PubMed Health⌕ Search

Biomedical subjects

D R Strachan

Publications and source records attributed to D R Strachan.

15 recordsLinked to original sources

Allergic otitis externa.

Chronic otitis externa is a common condition, which is usually successfully treated by topical medications and aural toilet. In cases that persist despite conventional treatment, a diagnosis of allergic otitis externa should be considered. Sensitization to otic medications (secondary contact otitis) is not uncommon. Topical aminoglycosides are the most common sensitizers although many components of topical preparations can cause sensitization. Patients who may have developed allergic otitis externa should undergo patch testing. Otolaryngologists should consider using topical antibiotics with a low allergenic potential and avoiding neomycin when treating patients with otitis externa. Primary contact otitis may occur to metals used in earrings and also to hearing aid moulds. Treatment of both primary and secondary contact otitis consists of identifying the allergen, avoiding further contact and use of simple preparations avoiding common sensitizers.

Chronic Disease↗

Do superconductors have zero resistance in a magnetic field?

We show that dc voltage versus current measurements of a YBa(2)Cu(3)O(7-delta) film in a magnetic field can be collapsed onto scaling functions proposed by Fisher et al. [Phys. Rev. B 43, 130 (1991)] as is widely reported in the literature. We find, however, that good data collapse is achieved for a wide range of critical exponents and temperatures. These results strongly suggest that agreement with scaling alone does not prove the existence of a phase transition. We propose a criterion to determine if the data collapse is valid, and thus if a phase transition occurs. To our knowledge, none of the data reported in the literature meet our criterion.

Journal Article↗

Neonatal hearing screening using the auditory brainstem response.

A targeted screen of babies at risk of having a sensorineural hearing loss (SNHL) using the auditory brainstem response has been in place since 1987 in Bradford and Airedale. The aims of this paper were to ascertain what proportion of a 4-year cohort of children with SNHL should have been identified by the programme; was identified by the programme; and the reasons for failing when children were missed. The cohort of 49 children had moderate to profound SNHL (> 50 dB) and were born between 1 April 1991 and 31 March 1995. Although 92% had at risk factors (higher than in other series), 80% was the maximum that could have been prospectively detected by the programme and only 37% were actually diagnosed as a result of the screening programme. Apart from a generalised under-recruitment, children with risk factors arising because of in utero, perinatal and postnatal events (as opposed to family history, craniofacial abnormalities and syndromes) tended to be missed (P < 0.01). The overall yield of the screening programme was 0.5/1000/year. While the yield of a universal neonatal screening programme based on otoacoustic emissions should be double this, a targeted infant distraction test later in infancy will be an essential backup. Improved liaison with paediatricians in particular as well as simplification of the referral criteria should improve targeting children at risk.

Cohort Studies↗

A case of Plummer-Vinson syndrome in childhood.

The Plummer-Vinson syndrome is characterized by an association of dysphagia, iron-deficiency anemia, and esophageal webs. The authors report the case of a 6 year old with Plummer-Vinson syndrome. Plummer-Vinson syndrome usually occurs in adults, rarely in adolescents, however, there have been no previous reports in the English-language literature of the syndrome occurring in childhood.

Child, Preschool↗

Endoscopic laser myotomy in the treatment of pharyngeal diverticula.

The endoscopic approach is a simple and cost-effective option in the treatment of hypopharyngeal diverticula. Whereas almost a third of all endoscopic myotomies performed by UK otolaryngologists are carried out with the stapling technique, CO2 laser diverticulotomy has not been given as much consideration (Koay et al., in press). We report on the first British series of 15 patients treated between 1985 and 1993 with microscopic laser diverticulotomy. The follow-up period was four to 11 years. Complications occurred in three patients, two patients required a repeat myotomy and 11 patients have been satisfied with their swallow since the operation. Our results are similar to those of larger studies. The laser technique is more established than the stapling gun myotomy and it has the advantage of superior visualization. It may also be used in small pouches which do not admit the insertion of a stapling gun.

Aged↗

Temporalis fascia grafts shrink.

Temporalis fascia, placed as an underlay graft, is commonly used to repair tympanic membrane perforations. Graft failure, however, is a well recognized complication. Grafts are often allowed to dry out during the procedure and, therefore, are often positioned in a dry or partially dehydrated state and only become fully rehydrated after placement. This study looked at how the size of the temporalis fascia alters with its state of hydration. The size of 20 temporalis fascia grafts was measured when fresh, after flattening and allowing them to dry, and finally after rehydrating the grafts with 0.9 per cent saline solution. Significant shrinkage was demonstrated. It is therefore proposed that a cause of increased failure rates, particularly in anterior myringoplasties, is loss of underlay due to graft rehydration and shrinkage. Thus graft shrinkage should be considered when positioning the graft.

Dehydration↗

Streptococcal tonsillitis and its association with psoriasis: a review.

Lancefield group A streptococcal upper respiratory tract infections are well known to be precursors of a number of disease processes. That they frequently herald a first attack of guttate psoriasis or a reactivation of chronic plaque psoriasis is well recognized, though this is perhaps more true among dermatologists than otolaryngologists. This paper briefly summarizes the historical background, recent research into, and current understanding of the connection between the two pathological phenomena.

Humans↗

Use of the Carden anaesthetic tube for surgery around a tracheostome.

This short communication describes the use of the Carden anaesthetic tube during surgery in and around a tracheostome. The technique, which greatly facilitates access to the operating field, is described along with it's indications and contraindications. We would like to recommend extending the use of the Carden tube to operations around a tracheostome, thereby maximizing surgical access.

Anastomosis, Surgical↗

The hearing-aid battery: a hazard to elderly patients.

Owing to the severity of its corrosive effects, an alkaline hearing-aid battery in the external auditory meatus is an otological emergency. This report emphasizes the particular risk to confused elderly patients and points out that a delay in diagnosis is common. Aetiology, clinical features and treatment are discussed with reference to three recent cases.

Aged↗

Life-threatening stridor presenting in a patient with rheumatoid involvement of the larynx.

A case of a female patient with extensive rheumatoid arthritis who presented to the Accident and Emergency Department with life-threatening stridor is described. Although clinical involvement of the larynx is found in over a third of patients with severe rheumatoid arthritis, acute airways obstruction is fortunately a very rare complication. Stridor is probably precipitated in the acute situation in such patients as a result of upper respiratory tract infection.

Acute Disease↗