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Biomedical subjects

S Loughran

Publications and source records attributed to S Loughran.

At least 19 recordsLinked to original sources
PubMed2006

Ear protection as a treatment for disruptive snoring: do ear plugs really work?

BACKGROUND: In the absence of surgical treatments with demonstrable long-term efficacy, conservative treatments for snoring remain appropriate. Only limited evidence evaluating the use of ear protection by partners has been published. METHODS: Eligible couples were invited to participate in a two-month trial, with each partner using custom-moulded ear plugs. Five questionnaires were completed by patients and their partners, at baseline and after two months: the snoring outcomes survey (SOS) or the spouse/bed partners survey (SBPS), the Epworth sleepiness scale (ESS), the general health questionnaire-12 (GHQ-12), the Nottingham health profile (NHP) and the Golombok-Rust inventory of marital status (GRIMS). RESULTS: After two months, there was a significant improvement in the SOS score for patients (p = 0.005), the SBPS score for partners (p = 0.001) and the ESS for partners (p = 0.004). CONCLUSIONS: For selected couples, ear plugs represent an effective short-term treatment for some of the social effects of disruptive snoring, as determined by the SOS, SBPS and ESS questionnaires.

Ear Protective Devices↗
PubMed2005

Quality of life and voice following endoscopic resection or radiotherapy for early glottic cancer.

OBJECTIVES: To assess whether proposed voice and quality of life (QoL) outcome measures were likely to be acceptable to patients previously treated for early glottic cancer by either radiotherapy or endoscopic resection, as well as looking for differences in QoL and voice between treatments. DESIGN: Questionnaire-based cohort study. SETTING: Secondary care, three centres. PARTICIPANTS: All patients treated for T1a or in situ glottic carcinoma between 1997 and 2003. Fifty-three patients were identified; those who had undergone salvage surgery or radiotherapy were excluded. A proportion refused to participate or could not be contacted and two patients had died of unrelated causes. Thirty-six patients completed the trial with 18 from each treatment arm. MAIN OUTCOME MEASURES: Quality of voice as assessed by three questionnaires, Voice Handicap Index (VHI), Vocal Performance Questionnaire (VPQ), Voice Symptom Score (VoiSS) and perceptual analysis of voice by Grade, Roughness, Breathiness, Asthenia and Strained (GRBAS) assessment of vocal recordings. Quality of life as assessed by the Hospital Anxiety and Depression Scale (HADS), University of Washington Quality of Life Questionnaire (UW-QoL), and the Functional Assessment of Cancer Therapy (FACT) questionnaire. RESULTS: All patients included in the trial were able to complete the questionnaires; however, 19% required assistance of some kind. GRBAS assessment showed no difference between groups for any criteria. All QoL questionnaires gave equivalent good scores. All of the voice questionnaires showed no statistical difference between groups except for the emotional subscale of the VoiSS which showed a significantly better score for the radiotherapy arm (P = 0.04). CONCLUSION: All outcome measures were applicable and acceptable to the patient group. Overall QoL and voice appears similar despite treatment arm, apart from the emotional subscale of the VoiSS. A randomized controlled trial is required to further assess this question.

Aged↗
PubMed2005

Interobserver reliability in evaluating postural stability between clinicians and posturography.

OBJECTIVES: To assess the interobserver reliability in assessing postural stability and to compare with results obtained by computerized posturography. DESIGN: Cross-sectional study. SETTING: Balance clinic, teaching hospital. PARTICIPANTS: 81 patients attending with a primary complaint of imbalance. MAIN OUTCOME MEASURES: Inter-rater reliability between two clinicians and the modified Clinical Test for the Sensory Interaction on Balance (mCTSIB) as assessed by the Neurocom VSR Balance Master platform. RESULTS: Inter-rater reliability scores were high (0.53-0.81) for all conditions of the mCTSIB except for the easiest, i.e. firm surface eyes open, where concordance levels were poor to fair. CONCLUSIONS: Overall there was good agreement between observers and the computerized mCTSIB.

Adult↗
PubMed2005

Endoscopic sphenopalatine artery ligation--when, why and how to do it. An on-line video tutorial.

KEYPOINTS: Endoscopic ligation of the sphenopalatine artery (ESPAL) has recently become the treatment of choice for refractory epistaxis. This paper reviews the background, indications and potential complications of ESPAL. The main focus of this article is an online video tutorial on the anatomy and surgical technique of ESPAL. Web links lead to video clips of operative steps and therefore this paper should be read in front of a computer with access to the Internet. To study the techniques the links detailed below should be followed. (For computers running RealPlayer software the .wmv extension in each of these links should be replaced with the .rm extension.) * Incision, http://nhsgg.org.uk/content/streams/Figure3.wmv * Flap elevation, http://nhsgg.org.uk/content/streams/Figure4.wmv * Pedicle location, http://www.nhsgg.org.uk/content/streams/Figure5.wmv * Clip application, http://www.nhsgg.org.uk/content/streams/Figure6.wmv.

Arteries↗
PubMed2005

Negative pathology following endoscopic resection of T1a squamous carcinoma of the glottis.

Endoscopic CO(2) laser excision for T(1a) glottic cancer is a recognized treatment modality producing equivalent disease-free and voice results to external beam radiotherapy. On reviewing a series of 15 patients who had undergone endoscopic resection of a T(1a) glottic squamous cancer, it was noted that five patients had negative excisional pathology following the initial biopsy of an invasive squamous carcinoma. The histopathology of each patient's resected specimen was reviewed by a second pathologist who confirmed the accuracy of the results in all cases. We conclude that a significant number of early squamous carcinomas of the glottis present with very small localized, minimally invasive disease and that a proportion may be treated by biopsy alone.

Aged↗
PubMed2004

A prospective, single-blind, randomized controlled trial of petroleum jelly/Vaseline for recurrent paediatric epistaxis.

The aim of the study was to determine if petroleum jelly was an effective treatment for paediatric epistaxis. A single-blind, prospective, randomized controlled trial was undertaken in an otolaryngology outpatient clinic of a paediatric hospital from March 2001 to March 2002. A total of 105 children referred with recurrent epistaxis were randomized into the study, 52 into the treatment arm and 53 into the control arm. Children in the treatment arm applied Vaseline twice a day bilaterally for 4 weeks and were monitored for any bleeds for the next 4 weeks. Children in the control arm were simply given an 8-week appointment and the number of bleeds were monitored for the 4 weeks prior to their appointment. The outcome measure was the proportion of children in each group without nosebleeds in the preceding 4 weeks. Both groups were equally distributed in age, duration of symptoms and duration of each bleed. Fourteen of 51 (27.5%) patients of the treatment arm and 18 of 53 (34%) of the control arm did not bleed in the 4 weeks before review (chi-square test, P = 0.472). It can be concluded that Vaseline alone confers no benefit over simple observation in recurrent childhood epistaxis.

Adolescent↗
PubMed2003

The perceived risk of variant Creutzfeld-Jakob disease and the effect of additional delay in tonsillectomy: a questionnaire based parents perspective.

OBJECTIVES: In February 2001 the United Kingdom Department of Health in conjunction with the British Association of Otolaryngology, Head and Neck Surgeons decreed that all non-emergency tonsillectomies should be performed using disposable instruments because of the theoretical risk of transmission of variant Creutzfeld-Jakob disease (vCJD). There was an understandable delay in the provision of these instruments by the various manufacturers, leading to an increase in waiting time for surgery. It was decided to assess parental attitudes to the risk of vCJD, and assess the effect the additional delay had on their child. METHOD: A questionnaire was sent to the parents of all 249 children on the waiting list for tonsillectomy. RESULTS: Seventy percent replied, and of these, 37% felt there was a risk of reusing instruments, only 10% felt there was no risk, and the remaining 53% did not know if there was any risk. Nevertheless 41% of parents would have gone ahead using old instruments if allowed. All parents of the 73 children waiting greater than 6 months were questioned on the effect of the additional delay. Only 7% reported improvement in symptoms, and 68% felt the additional delay had badly affected their child's health and wellbeing. Ninety percent of parents felt their child's symptoms still warranted tonsillectomy. CONCLUSION: There is an awareness of risk of vCJD among parents whose children await tonsillectomy, although understandably the level of risk they feel is hard to quantify. The rate of symptom resolution whilst on the waiting list was very low.

Adult↗
PubMed2002

Environmental risk factors and gender in nasal polyposis.

The aetiology of nasal polyps remains obscure. Although clinically associated with asthma, notably in women, there is a marked male preponderance of polyposis. This study aimed to explore environmental pollutant triggers and gender differences in risk factors for nasal polyps. In total, 900 patients having surgery for polyposis and 120 new patients with nasal polyps completed a questionnaire with regard to occupational dust and chemical exposure. The male to female ratio was 2:1, and 52% were smokers, although only 37% of women smoked compared with 66% of men. Exposure to occupational dusts and chemicals was noted in 45% (retrospective) and 53% (prospective) of respondents. Women were 1.6 times more likely to be asthmatic and 2.7 times more likely to have allergic rhinitis than men. Men were 2.25 times more likely to be smokers and 2.48 times more likely to have been exposed to chemicals and dusts than women (all statistically significant differences). No significant gender associations were found for hayfever, eczema, aspirin intolerance, alcohol intake or hobby dust exposure.

Air Pollutants↗
PubMed2002

Bioplastique medialization therapy improves the quality of life in terminally ill patients with vocal cord palsy.

Unilateral vocal cord palsy can result in a weak breathy voice and an inability to communicate effectively. This study was designed to assess prospectively the efficacy of polymethylsiloxane elastomer (Bioplastique) medialization injection therapy in patients with vocal cord palsy and terminal disease with particular regard to quality of life issues. Patients with unilateral vocal cord palsy secondary to malignant disease were offered Bioplastique injection. A digital voice recording was taken preoperatively and at 1 month, 3 months and 6 months postoperatively. Maximum phonation time (MPT) was recorded at the same intervals, and patients completed two questionnaires: the voice handicap index (VHI) and SF 36 general health questionnaire. Sixteen patients were entered into the study. There was a significant improvement in voice score, MPT, VHI and in three subgroups of the SF 36 at 1 month postoperatively, and the improvement was maintained in the small number who survived to 3 and 6 months. Bioplastique injection for unilateral vocal cord palsy produces a significant improvement in quality of life in addition to measured voice quality in patients with terminal disease. It should be recommended in patients even when the life expectancy is short.

Aged↗
PubMed2002

Current aetiology of unilateral vocal fold paralysis in a teaching hospital in the West of Scotland.

Between May 1997 and May 2001 all patients presenting with a unilateral vocal fold palsy at Gartnavel General hospital were entered into a prospective observational study. The sex, age, side of palsy and aetiology were documented. The aim of the study was to assess the current aetiology of vocal fold palsy in a large teaching hospital in the West of Scotland, and to compare this with the established aetiology in other parts of the world. Seventy-seven patients were studied. Eighty-three per cent were found to have a left and 17 per cent a right vocal fold palsy. The male to female ratio was 2:1, with an age range of 23-85, mean 61. Forty-three per cent of all vocal fold palsies were secondary to an underlying bronchogenic carcinoma and a further nine per cent due to other malignancies. This contrasted with figures quoted in other studies, that gave lung cancer causes of vocal fold palsies ranging from four to 22 per cent. Surgical trauma accounted for 24 per cent and in 11 per cent no cause was found. In conclusion, in our hospital population there is a high rate of vocal fold palsy secondary to bronchogenic carcinoma. This is likely to be associated with the high levels of smoking found in Scotland. Lung cancer rates in Scotland are 1.6 times greater for men, and two times greater for women than the world standard. Malignancies overall cause over 50 per cent of our vocal fold palsies. Vigilance is required in any patient presenting with a vocal fold palsy to ensure a malignancy is not overlooked.

Adult↗
PubMed2000

Management of sudden sensorineural hearing loss: a consultant survey.

A questionnaire was sent to 100 consultant otolaryngologists from three selected health regions in the United Kingdom enquiring about their assessment and management of a patient presenting with sudden-onset sensorineural hearing loss. Seventy-six replied, of whom 42 stated a sub-specialist interest in otology. Seventy-eight per cent of respondents would order routine blood tests including the erythrocyte sedimentation rate (ESR) and syphilis serology; in addition 38 per cent would order a magnetic resonance image (MRI) scan at the first presentation. The vast majority would treat such a patient (89 per cent), although the method and combination varied widely. A review of the literature confirmed that the level of evidence for treating this condition is limited and therefore the wide disparity in consultants' practice is not surprising.

Consultants↗
PubMed2000

Primary chordoma of the ethmoid sinus.

Primary chordoma of the paranasal sinuses are extremely rare tumours, with only a small number of cases verified and published in the literature. It appears that only five of these cases involved the ethmoid sinuses either as a primary or by local invasion, and of these documented cases only one other has been found to solely involve the ethmoid sinus. We present a case of primary ethmoid sinus chordoma treated by wide local surgical excision and present a review of the literature with regard to prevalence and treatment rationale.

Adult↗
PubMed1999

Tracheo-oesophageal puncture by retrograde passage of a gastroscope via mini-laparotomy and gastrotomy.

Secondary tracheo-oesophageal puncture is frequently used for voice restoration after laryngectomy. A method utilizing a flexible gastroscope passed via a mini-laparotomy and gastrotomy in a retrograde manner is described in a patient where extensive pharyngeal resection made it impossible to cannulate the upper aerodigestive tract. The patient suffered minimal morbidity and produced reasonable speech.

Carcinoma, Squamous Cell↗
PubMed1987

Secondary structure predictions and medium range interactions.

Several authors have proposed that predictions of protein secondary structure derived from statistical information about the known structures can be improved when information about neighboring residues participating in short and medium range interactions is included. A substantial improvement shown here indicates that current methods of including this information are not more successful than methods that do not. Evaluations of the Chou and Fasman method (Adv. Enzymol. 47 (1978) 45-148), that does not include information about interactions (except in averaging), have shown it to be about 49% correct for three states (helix, beta-sheet and undefined). In comparison, the method of Garnier et al. (J. Mol. Biol. 120 (1978) 97-120), that explicitly includes information about neighboring residues, has an accuracy of 57% residues correct for three states. However, we have obtained an 8% improvement for predictions of secondary structure based on the algorithm by Chou and Fasman. The improvements are obtained by eliminating many rules and by choosing the best decision constants for structure assignments. The simplified method described here is 57% correct for three states using preference values calculated in 1978.

Amino Acids↗