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Biomedical subjects

I Donaldson

Publications and source records attributed to I Donaldson.

At least 19 recordsLinked to original sources

The Biomolecular Interaction Network Database and related tools 2005 update.

The Biomolecular Interaction Network Database (BIND) (http://bind.ca) archives biomolecular interaction, reaction, complex and pathway information. Our aim is to curate the details about molecular interactions that arise from published experimental research and to provide this information, as well as tools to enable data analysis, freely to researchers worldwide. BIND data are curated into a comprehensive machine-readable archive of computable information and provides users with methods to discover interactions and molecular mechanisms. BIND has worked to develop new methods for visualization that amplify the underlying annotation of genes and proteins to facilitate the study of molecular interaction networks. BIND has maintained an open database policy since its inception in 1999. Data growth has proceeded at a tremendous rate, approaching over 100 000 records. New services provided include a new BIND Query and Submission interface, a Standard Object Access Protocol service and the Small Molecule Interaction Database (http://smid.blueprint.org) that allows users to determine probable small molecule binding sites of new sequences and examine conserved binding residues.

Animals↗

Superficial siderosis of the meninges and its otolaryngologic connection: a series of five patients.

OBJECTIVE: To study the otolaryngologic disorders in patients with superficial siderosis of the meninges. BACKGROUND: Superficial siderosis of the central nervous system is a rare disorder characterized by progressive bilateral hearing loss and ataxia caused by recurrent bleeding into the subarachnoid space. The cerebellum, eighth cranial nerve, and olfactory nerve are particularly susceptible to the deposition of hemosiderin, which is responsible for the symptoms. The diagnosis is confirmed by magnetic resonance imaging. METHODS: The clinical notes of five patients with superficial siderosis of the meninges were reviewed with the intent of reporting the otolaryngologic symptoms and signs, the clinical investigations, and treatments. RESULTS: Four of the five patients had sensorineural deafness, two had smell disturbances, and three had gait abnormalities. Magnetic resonance imaging was the most important investigation used to identify the condition. CONCLUSIONS: Superficial siderosis of the meninges is an important differential diagnosis in patients with progressive sensorineural deafness.

Adolescent↗

Cervical lymphadenopathy in children.

The management of cervical lymphadenopathy in children varies widely between clinicians. It is recognized that clinical management can be improved by standardizing the diagnostic and treatment methods. This article presents an algorithm based on the available evidence for the management of cervical lymphadenopathy in children.

Algorithms↗

BIND--The Biomolecular Interaction Network Database.

The Biomolecular Interaction Network Database (BIND; http://binddb. org) is a database designed to store full descriptions of interactions, molecular complexes and pathways. Development of the BIND 2.0 data model has led to the incorporation of virtually all components of molecular mechanisms including interactions between any two molecules composed of proteins, nucleic acids and small molecules. Chemical reactions, photochemical activation and conformational changes can also be described. Everything from small molecule biochemistry to signal transduction is abstracted in such a way that graph theory methods may be applied for data mining. The database can be used to study networks of interactions, to map pathways across taxonomic branches and to generate information for kinetic simulations. BIND anticipates the coming large influx of interaction information from high-throughput proteomics efforts including detailed information about post-translational modifications from mass spectrometry. Version 2.0 of the BIND data model is discussed as well as implementation, content and the open nature of the BIND project. The BIND data specification is available as ASN.1 and XML DTD.

Binding, Competitive↗

Total decompression of facial nerve for Melkersson-Rosenthal syndrome.

Melkersson-Rosenthal syndrome (MRS) is a rare condition characterized by recurrent facial paralysis in addition to various orofacial manifestations. The condition appears to be a granulomatous disorder causing oedema and inflammation of the soft tissues of the face, lips, oral cavity and particularly, the facial nerve. There is general agreement that the symptoms and signs resolve spontaneously, aided perhaps by an empirical course of oral steroids. However, in some patients the condition may be progressive, leading to disfiguring facial synkinesis and increasing residual paralysis. There is anecdotal evidence in the literature to suggest that surgical decompression of the facial nerve in its entire intratemporal course may prevent further attacks of facial paralysis and its sequelae. We present here our experience with surgical decompression of the facial nerve in a 27-year-old woman with MRS who had sufferent recurrent left-sided facial palsy since the age of four. A review of the literature pertaining to facial nerve decompression for Melkersson-Rosenthal syndrome is presented.

Adult↗

Intravenous therapy in critically ill adults: developing a clinically and cost-effective approach.

Intravenous therapies are the most common intervention for critically ill adults. Using a systematic approach as described by Droogan and Song (1996), a review of the literature was undertaken to determine whether the frequency of changing intravenous administration sets in critically ill adults with central venous catheters (CVCs) affected the incidence of CVC-related sepsis/systemic inflammatory response syndrome (SIRS)/bacteraemia. Two major randomized controlled trials were included in the review (Maki et al. 1987; Snydman et al. 1987), which conclude that increasing the change frequency of administration sets from 24 to 72 hours does not significantly increase the incidence of sepsis. This can therefore lead to considerable cost savings as well as ensuring clinically effective care. The review criteria excluded a plethora of related studies. However, these studies do corroborate the findings of Maki et al. and Snydman et al. They are summarized in the tables and are taken into account when making recommendations for clinical practice and future research. Clinical practice guidelines which are being implemented and evaluated locally are offered for the reader's consideration.

Adult↗

Schwannoma (neurilemmoma) of the tonsil.

Schwannoma of the tonsil is an extremely uncommon clinical entity with only one reported case in an adult in the medical literature to date. We report, to our knowledge, the first known case in a child.

Adolescent↗

Medical, surgical and audiological complications of the first 100 adult cochlear implant patients in Birmingham.

Of the first 100 patients implanted on the Midland Cochlear Implant Programme the commonest aetiologies of deafness were idiopathic 31 per cent, meningitis 28 per cent and cochlear otosclerosis 16 per cent. The major complication rate was three per cent. The most severe was one individual who post-operatively developed a cerebral infarct and subsequently died. The minor complication rate was 39 per cent, all of which successfully resolved, and included 11 cases of wound infection, nine cases of vertigo, three transient facial palsies and two post-operative bleeds. Older patients and men were most likely to have a post-operative medical complication. Women were more likely to have an abnormal electrode insertion. Meningitis and otosclerosis were the most complicated aetiologies in terms of cochlear ossification and electrode insertion. A non-patient cochlea was associated with fewer active electrodes. In six cases which had been reported pre-operatively as showing patent cochleas, some form of obstructional ossification was encountered. Patients functioning with greater than 15 active electrodes performed better on auditory tests than patients with fewer than 15 active electrodes.

Adult↗

Outcomes from adult implantation, the first 100 patients.

We present the outcome of implantation in the first 100 adult patients treated under the Midland Cochlear Implant Programme. All patients were post-lingually deaf with profound or total hearing loss. Performance was tested in lip-reading, implant only and combined lip-reading and implant modes using BKB sentences, connected discourse tracking (CDT) and environmental sound recognition. Assessments were made at nine and 18 months post-implant. The dominant aetiologies were idiopathic and meningitis. Meningitis was associated with the greatest numbers of ossified cochleas. Forty-three per cent of cases of partial ossification were identified only at surgery. Four per cent of patients became non-users of their devices, however the majority used their implants for more than 12 hours each day. The mean scores at nine months post-implant, in the implant only mode, were for environmental sound recognition 56.7 per cent, for BKB sentences 46.6 per cent (80 per cent of patients scored above 0 per cent) and for CDT 31.2 words per minute (w.p.m.) (62 per cent scored above zero per cent). In the combined lip reading and implant mode the mean scores, at nine months, were for BKB sentences 81.5 per cent and for CDT 65.8 w.p.m. All results were sustained at 18 months. Patients reported that implantation significantly reduced their hearing handicap. Pre-operative measures of depression were also significantly reduced at nine months post-implant. Results were sustained at 18 months. Post-operative audiological outcomes in the electrical stimulation only mode correlated significantly with length of profound deafness. Results suggest that performance outcome is also related to the number of active electrodes.

Aged↗

Tinnitus, cochlear implants and how they affect patients.

The relationship between tinnitus and cochlear implantation is an important issue that needs to be established because it may affect implant use. In this study 99 patients over 15 years of age completed pre- and post-cochlear implantation questionnaires, and underwent performance testing. The findings show that after implantation, there was marked suppression of tinnitus in both implanted and contralateral ears whilst the implant was off, and this was further enhanced when the implant was switched on. These effects are probably a combination of local and central factors. Presence of tinnitus, before or after implantation, had no detrimental effects on performance. In conclusion, providing all other factors permit, this study recommends implanting the ear with the worst tinnitus.

Adult↗

Use of homeopathy in the treatment of tinnitus.

Tinnitus is a prevalent condition which has no practical and effective pharmacological treatment. In the absence of relief by conventional routes, sufferers are increasingly turning to 'alternative' or 'complementary' medicine. This paper reports the evaluation of a homeopathic preparation 'Tinnitus' by a double-blind, placebo-controlled clinical trial. The remedy was taken in tablet form at a homeopathic D60 potency. Perceived intensity and intrusiveness of the tinnitus was assessed at four points during the trial by subjective procedures (visual analogue scales and questionnaires) and by a battery of audiological measurements. Although questionnaire responses indicated that the homeopathic preparation was preferred to placebo by 14 of the 28 subjects, an analysis of variance indicated that neither the VAS scores nor the audiological measures showed significant improvement in tinnitus symptoms in response to 'Tinnitus' versus the placebo. It was concluded that 'Tinnitus' could not be shown to be more effective than the matched placebo.

Double-Blind Method↗

Mass in the post nasal space and acquired immune deficiency syndrome.

We report a case of previously undiagnosed acquired immunodeficiency syndrome (AIDS) who had a mass in the post-nasal space causing almost complete nasal obstruction. Histology showed both respiratory and squamous epithelium covering an active chronic inflammatory infiltrate. Lymphoma, Kaposi's sarcoma and infiltrative fungal sinusitis were excluded. There was no evidence of the common viruses associated with lesions in AIDS. Unlike adenoid hypertrophy, the lesion was an exuberant growth with an additional chronic inflammatory reaction due to ulceration of the surface epithelium.

Acquired Immunodeficiency Syndrome↗

The usefulness of nimodipine, an L-calcium channel antagonist, in the treatment of tinnitus.

Thirty-one patients were drawn from a tinnitus clinic, screened for other medical problems and treated for 4 weeks with 30 mg nimodipine four times daily. Before and after treatment, the intensity of their tinnitus was assessed subjectively on a scale 1-10. Five patients reported to have a great improvement in their tinnitus whilst two claimed a worsening of the condition. Of the five positive responders, four were treated further with 30 mg nimodipine per day for 4 weeks and 60 mg per day for a further 4 weeks. During this treatment they were assessed more objectively by the determination of the minimal masking level using narrow band noise. There was a good correlation between the subjective and objective assessment of their responses.

Audiometry, Pure-Tone↗

The role of nasolacrimal intubation in the management of childhood epiphora.

Nasolacrimal intubation has been advocated to obviate the need for dacryocystorhinostomy (DCR) for childhood epiphora which fails to resolve despite apparently successful probings. Twenty-eight intubations were attempted on children falling into this category. Of these, 25 were anatomically successful intubations (3 having had to be abandoned because of difficulties in retrieving the silicone tubes from the nose). Twenty patients (80%) had complete resolution of symptoms, 2 (8%) had improvement of symptoms such that no further intervention was necessary and 3 (12%) proceeded to DCR. A greater likelihood of a good outcome was seen if the tubes were left in situ for 6 months or more. We suggest that primary nasolacrimal intubation (that is nasolacrimal intubation without DCR) should be the next step in the management of childhood epiphora which fails to resolve after two probings. This approach may avoid a DCR in over 80% of children.

Child↗

Prevalence of hearing loss among people aged 65 years and over: screening and hearing aid provision.

The aim of this study was to assess the prevalence of hearing loss among people aged 65 years and over and to offer hearing aids where necessary. The study was carried out in a large health centre practice in Birmingham with a computerized record system. All patients aged 65 years, and a 20% random sample of patients aged 66 years and over were invited for interview. They were questioned about hearing loss and examined audiometrically. All patients with a hearing loss in the better ear of 35 decibels or more over the speech frequencies (0.5-4 kHz) were offered a hearing aid. A total of 322 patients attended (72% of those invited) and of these 34 patients already had a hearing aid. A further 142 patients were identified for whom an aid was recommended and 69 of these accepted. The acceptance rate was higher among men than women (57% compared with 43%). Sixty one patients (19% of those screened) had an asymmetrical hearing loss and of these 24 required consultant assessment; none had serious underlying pathology. There is a large unmet need for hearing aid provision. Simple audiometric assessment in health centres provides an opportunity to meet this need.

Aged↗

Diencephalic idiopathic gliosis: an unusual hypothalamic syndrome of dermopathy, diarrhea and growth arrest.

This case report of a 16-year-old girl describes the association of chronic diarrhea and lower limb dermopathy with an unusual and widespread gliosis within hypothalamic and other diencephalic structures. This syndrome to our knowledge has not been previously reported. Hypothalamic disease was suggested during life by examination findings of sustained hypothermia, altered sleep-wake cycles and abnormal cortisol diurnal rhythms. Profound growth arrest from the age of 8 yr (growth velocity < 1.4cm/yr) despite normal levels of growth hormone and response to physiological stimuli were additional unusual features. Autopsy after sudden death at 16 yr showed extensive gliosis in hypothalamic and adjacent diencephalic structures with proportionately little neuronal loss--suggesting an unidentified stimulus to glial proliferation. In the absence of evidence of other organ dysfunction it is suggested that dermopathy and chronic diarrhea in this case may have an autonomic basis. The impaired tissue response to growth hormone could be due to chronic hypothermia or involvement of some other (unidentified) hypothalamic factor regulating growth velocity.

Adolescent↗