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Biomedical subjects

T McBride

Publications and source records attributed to T McBride.

26 records · Page 2Linked to original sources

Predicting nursing-home admission and length of stay. A duration analysis.

Information on who enters nursing homes and how much nursing-home care people use continues to be important for the consideration of various long-term care policies. Research on how characteristics of noninstitutionalized disabled elderly persons are related to both risk of admission and length of stay is presented here. Hazard models were developed using data from the 1982-84 National Long-Term Care Survey. Personal characteristics of elderly persons and state policy variables had varying effects on nursing-home use in a 2-year period.

Activities of Daily Living↗

A randomized controlled trial of glucocorticoid prophylaxis against experimental rhinovirus infection.

The effects of combined intranasal and systemic glucocorticoid steroids on the local inflammatory response, and symptoms due to experimental rhinovirus infection were studied in 45 adults randomized to prophylaxis with either placebo or steroids. Intranasal beclomethasone (168 micrograms twice a day) was begun 4 days before viral challenge and continued 5 days after challenge. Oral prednisone (30 mg twice daily) was given for 3 days beginning 1 day before challenge. During the first 48 h after viral inoculation, nasal obstruction, nasal mucus weights, and kinin concentrations in nasal lavages were lower in steroid recipients, but subsequent increases in these variables in the steroid group resulted in no significant cumulative differences between treatment groups. These data suggest that steroid prophylaxis may suppress nasal inflammation and cold symptoms during the first 2 days in experimental rhinovirus colds.

Administration, Intranasal↗

Lingual thyroid in a young infant presenting as airway obstruction: report of a case.

A case of lingual thyroid causing airway obstruction in a 3-month-old infant is reported. Endoscopic examination for stridor disclosed an obstructing 4 X 3 cm base of tongue lesion. Nuclear isotope scanning confirmed this to be the only thyroid tissue present in this patient. A transoral excision using the CO2 laser was performed without complication. Only one other case of airway obstruction in the young infant secondary to lingual thyroid has been reported, that being the original case description in 1869. A review of the embryology and discussion of the suggested therapies is presented. The rationale for use of the CO2 laser for this lesion is discussed.

Airway Obstruction↗

An assessment of preoperative coagulation screening for tonsillectomy and adenoidectomy.

Preoperative coagulation studies are commonly employed in order to try to identify the 2-4% of all patients undergoing tonsillectomy/adenoidectomy surgery who experience hemorrhagic complications. In an atmosphere of increasing cost consciousness, evaluation of the efficacy of screening tests is warranted. The records of 994 out of 1050 patients consecutively scheduled for tonsillectomy, adenoidectomy or T&A over a 2.5-year period were retrospectively reviewed in order to determine the usefulness of partial thromboplastin (PTT) and prothrombin time (PT) screening in predicting surgical and postsurgical bleeding. For patients with no history or clinical signs indicating possible bleeding disorder, preoperative PT and PTT failed to predict bleeding as an outcome. Also no patients were identified in this series to have previously undiagnosed coagulopathies on the basis of screening PT/PTT. The purpose of any screening test is to identify disease early enough for therapeutic intervention to be effective. Although preoperative PT/PTT will occasionally identify an unsuspected von Willebrand's or other coagulopathy, the prevalence of bleeding disorders in patients with negative history and examination is low enough that PT/PTT has essentially a zero predictive value for surgical bleeding. Screening PT/PTT should therefore be reserved for patients with known or suspected coagulopathies.

Adenoidectomy↗

Pseudotumor of the pterygomaxillary space presenting as anesthesia of the mandibular nerve.

Pseudotumor is a term used to describe a space occupying inflammatory lesion which mimics a true neoplastic process in its clinical presentation. In this paper, we report a pseudotumor of the pterygomaxillary space that presented with anesthesia and paralysis of the mandibular nerve. The importance of this case is to call attention to pseudotumors as a clinical entity and to document a case of an extraordinarily aggressive variant that required a surgical approach usually reserved for malignant tumors.

Cranial Nerve Diseases↗