drooling after infancy is rarely seen in normal children. Neurologically damaged children are more likely to continue to drool, and it may be so severe in some cases as to require surgical correction. Submandibular duct relocation is a procedure with minimal morbidity and excellent results. This procedure has been carried out on 16 children at the Eye and Ear Hospital and Temple Street Children's Hospital, Dublin, between the years 1982 to 1987. An overall improvement occurred in 13 cases with only one post-operative complication. Such surgery has transformed the lives of these children as well as being a great source of relief for the parents.

Adolescent↗
PubMed1975

Psychiatry's image today: Results of an attitudinal survey.

The authors report the results of a survey designed to assess opinions and attitudes toward psychiatry among three groups of physicians and two groups of medical students. In general, the role of psychiatry was regarded favorably, and respondents' comments and criticisms were constructive and consistent. The authors suggest that the survey results may reflect an improvement in psychiatry's image.

Attitude of Health Personnel↗