Biomedical subjects

C C Baranak

Publications and source records attributed to C C Baranak.

8 recordsLinked to original sources

PubMed1989

Bacteriology of tonsil surface and core in children.

The tonsils of 97 children undergoing tonsillectomy were studied to determine the correlation between surface culture swab and culture of tonsillar core. In many cases, pathogenic organisms were found in the tonsil core, despite the fact that surface cultures revealed only normal respiratory flora. The tonsil core cultures showed a high incidence of Hemophilus influenzae and Staphylococcus aureus, which was rarely reflected on surface culture. The study indicates that pharyngeal swab cultures do not reliably reflect the presence of pathogens in the tonsil core. The value of parameters such as history of recurrent bouts of tonsillitis and presence of erythema or cryptic debris on physical examination for predicting the differential bacteriology of the tonsil is studied. The implications for treatment of children with adenotonsillar hypertrophy are discussed.

Bacteria↗

PubMed1988

Cis-platinum ototoxicity after radiation treatment: an animal model.

The chemotherapeutic agent cis-platinum has been used effectively as a treatment for many tumors. One of the most common toxic effects caused by this treatment is ototoxicity. More severe hearing loss has been reported in patients who had received cranial radiation prior to chemotherapy with cis-platinum. The present laboratory study was undertaken with chinchillas to determine whether ototoxicity is potentiated by cis-platinum administration after cochlear irradiation. Results support the clinical observation that cranial radiation prior to administration of an ototoxic chemotherapeutic agent can have a synergistic effect of increased susceptibility to the ototoxic potential of the agent.

Acoustic Stimulation↗

PubMed1987

Postoperative complications following tonsillectomy and adenoidectomy--who is at risk?

Postoperative complications following a large series of adenotonsillectomies (784 patients) at the Children's Hospital of Philadelphia fell into two major categories: hemorrhage and airway problems. Bleeding requiring operative intervention occurred in one child in the immediate postoperative period and in 16 children (2.0%) within 7-10 days. Eight patients (1.0%) had minor bleeding requiring only observation, and 9 others (1.2%) reported mild bleeding at home. Airway obstruction requiring the reinsertion of an airway or intensive care observation occurred in 10 children (1.3%). In general, these children were younger and most had significant underlying medical problems. We conclude that many complications encountered after adenotonsillar surgery are intrinsic to the patient's disease and overall medical condition. Improved surgical and anesthetic techniques have minimized the complications noted in earlier studies.

Adenoidectomy↗

PubMed1986

The effect of antibiotic therapy on recovery after tonsillectomy in children. A controlled study.

Tonsillectomy continues to be a commonly performed operation in the pediatric age group. The postoperative period is often protracted and characterized by throat and ear pain, intermittent fever, foul odor from the oral cavity, and poor oral intake. Consequently, antibiotics are frequently prescribed in an effort to minimize these symptoms and/or avoid complications such as dehydration or secondary infection of the operative site. However, to our knowledge, no study to date has been performed to demonstrate the efficacy of antibiotic therapy in this setting. At the Children's Hospital of Philadelphia, a prospective, randomized, double-blind study was undertaken in which ampicillin (or placebo) was administered intravenously at the time of surgery and for 12 to 24 hours postoperatively. The children then continued to receive oral amoxicillin therapy (or placebo) for an additional seven days. The patients were then evaluated for the incidence and severity of postoperative symptoms and complications. Intraoperative cultures of the oropharynx and tonsillar tissue, as well as cultures of the tonsillar fossa, were obtained following completion of one week of therapy. Our results indicate that ampicillin sodium/amoxicillin trihydrate therapy is well tolerated and safe in the nonallergic child and is effective in minimizing fever and other troublesome postoperative symptoms, such as pain, lassitude, mouth odor, and poor oral intake after tonsillectomy.

Adenoidectomy↗

PubMed1986

Post-tonsillectomy hemorrhage: incidence, prevention and management.

Tonsillectomy (with or without adenoidectomy) continues to be a commonly performed operation in the United States. Over the years, the incidence of post-tonsillectomy hemorrhage (reported between 0% and 20%) has decreased, but continues to pose serious problems. We reviewed 1,445 tonsillectomies performed over a 2-year period to study the incidence of post-tonsillectomy hemorrhage. Thirty-eight of 1,445 children (2.62%) had postoperative bleeding. The incidence of primary hemorrhage (within 24 hours) was 0.14%. Delayed hemorrhage requiring operative intervention or observation in the hospital was 1.03% and 0.76%, respectively. Ten patients (0.69%) had delayed hemorrhage of a minor nature that had stopped by the time they reached the hospital; these children were treated with observation alone and did not require hospitalization or operative intervention. The proposed reasons for this low rate of post-tonsillectomy hemorrhage include complete preoperative coagulation screening, meticulous attention to surgical technique, use of suction-cautery to obtain hemostasis and, possibly, use of postoperative antibiotics. Management of hemorrhage is discussed with respect to observation, surgical intervention, and blood transfusion.

Adolescent↗

PubMed1986

Relief of upper airway obstruction by adenotonsillectomy.

Adenotonsillectomy is often performed to relieve upper airway obstruction, even in children who do not present with severe apnea. Although adenotonsillectomy provides dramatic relief from obstructive sleep apnea, little evidence is available as to the efficacy of surgery in the far more prevalent cases of partial airway obstruction. We report the results of a prospective study of 100 children with adenotonsillar obstruction (without severe apnea) and 50 age-matched control children. The majority of patients exhibited appreciable sleep disturbances preoperatively, as compared to controls, and had substantial postoperative improvement, as demonstrated by parental questionnaire and sleep sonography--the computer-aided analysis of respiratory sounds. Mouth breathing and behavior problems were also prevalent preoperatively and were affected positively by adenotonsillectomy. It appears that surgery in such cases can have far-ranging benefits, even for the child whose obstruction does not demonstrate severe apnea.

Adenoidectomy↗

PubMed1985

Hearing loss and visco-elasticity of middle ear fluid.

It has been suggested that the physical properties of middle ear effusion--its viscosity and elasticity--affect the degree of conductive impairment. Exogenous mucus having substantial visco-elasticity was instilled in the bullae of guinea pigs, and the resulting hearing loss was determined by measurements of the cochlear microphonic potential. In this preparation the hearing loss induced by mucus did not differ significantly from that found when the bulla was filled with saline. We find no evidence of a relationship between visco-elasticity of middle ear fluid and amount of conductive impairment.

Animals↗

PubMed1984

Sedation in brainstem response audiometry.

In many children, sedation is virtually essential for reducing myogenic interference during brainstem response (BSR) audiometry. The most widely accepted sedative for young children is chloral hydrate. Children who are tired before the sedation is given fall asleep much more quickly with sedation, and in turn, require fewer doses of chloral hydrate. Instructing the parents to keep the child tired has produced significant increases in percent of those sleeping after the first dose (z = 2.08, P less than 0.05).

Audiometry↗