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Biomedical subjects

P Freeman

Publications and source records attributed to P Freeman.

69 records · Page 4Linked to original sources
PubMed1978

Fistula of the lateral semicircular canal.

The principles enunciated by Adam Politzer concerning the management of fistula of the lateral semicircular canal are as true today as they were during his time, in spite of the advances made in otologic surgery during the past 25 years or more. If a fistula of the lateral semicircular canal is suspected or proven, the patient's hearing has a greater chance of being preserved if the fistula is left undisturbed. Several illustrative cases are presented.

Adult↗
PubMed1978

Rupture of the round window membrane.

The mechanism of development of rupture of the round window membrane appears to be an increase in pressure in the cerebrospinal fluid transmitted to the inner ear via the cochlear aqueduct. Two cases of rupture of the round window membrane in divers are described in detail. One diver had ruptures of both round window membranes following difficulty in autoinflating when diving, and the other had a rupture of one round window membrane, having presented with acute prostating vertigo and normal hearing. Surgical repair restored the hearing in the former case and preserved normal hearing in the latter. The similarity between ruptures of the round window membrane and poststapedectomy fistula is emphasized, and it is suggested that spontaneous healing of ruptures may well occur. A case history supporting this hypothesis is presented. The technique of repair of ruptures of the round window membrane is described as well as postoperative management. Normal nasal function in divers is essential if inner ear barotrauma and ruptures of the round window membranes are to be avoided.

Adult↗
PubMed1975

Childhood urinary infection associated with vesico-ureteric reflux.

Among 222 children investigated in hospital for urinary infection 98 had vesicoureteric reflux only, and of these a group of 59 has been followed at a special clinic for from three to 14 years (mean 5.4 years). Children with reflux had an earlier age of onset and a greater likelihood of a family history of urinary infection than those with other diagnoses. Fifty-five were conservatively treated, and more than half of these still had reflux at the end of the study. Children with severe grades of reflux and an early onset of symptoms had least chance of reacting favourably to medical treatment. Evidence of renal deterioration was exceptional and virtually confined to the pre-school age group. It is argued that severe grades of reflux in pre-school children should be treated surgically, and that voiding cystograms need only be part of routine investigation in two circumstances, namely when the patient is under five, and on the very rare occasion when an older child shows progressive renal damage in serial pyelograms.

Age Factors↗
PubMed1975

Rupture of the round window membrane.

Considerable interest has been displayed in sudden sensori-neural deafness in recent years, and especially since Blair Simmons postulated that this could be caused by mechanical disruption of the membranes in the inner ear. The literature concerning such reports is reviewed briefly and two cases of rupture of the round window membrane resulting from inner ear barotrauma are reported in detail. Both these cases were experienced divers who had had little difficulty in auto-inflation whilst diving. The first case had progressive sensori-neural deafness with mild vertigo, and tympanotomy revealed rupture of the round window membrane in both ears. These ruptures were repaired with plugs of fat, following which his hearing was restored. The second case developed marked vertigo following a dive and was thought to be suffering from decompression sickness. When the appropriate treatment did not help him, tympanotomy was performed and a rupture of the round membrane was found. This was plugged with fat with a most satisfactory result. Both of these cases had difficulty with autoinflation, and had been aware of such difficulties for some time. Nasal problems were responsible for this, and it is strongly recommended that all divers should have normal nasal function and that they should be educated in the technique of autoinflation, and, in particular, in the importance of avoiding forceful autoinflation at all times. A third case of rupture of the round membrane following an injury to the head is also reported.

Adult↗
PubMed1970

Value of routine multiple blood tests in patients attending the general practitioner.

The paper describes the investigation of 296 patients selected at random from those attending the general practitioners' surgery and studied by means of multiple biochemical and haematological tests. The tests that would not normally have been requested led to a new diagnosis of clinical significance in 16.9% of patients, in most instances requiring an alteration of the patient's therapy. The effect of the profile tests on patient follow-up, referral of patients to hospital, and the need for subsequent investigations was studied by comparing the patients profiled with a control group of patients not having a blood profile. The place of such an investigation in general practice is considered.

Adolescent↗
PubMedDate not supplied

Type A behavior and blood pressure during general surgery.

The Type A behavior pattern (TABP) has been demonstrated as a risk factor for the development of coronary heart disease (CHD). Psychophysiologic studies suggest that the TABP may be associated with autonomic hyperreactivity to a variety of stressors. Recent studies report an association of TABP with autonomic hyperreactivity in patients under general anesthesia for coronary artery bypass surgery. The present study did not find a significant correlation between the TABP and intraoperative rise in blood pressure for 44 noncardiac patients undergoing anesthesia for elective general surgical procedures. Suggestive associations were found in sub-samples with family history of CHD or age greater than 60 years. Thus, the TABP may be correlated with heightened physiologic response under anesthesia only in selected populations.

Adult↗