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Biomedical subjects

P Walshe

Publications and source records attributed to P Walshe.

24 records · Page 2Linked to original sources
PubMed2001

A worrying development in the microbiology of otitis externa.

Methicillin-resistant Staphylococcus aureus (MRSA) is causing growing concern in hospitals. There has been a steady increase in the number of cases of nosocomial MRSA infections recently and this will no doubt apply to otitis externa, one of the most common ENT infections. The total number of cases of otitis externa presenting to the Accident and Emergency Department over a 3-month period was recorded and the offending microbes cultured and tested for drug sensitivities. Although Pseudomonas aeruginosa was the most frequent organism, 30% of patients grew S. aureus. Of these, 6% (15 patients) were MRSA cultures. The contact histories, antibiotic sensitivities and treatment of these 15 patients were studied. Recommendations as a result of this study include the routine culture and sensitivity in otitis externa and where MRSA is cultured, a full contact history should be elicited and appropriate precautions taken. Specifically, a history of hospital contact should be sought. Treatments used successfully in the treatment of MRSA otitis externa were aural toilet and fucidic acid-betamathasone 0.5% wicks where the organism was gentamycin-resistant (GMRSA), whereas aural toilet with aminoglycoside-steroid drops was sufficient if it was gentamycin-sensitive.

Anti-Bacterial Agents↗
PubMed2001

Is reflux noted at diagnostic rigid oesophagoscopy clinically significant?

This study assessed the ability of otolaryngologists to diagnose and grade reflux disease at rigid endoscopy. Twenty-one out of 25 senior otolaryngologists who were questioned by means of a telephone survey said that if they find evidence of reflux disease at rigid endoscopy of the oesophagus and larynx, their practice is to place the patient on a proton pump inhibitor for six weeks without requesting pH and manometry studies, and without referral to a gastroenterologist. Over a two year period, 21 patients were diagnosed as having reflux disease at rigid endoscopy. This was based on the finding of fluid and erythema in the aerodigestive tract and upper oesophagus. Subsequent oesophageal pH and manometry was performed. Nine out of 21 patients were confirmed as refluxers. This demonstrated an accuracy of less than 50 per cent when using these findings to diagnose gastro-oesophageal reflux at rigid endoscopy.

Clinical Protocols↗
PubMed2001

The use of botulinum toxin in otorhinolaryngology.

In recent years, the use of botulinum toxin has become more popular for the treatment of a wide variety of diseases in the head and neck. It offers the possibility of non-invasive treatment of conditions whose aetiology lies in neuromuscular dyskinesis.

Botulinum Toxins, Type A↗
PubMedDate not supplied

Maxillary artery embolisation in the management of epistaxis.

Serious consideration needs to be given to the importance of early embolisation of the maxillary artery in severe and refractory epistaxis. This is particularly true in the young fit person with traumatic epistaxis and in the elderly person who is unfit for general anaesthesia. Embolisation is now a safe and reliable technique. Six patients were embolised. In the two institutions from 1999 - 2000. All responded well to embolisation without complication. This paper describes the technique used in our hospitals and suggests that with the advent of platinum coils and pre embolisation arteriography, the chances of cerebrovascular accident is very small.

Adult↗
PubMedDate not supplied

The problem of seeing hospital staff without G.P. referral--the otolaryngological experience.

Over a three month period, a record was kept of the number of hospital staff who approached the E.N.T. team requesting help for a medical problem. Staff members included doctors, nurses, clerical staff, paramedical staff and porters. The total number of employees in the hospital was recorded. The average General practitioner public patient list (General medical Service cardholders) for South Dublin was recorded (our hospital is in south west Dublin). The total number of hospital staff seen by E.N.T. in 3 months was seventy seven. The total number of hospital staff seen by other surgical specialties was approximately one hundred and sixty seven. Extrapolation of numbers seen by E.N.T. service in three months to numbers seen over a one year period is 308 patients. The numbers seen by the E.N.T. service in three months corresponds to 11.7% of the average South Dublin General Practitioner Medical card list. It has been estimated that approximately 20% of all problems the average General practitioner sees in a week are E.N.T. related. Those practices with a smaller paediatric population would have approximately 15% of the total practice concearned with E.N.T. problems. Therefore as 15% of 2,400 (total hospital staff) = 360, there is potentially a small General Practice which is 'hidden' within the hospital.

Family Practice↗