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T M Davidson

Publications and source records attributed to T M Davidson.

At least 19 recordsLinked to original sources
PubMed1999

A sleep medicine curriculum for otolaryngology-head and neck surgery.

As otolaryngologists play increasingly important roles in the evaluation and treatment of sleep disordered breathing, it is important that all practitioners systematically study the field of sleep. The curriculum outlined in this article has been developed for resident training at the University of California, San Diego, School of Medicine. It is divided into goals and objectives, curriculum, differential diagnosis of sleep disordered breathing, international classification of sleep disordered breathing, a glossary of sleep terms, and a list of resources.

Adult↗
PubMed1999

The use of ENT-prescribed home sleep studies for patients with suspected obstructive sleep apnea.

Sleep disordered breathing, including obstructive sleep apnea, is a common and morbid health problem. Traditionally, sleep disordered breathing is diagnosed by complex sleep studies. However, newer, easy-to-use, highly sensitive, and highly specific home sleep study equipment is now available. The present study was undertaken to determine whether an otolaryngologist could easily and effectively dispense home sleep equipment from the office. We used a portable AutoSet home sleep machine. Our experience with the first 100 consecutively presenting patients was recorded and analyzed under institutional review board approval. Ninety-nine of the 100 tests were completed successfully on the first attempt; the one failure was successful on the second attempt. Our results were consistent with those reported from in-house polysomnogram sleep studies; 71% of our patients had an apnea-hypopnea index (AHI) of 15 or higher, and 93% had an AHI at least 5. We conclude that an otolaryngologist, using state-of-the-art home sleep testing equipment, can accurately and cost-effectively prescribe home sleep studies.

Equipment Design↗
PubMed1999

Standard of care?

Explore the source record for details and available documents.

Facial Nerve↗
PubMed1998

Rapid clinical evaluation of anosmia in children: the Alcohol Sniff Test.

Smell impairment affects 1-2% of Americans and leads to frequent physician visits. Olfactory functional testing is available in chemosensory centers, but is frequently omitted in routine cranial nerve examinations. A new smell test, using the standard 70% isopropyl alcohol pad, was developed at the UCSD Nasal Dysfunction Clinic: The Alcohol Sniff Test (AST). The current study examined the reliability of the AST in children, using test-retest measures. A standard 70% isopropyl alcohol pad was moved upward 1 cm per exhalation until the participant reported detection. Test-retest reliability of the AST in children was significant, r = 0.80. The AST predictably classified children as anosmic, hyposmic or normosmic, p < 0.0001. The AST requires only 5 minutes to administer with materials readily available in any physician's office or hospital. The AST is an effective screening tool, even in children, for the average physician who can then refer patients who show less than normal function for further comprehensive testing.

2-Propanol↗
PubMed1998

Morbidity and mortality in the wilderness.

The medical literature is limited regarding current wilderness morbidity and mortality statistics. Available studies concentrate on selected wilderness activities. This study retrospectively examines wilderness injuries, illnesses, and mortality based on case incident report files from eight National Park Service parks within California over a three-year period. Data were extracted regarding type of illness or injury, body area affected, age, gender, month in which the event occurred, and activity in which the victim was involved at the time of the event. The overall occurrence of nonfatal events was 9.2 people per 100,000 visits. More than 70% of all nonfatal events were related to musculoskeletal or soft-tissue injury. The most frequently involved body area was the lower limbs (38%). Seventy-eight mortalities occurred during the three years studied, resulting in an overall mortality rate of 0.26 deaths per 100,000 visits. Men accounted for 78% of the deaths. Heart disease, drowning and falls were the most common causes of death. The information and statistics on morbidity and mortality in California wilderness areas that this study provides may be used to guide future wilderness use, education, and management. A standardized, computerized database would greatly facilitate future evaluations, decisions, and policies.

California↗
PubMed1997

Rapid clinical evaluation of anosmia. The alcohol sniff test.

BACKGROUND: Smell impairment affects 1% to 2% of Americans and leads to frequent physician visits. Olfactory testing is available in chemosensory centers, but not as part of a routine cranial nerve examination. The alcohol sniff test (AST), which uses the standard 70% isopropyl alcohol pad, was developed as a quick, reliable measure of olfactory function. METHODS: Sixty-four patients and 36 healthy control subjects (N = 100) were tested with the AST and with a standard butanol threshold test. RESULTS: The AST reliably, consistently, and correctly measured olfactory function. CONCLUSIONS: The AST is a rapid, reliable olfactory test that can be used for screening olfactory function and should be incorporated in the routine cranial nerve examination.

1-Propanol↗
PubMed1996

Mast cell TNF mRNA expression in nasal mucosa demonstrated by in situ hybridization: a comparison of mast cell detection methods.

We have used 35S-labelled RNA probes to detect TNF cytokine gene expression in nasal mucosa derived from patients with perennial rhinitis. As mast cells comprise a minor component of the total cell population in nasal mucosa, additional methods are needed to determine whether mast cells contribute to the cytokine mRNA detected by in situ hybridization. We have combined in situ hybridization with alternate methods to detect mast cells (tryptase immunostaining or toluidine blue staining) and determined that in situ hybridization coupled with tryptase immunostaining provides optimal methods to detect mast cell cytokine gene expression in tissue sections. Using in situ hybridization and tryptase immunostaining, we demonstrate that mast cells in nasal mucosa can express TNF mRNA. However, the number of tryptase-, TNF+ cells (1.99 +/- 1.59 cells/mm2) exceeded the number of tryptase+, TNF+ mast cells (0.09 +/- cells/mm2). Mast cells thus comprised a subpopulation of the total number of TNF mRNA positive cells in nasal mucosa.

Adult↗
PubMed1996

Differential expression of vascular cell adhesion molecule mRNA and protein in nasal mucosa in response to IL-1 or tumor necrosis factor.

IL-1 and tumor necrosis factor (TNF) are cytokines that share many overlapping functions, including induction of expression of the vascular cell adhesion molecule (VCAM) by endothelial cells. However, because most studies of cytokine induction of adhesion molecules have used human umbilical vein endothelial cells (HUVECs) and not microvascular endothelial cells, the functional significance of such observations to sites of allergic inflammation, such as the nasal mucosa, are at present unknown. We have therefore used nasal mucosa to compare the functional response of these microvascular endothelial cells with HUVECs. HUVECs or nasal mucosal explants were stimulated in vitro with varying concentrations of IL-1 or TNF for 0 to 48 hours, and VCAM mRNA and protein expression were determined by means of immunostaining and in situ hybridization. TNF and IL-1 were equivalent in their ability to induce VCAM mRNA and protein expression by HUVECs. In contrast, TNF was significantly more potent than IL-1 in inducing VCAM mRNA and protein expression by nasal mucosal microvascular endothelial cells. The recovery of significant amounts of IL-1 after incubation of recombinant IL-1 with nasal mucosa, as well as the ability of IL-1 to induce intercellular adhesion molecular expression by nasal mucosa, suggests that neither degradation of IL-1 nor downregulation of IL-1 receptors in nasal mucosa is likely to explain the inability of IL-1 to induce VCAM expression by nasal mucosa. These studies suggest that microvascular endothelial cells in the nasal mucosa differ functionally from HUVECs and that TNF may be more important than IL-1 in induction of VCAM expression in the nasal mucosa.

Cells, Cultured↗
PubMed1996

Prevalence and assessment of qualitative olfactory dysfunction in different age groups.

The prevalence of parosmia and phantosmia among 363 chemosensory and nasal/sinus patients was studied, as was the accuracy with which our clinical questionnaire could assess these dysfunctions. We then investigated whether patients with parosmia or phantosmia, matched for odor intensity, perform poorer on odor identification than do patients with no dysosmia. More than 40% of the study group evidenced either parosmia (18.7%) and/or phantosmia (25.6%), a finding that suggests that more attention should be paid by the medical practitioner in addressing qualitative olfactory dysfunction. Furthermore, it appears that assessment of these dysfunctions may aid in differential diagnosis, and that questionnaires can be used with reasonable validity irrespective of the patient's age. Finally, the results imply that parosmia may be reflected in a discrepancy between odor identification and detection.

Adult↗
PubMed1996

Alpine skiing injuries. A nine-year study.

Injury patterns in alpine skiing have changed over time as ski, boot, binding, and slope-grooming technologies have evolved. We retrospectively examined injury patterns in alpine skiers over a 9-year period at the Mammoth and June mountains (California) ski area. A total of 24,340 injuries were reported for the 9 seasons studied, and total lift tickets sold numbered 9,201,486. The overall injury rate was 2.6 injuries per 1,000 skier days and increased slowly over the period studied. The knee was the most frequently injured area at 35% of all injuries. Increasing trends (P < .05) were noted for the rates of lower extremity injuries (37%) and knee injuries (45%). A decreasing trend was noted for the rate of lacerations (31% decrease). Slight increases were noted in upper extremity and axial injury rates. Skiing injuries continue to be a worrisome recreational problem despite improvements in ski equipment and slope-grooming techniques. The increasing trend in lower extremity, particularly knee, injury rates highlights the need for continued skier education and equipment innovation.

Arm Injuries↗
PubMed1996

Snowboarding injuries, a four-year study with comparison with alpine ski injuries.

Snowboarding is a rapidly growing winter sport. Its unorthodox maneuvers and young participants raise many safety concerns. We examined injury patterns in recreational snowboarders, comparing these patterns with those found in alpine skiers. Snowboarding and skiing injury patterns differed significantly (P < .05) for the following categories: 49% of injured snowboarders were beginners versus 18% of skiers. Snowboarders were more likely to suffer wrist (19% versus 2%) and ankle (16% versus 6%) injuries, but less likely to sustain knee (17% versus 39%) or thumb (2% versus 4%) injuries than skiers. For snowboarders, wrist injuries were most common in beginners (30%), knee injuries in low intermediates (28%), ankle injuries in intermediates (17%), and shoulder or clavicle injuries in advanced snowboarders (14%). Most snowboarders (90%) wore soft-shelled boots, 73% of lower extremity injuries occurred to the lead-foot side, and 73% of wrist injuries occurred during backward falls; 67% of knee injuries occurred during forward falls. Of all injuries, 8% occurred while loading onto or unloading from a ski lift. The sport of snowboarding brings with it a different set of injuries from those seen in alpine skiing. The data focus attention on improvements such as wrist guards or splints, releasable front-foot bindings, and better instruction for beginner snowboarders to improve the safety of this sport. Finally, the data confirm that snowboarders and skiers may be safely combined on the same slopes.

Adult↗