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PubMedDate not supplied

Kouska's fallacy: the error of the divided denominator.

The significance of two normally independent findings in a single patient is often difficult to assess. One simple measure of the likelihood of random coincidence is the joint probability, based on the assumption that the findings are independent. Unfortunately, this technique is often used wrongly. The error is the division of an event into its components, followed by calculation of their joint probability. These two processes, used together, make the likelihood of a common event happening seem very improbable. This can be termed the error of the divided denominator, or Kouska's fallacy, after a fictional character who used this technique to disprove the existence of life.

Child↗
PubMed1990

Diathermy haemostasis at tonsillectomy: current practice--a survey of U.K. otolaryngologists.

The use of diathermy in achieving haemostasis at tonsillectomy was assessed by means of a postal questionnaire sent to consultant otolaryngologists practising in the U.K. A response of 81 per cent was obtained. Forty-four per cent presently use diathermy. Few considered the age of the patient or a history of a quinsy a contraindication to its use. The diathermy experience of users and non-users with regard to speed, post-operative pain and haemorrhage differs markedly. This dichotomy of opinions is confirmed by a review of the literature. Clearly there is a need for further studies to clarify the role of diathermy in tonsillectomy.

Adult↗
PubMed1994

Cervical necrotizing fasciitis and tonsillitis.

We present a case of cervical necrotizing fasciitis following quinsy in a previously fit and healthy man. This is a potentially fatal condition with few specific clinical signs that requires early diagnosis and surgical debridement. Other features of the disease are discussed.

Anti-Bacterial Agents↗
PubMed1984

Quinsy following tonsillectomy (five case reports).

Five cases of post-tonsillectomy quinsy are presented, usually associated with tonsillar remnants. Four of these had no pus and one did, but the clinical picture was the same. Hence, if tonsillectomy is performed to prevent further quinsies, it must be careful and complete.

Adult↗
PubMed2001

Neutrophil migration in tonsils.

Recent studies have indicated the existence of an active cellular defence in the secretion on the tonsillar surface. This defence seems to consist partly of physiologically active neutrophils and is present in health and during disease. The present study was undertaken to examine the migration of these neutrophils to the secretion on the mucosal surface. Tonsils from 6 patients with acute tonsillitis and 5 patients with snoring problems were removed and sectioned. Sections were stained immunohistochemically against CD15 to visualise neutrophils. Other sections were stained with acridine orange to detect bacteria. Clusters of neutrophils were frequently seen in tonsils both from patients with acute tonsillitis and from snorers. They were observed to be accumulated within the tonsillar epithelial layer. Streaks of neutrophils could be observed running not only from vessels mainly near or within the epithelium to the epithelial surface, but also from vessels far from the epithelium through the extrafollicular areas to the epithelial surface. Bacteria were not present in the epithelium. We consider that the findings indicate an active physiological migration of neutrophils to the tonsillar surface.

Acridine Orange↗
PubMedDate not supplied

Characterizations of life-threatening deep cervical space infections: a review of one hundred ninety-six cases.

PURPOSE: The incidence of deep cervical space infections has decreased after the introduction of antibiotics and improvement of oral hygiene, but they still may be lethal especially when life-threatening complications occur. In this article, we try to find out whether there are predisposing factors related to complicated deep cervical space infections and prolonged hospitalization. MATERIALS AND METHODS: We conducted a retrospective analysis of medical records of 196 patients with deep neck infections during the period from March 1996 to February 2002. Among the 196 patients, 15 patients developed lethal complications. As for data analysis, multiple regression and logistic regression with dummy variable were used. RESULTS: In multiple regressions, patients with older age or with neck swelling, trismus, underlying diseases, complications, and C-reactive protein more than 100 microg/mL stayed longer in the hospital, and the P value reached statistical significance (P <.05). In logistic regression, male patients and patients with neck pain had negative correlation, and the P value reached statistical significance (P <.05). Patients with neck swelling and patients with respiratory difficulty had positive correlation, and the P value reached statistical significance (P <.05). That means female patients, patients with neck swelling, and patients with respiratory difficulty were more likely to have complicated deep neck infections. CONCLUSION: Complicated deep neck infections remain potentially fatal, but the morbidity and mortality can be reduced. Doctors should pay more attention to those high-risk patients; they are female patients, patients with neck swelling, and patients with respiratory difficulty.

Adolescent↗
PubMed1994

[Brain damage after tonsillectomy?].

We report on a 47-year old male patient who developed persistent postoperational bleeding after tonsillectomy, which made tamponading of the pharynx necessary. Even though the patient left the hospital after one week with a haemoglobin value of 10.6 g% and without any complaints, he developed personality changes and later severe neurological symptoms which led to the diagnosis of hypoxic brain damage as suggested by a variety of neurologists and psychiatrists. The diagnosis was finally disproved by a brain biopsy revealing the existence of Jakob-Creutzfeldt disease, a degenerative inflammatory disease due to a slow virus infection. By this final diagnosis the reproach of a maltreatment could be ruled out. The accidental coincidence of the tonsillectomy and the beginning of the Jakob-Creutzfeldt disease had led to the incorrect diagnosis of an operation-caused brain damage. A relation to the tonsillectomy could be ruled out by an extensive neurological examination using every possible diagnostic aid including brain biopsy.

Brain↗
PubMed2004

Chron's disease, rare association with selective IgA immunodeficiency, and development of life-threatening bacterial infections.

Life-threatening necrotizing fasciitis and relapsing Lemierre syndrome associated with Fusobacterium necrophorum septicaemia occurred in young adults with a moderate Chron's disease and a missed profound IgA deficiency. This unexpected association of a chronic bowel inflammatory syndrome with prominent IgA abnormalities and severe bacterial infection deserves careful attention by physicians faced with young patients with Chron's disease.

Adult↗