PubMed Health⌕ Search

Biomedical subjects

B Barry

Publications and source records attributed to B Barry.

At least 37 records · Page 2Linked to original sources
PubMed2000

[Retro-pharyngeal and pharyngeal-laryngeal lipomas].

Pharyngeal and laryngeal lipoma are uncommon mesenchymal tumors. This report discusses the clinical and pathological features of five cases and a review of the literature. Symptoms included dysphagia, throat discomfort and airway obstruction in three patients. These complaints occurred over several years. One patient had a recurrent fibrolipoma and had experienced several surgical procedures. Surgery is the treatment of choice including conservative procedures but for large tumors open surgical approaches rather than endoscopic techniques should be employed. Recurrent tumor may be a sign of incomplete excision but also of a well-differentiated liposarcoma.

Adult↗
PubMed1999

Otogenic intracranial infections in adults.

OBJECTIVE: To assess the type and bacteriology of otologic diseases associated with bacterial meningitis in adults. METHOD: Retrospective review of 79 patients over an 18-year period. RESULTS: Acute otitis media was diagnosed in 32 patients, chronic otitis in 29 (16 with cholesteatoma), and cerebrospinal fluid leak in 18. Streptococcus pneumoniae was a common cause of meningitis-complicating acute otitis media (69%) or cerebrospinal fluid leak (50%), whereas other bacteria or negative cultures were found in the cerebrospinal fluid of patients with chronic otitis. Surgery was performed promptly in 26 patients; four patients died. CONCLUSIONS: Early diagnosis of otogenic bacterial meningitis is essential to allow appropriate antimicrobial treatment. Antimicrobials active on gram negative bacilli and anaerobes should be used in patients with chronic otitis. An emergency surgical procedure is required in patients whose neurologic or infectious status fails to improve under antimicrobial treatment.

Adolescent↗
PubMed1999

Eradication by ceftriaxone of Streptococcus pneumoniae isolates with increased resistance to penicillin in cases of acute otitis media.

This multicenter, noncomparative, nonrandomized study evaluated the clinical efficacy and safety of ceftriaxone for treating acute otitis media in children following clinical failure of oral antibiotic therapy. Middle-ear fluid samples were collected on day 0 and on day 3, 4, or 5 (day 3 to 5) and were used to test whether ceftriaxone therapy can eradicate Streptococcus pneumoniae isolates with increased resistance to penicillin (MIC >/= 1 mg/liter). At the first visit, on day 0, middle-ear fluid was sampled for bacteriological testing by tympanocentesis or otorrhea pus suction. Patients were administered 50 mg of ceftriaxone/kg of body weight/day, injected intramuscularly once daily, for 3 days. A second sample was collected by tympanocentesis if a pneumococcus isolate for which the MIC of penicillin was >/=1 mg/liter was detected in the day-0 sample and if the middle-ear effusion persisted on day 3 to 5. This second sample was tested for bacterial eradication. One hundred eighty-six children aged 5 months to 5 years, 10 months, with acute otitis media clinical failure were enrolled and treated in this trial. On day 10 to 12, 145 (83.8%) of the 173 patients evaluable for clinical efficacy were clinically cured. Of the 59 patients infected by pneumococci, 36 had isolates for which the MICs of penicillin were >/=1 mg/liter. Of those patients, on day 10 to 12, 32 (88.9%) were clinically cured. Middle-ear fluid samples collected by day 3 to 5 following the onset of treatment with ceftriaxone were sterile for 24 of the 27 (88.9%) patients who were infected as of day 0 by pneumococci for which the MICs of penicillin were >/=1 mg/liter and who were evaluable for bacteriological eradication. On day 10 to 12, 81.4% of S. pneumoniae-infected children and 87.5% of Haemophilus influenzae-infected children were clinically cured. No discontinuation of treatment due to adverse events, particularly due to local reactions at the injection site, were reported. Only 11 adverse events which had doubtful, probable, or possible links with the study treatment were recorded. Both the bacteriologically assessed eradication of pneumococci for which the MICs of penicillin were >/=1 mg/liter and the clinical cure rates demonstrate that ceftriaxone is of value in the management of acute otitis media unresponsive to previous oral antibiotic therapy.

Ceftriaxone↗
PubMed1999

Decreased lactic acidosis and anemia after transfusion of o-raffinose cross-linked and polymerized hemoglobin in severe murine malaria.

Severe anemia is a major cause of death in falciparum malaria. Blood transfusion increases survival in humans and in animal models of this disease. Because of logistic constraints and viral contamination of the blood supply, transfusions are frequently not practical in endemic regions. Modified hemoglobin is an effective O2 carrier in hemorrhagic shock. It is free of infectious contamination, may not require refrigeration, and because of its nitric oxide scavenging and small size, may have pharmacologic benefits in malaria. The effects of transfusions of modified hemoglobin in rats with high-grade parasitemia were evaluated. Modified hemoglobin decreased lactic acidosis and corrected anemia as well as transfusions with red blood cells; these findings may correlate with improved survival and suggest a possible proerythropoietic effect. Further study of this novel therapy is warranted.

Acidosis, Lactic↗
PubMed1999

[Squamous cell carcinoma of the ENT organs in the course of the HIV infection].

UNLABELLED: The link between the occurrence of a SCC in the head and neck and human immunodeficiency virus infection is controversial. METHODS: A survey of specialists in France was carried out in 1995 to investigate it's incidence since the start of the epidemic. RESULTS: Twenty one patients (sex ratio 20/1) with concomitant HIV infection and SCC of the head and neck were evaluated. The age distribution ranged from 30 to 63 with a mean of 44 years-old. Twelve patients were under 45 years-old. There was no obvious relationship between any peculiar risk group for HIV infection and occurrence of a SCC. At the time of diagnosis of their carcinoma 10 patients had clinical and/or biological features for AIDS. Alcohol and tobacco consumption were present in twelve patients, moderate in four and absent in five patients. Oropharyngeal carcinoma was frequent in patients without risk factors and immunodepression. CONCLUSION: The high rate of young adults and patients with no or moderate risk factors for SCC suggests that SCC could be related to HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1999

[Invasive aspergillosis sinusitis in patients infected by the human immunodeficiency virus].

Invasive aspergillus sinusitis invasive is a rare, life threatening infection observed in immunocompromised patients. We report three cases of patients with AIDS. Diagnosis was based on surgical biopsy specimen performed on patients with unilateral sinusitis with facial pain and osteolysis on CT scanning, associated in one patient with neurological disorders. One patient with frontal sinusitis and meningeal involvement died despite therapy. One patient with limited maxillary sinusitis who underwent surgical satisfactory resection and antifungal therapy was successfully treated without relapse 12 months later. One patient with orbital and cavernous sinus extension of ethmoiditis was successfully cured with antifungal therapy by itraconazole. Our results confirm the necessity of early diagnosis when clinical and CTscanning are suggestive and the curability of aspergillus sinusitis.

AIDS-Related Opportunistic Infections↗
PubMed1999

[Endoscopic surgical treatment of Zenker hypopharyngeal diverticuli. Apropos of 59 cases].

We report our experience with 59 cases of Zenker's diverticulum, all treated endoscopically from 1979 to 1998. The ages ranged from 59 to 98 years. There were contraindications for conventional surgery or deep general anesthesia for all the patients. The surgical technique of endoscopic treatment was performed under general anesthesia, using a specially designed endoscope for exposure. Scissors, and after 1990 CO2 LASER, were used to divide the posterior cricopharyngeal muscle fibers. There was no major complication. Our results are comparable with literature, 92% success, even though a small diverticulum may paradoxically remain. Besides, from our experience, it may be necessary to perform two sessions for diverticulum larger than 3 cm. This safe and efficient treatment can be recommended for patients of all ages with a contraindication for conventional surgery.

Aged↗
PubMed1999

[Value of MRI and computerized tomography scanner in oro-buccopharyngeal cancers with bone invasion].

The purpose of this prospective study was to assess the impact of Magnetic Resonance Imaging (MRI) and Computed Tomography (CT) in the surgical management of carcinomas with mandibular bone invasion. Thirty-five patients with squamous cell carcinoma of oral cavity or oropharynx, with mandibular spread, were studied with both imaging methods before surgical treatment. We compared the radiographic findings with histologic examination. Sensitivity of CTScan and MRI was respectively 25% and 80% to identify bone invasion. CTScan was found less effective in the assessment of bone invasion before mandibular resection and was considered more radiologist dependent. MRI is becoming the imaging method of choice for these cancers, despite inherent disadvantages including limited availability and increased cost over CTScan. MRI is accurate in large oropharyngeal tumors with extension of base of tongue and pterygoid muscle, and to study bone invasion before surgery in oral cavity tumors.

Adult↗
PubMed1999

Pharyngeal flora in patients undergoing head and neck oncologic surgery.

In order to specify the correlation between pharyngeal flora and the onset of surgical wound infection, we conducted two prospective studies on patients undergoing oncologic surgical procedures with expected contamination by pharyngeal secretions. In the first study, an oropharyngeal swab and a specific swab of the tumour were collected the day before, or on the day of surgery. As potential pathogens were always isolated in the oropharyngeal swab, it was considered that the tumour is not infected but is colonised by the oropharyngeal flora. A second pharyngeal swab was collected at day 5-7 in the second study. Preliminary results in the second study showed that 50% (11/22) of patients were orpharyngeal carriers of pathogens before surgery. This rate is 70% (15/22) in the post-operative period with a higher rate of gram negative rods. WSI occurred in 7/22 patients (32%), mainly with isolated rods similar to those observed in the oropharyngeal post-operative flora and potential pathogens in 5/7 patients. More patients are necessary to establish a link between pre-operative ropharyngeal pathogens and the occurrence of SWI.

Amoxicillin-Potassium Clavulanate Combination↗
PubMed1999

Risk factors for surgical wound infections in patients undergoing head and neck oncologic surgery.

Risk factors for surgical wound infection are difficult to establish in head and neck surgery. Flap reconstruction, which correlates with tumour size and surgical procedure, appears to be the main risk factor. Attempts should be made by the surgical staff to improve surgical procedures in terms of duration of surgery and choice of the procedure. The intraoperative choice between primary closure and flap reconstruction should be studied further. More subtle risk factors may appear in studies of large groups of patients and/or if a distinction is drawn between early and late SWI.

Antibiotic Prophylaxis↗
PubMed1998

Comparison of air tonometry with gastric tonometry using saline and other equilibrating fluids: an in vivo and in vitro study.

OBJECTIVE: 1) To compare saline gastric tonometry monitoring with air tonometry (Tonocap) in a group of general ICU patients. 2) An in vitro investigation of the performance of other fluids used in gastric tonometry and to assess the effects of variation of temperature and carbon dioxide concentration within the range encountered in clinical use. DESIGN: a) A prospective, observational study in ICU patients b) A comparative laboratory study. SETTING: The general Intensive Care Unit (ICU) and the laboratory at Leeds General Infirmary. PATIENTS AND PARTICIPANTS: Nine patients in the general ICU with severe sepsis or septic shock. MEASUREMENTS AND RESULTS: In vivo comparison of saline and air tonometry demonstrated a difference between the two techniques. Bland & Altman analysis showed a mean bias in the measurement of gastric PCO2 of 1.88 kPa with a precision of 1.22 kPa, with saline giving the lower result. In vitro, saline, air (Tonocap), gelatin and heparinised blood were used, at temperatures of 33-42 degrees C and at carbon dioxide concentrations of 4-8 kPa. While gelatin and blood gave unpredictable results, dependent on temperature and carbon dioxide concentration, air tonometry gave highly reproducible results. A consistent bias between the results with saline and air tonometry was seen over the range of temperatures and carbon dioxide (CO2) concentrations studied. The mean bias was 0.85 kPa with a precision of 0.40 kPa, saline consistently giving lower results. CONCLUSIONS: There are clinically significant differences in values for gastric mucosal PCO2 measured by air tonometry and saline tonometry both in vivo and in vitro.

Acidosis↗
PubMed1997

[Endoscopic treatment of a Zenker diverticulum. 50 cases].

OBJECTIVES: Endoscopy has been used for many years as an alternative to surgery for the treatment of Zenker's diverticulum. We report our experience in 50 cases. METHODS: From 1979 to 1995, we treated 50 cases of Zenker's diverticulum endoscopically. Patients' age ranged from 59 to 98 years. All patients had contraindications for conventional surgery or deep anesthesia. The surgical technique of endoscopic treatment is performed under general anesthesia using a specially designed endoscope for exposure. Scissors, then after 1990, CO2 LASER, was used to divide the posterior crico-pharyngeal muscle fibers. RESULTS: There were no major complications. Our results, 95% success, were comparable with those reported in the literature even though, paradoxically, a small diverticulum may remain. Our experience also showed that it may be necessary to perform two sessions for diverticula larger than 3 cm. CONCLUSION: This safe and efficient treatment can be recommended for patients of all ages with a contraindication for conventional surgery.

Aged↗
PubMed1997

Composition, process, and performance in self-managed groups: the role of personality.

Using the five factor model with an emphasis on extraversion and conscientiousness, the authors investigated how personality is related to small group processes and outcomes. Graduate students (N = 289) assigned to 4- and 5-person teams in 61 groups engaged in a series of creative problem-solving tasks over a period of several weeks. Extraversion was associated with group processes and outcomes at both individual and group levels of analysis. At the individual level, extraverts were perceived by others as having greater effect than introverts on group outcomes. Covariance structure modeling suggested that extraverts induce these perceptions through the provision of both socioemotional and task-related inputs. At the group level, the proportion of relatively extraverted members was related curvilinearly to task focus and group performance. Contrary to expectations, Conscientiousness was unrelated to processes and outcomes at either the individual or group level.

Extraversion, Psychological↗
PubMed1997

Effects of exogenous cytokines on intravascular clearance of bacteria in normal and splenectomized mice.

BACKGROUND: Pretreatment with interleukin-1 (IL-1), granulocyte colony-stimulating factor (G-CSF), and granulocyte macrophage colony-stimulating factor (GM-CSF) can improve alveolar macrophage bactericidal activity against pneumococci. These effects vary in eusplenic and asplenic mice. Likewise, these cytokines have been shown to improve survival after an aerosol pneumococcal challenge. Mice dying in these studies had positive blood cultures and disseminated infection. The purpose of this study was to determine the effect of cytokine pretreatment on intravascular clearance of bacteria from eusplenic and asplenic mice. METHODS: Two weeks after splenectomy or sham operation, mice were pretreated for various times with IL-1, G-CSF, or GM-CSF or their corresponding vehicles. Mice then received tail-vein injections of bacteria (0.1 mL), and quantitative blood cultures were performed 15 and 30 minutes thereafter. RESULTS: Splenectomized mice had impaired clearance of both pneumococci and Pseudomonas compared with sham-operated mice (p < 0.05). IL-1 enhanced clearance in splenectomized mice (p < 0.001) but not in sham-operated mice (p not significant). G-CSF enhanced bacterial clearance in sham-operated mice (p < 0.01) but not in splenectomized mice (p not significant). GM-CSF enhanced clearance in both groups (p < 0.001). CONCLUSION: The net effects of exogenous cytokine therapy for infections depends on the state of the host defenses at the time of therapy. These agents may be useful as adjuvants for the treatment of infections, but further study is warranted.

Animals↗
PubMed1996

Nature of decision-making in the terminally ill patient.

The increasing emphasis on the consumer's choice in health care treatment has contributed to the growing trend for decision-making to be shared between the patient and the health care team. If responsibility is to be shared, then it is important that health professionals identify the degree to which patients wish to participate in the decision-making process, in order that they can assist patients to achieve this goal. The seven patient case studies in this pilot study explored terminally ill patients' perceptions of their own participation in the decision-making process. A simple strategy, through the use of picture cards, established patients' actual and preferred forms of decision-making. These cards were presented to the patients at various stages of their illnesses, which permitted a longitudinal analysis of the decision-making process. Patients initially stated that they did not want much input into the decision-making process. In this study, however, as patients became more knowledgeable about their conditions, they desired greater input into the decision-making process. These findings also revealed that, although there was consistency between patients' preferred and actual forms of decision-making when they were initially admitted to hospital, discrepancies became apparent during the later phases of their illness. This emphasises the need for communication between all parties involved in health care decisions.

Adolescent↗